Good afternoon. Welcome, everyone, to this Plenary session. Before we begin, I want to set out a few points. This meeting will be held in a hybrid format, with some Members in the Senedd Chamber and others joining by video-conference. All Members participating in proceedings of the Senedd, wherever they may be, will be treated equally. A Plenary meeting held using video-conference, in accordance with the Standing Orders of the Welsh Parliament, constitutes Senedd proceedings for the purposes of the Government of Wales Act 2006. Some of the provisions of Standing Order 34 will apply for today's Plenary meeting, and these are noted on your agenda.
Thank you very much, Cefin Campbell, for the question. The management of water levels and releases from the Clywedog reservoir are governed by well-established and clear legislation. The Environment Agency in England has responsibility for managing the releases and water levels, in consultation with Natural Resources Wales.
Thank you very much. Recently I had a meeting with a number of farmers in the Llanidloes area in Powys and I discussed with them concerns about how water levels are managed in the Clywedog reservoir and the impact this was having further down the valley, with agricultural land and property being affected by flooding as recently as February this year.
Now, my fellow Member for Montgomeryshire, Russell George, has already drawn the attention of the Senedd to this, and apparently there is considerable ambiguity regarding who manages the reservoir and the water discharges—whether it's the Environment Agency in England or NRW. I know that water is a very emotive issue in Wales and that this reservoir was established to provide water and to mitigate flooding away from Wales, so I'm sure you understand local concerns. And it is arguable that mismanagement across institutions has caused flooding on this side of the border. So, may I ask what discussions the Welsh Government has had with the different agencies to address any concerns regarding flood management on Wales's side and can you confirm whether there is an intention to expand the Clywedog reservoir in the future?
Yes, thank you very much for that series of queries. And of course we understand the sensitivity of these kinds of issues for the people of Wales and also for all the people who rely on the rivers and catchment areas for a variety of things, including their drinking water.
So, as I'm sure you already know, Hafren Dyfrdwy owns the Clywedog reservoir. Proposals for additional use of the water or transfer options should be included in the company's water resource management plan. Both the Environment Agency and NRW recognise the impacts of high water flows to local landlords and further downstream on the River Severn. And all the organisations involved have committed to undertaking a long-term review to modernise the management of the reservoir to best meet the challenges of the future, which is obviously a really complicated thing to do, and which is likely to take quite a considerable period of time and new legislation to ensure that sustainable long-term change. Meanwhile, NRW is working with the Environment Agency to implement any possible changes to the working procedures under the current rules and legislation that could improve the current operation of the scheme, drawing on experiences of managing other comparable systems in Wales and elsewhere. The changes should have a beneficial impact on flood alleviation given the nature of the catchments, but it's unlikely that these changes could make significant differences during repeated rainfall events of the magnitude we've seen over the last few years, and hence the need for the longer term review of the whole process.
Our policy is obviously to reduce and manage the risk of flooding to people and communities over the next decade and it's set out in the national flood strategy. It underlines the importance we place on flood risk and the growing risks associated with climate change from the flooding and coastal erosion.
Also, as part of the longer term planning for water supply, we're looking at schemes that could supply water where deficits are predicted over the next 50 years. Hafren Dyfrdwy, which operates the reservoir, as I've already said, and Severn Trent are looking at a joint scheme to look at the feasibility for the dam so that more water could be sent down the River Severn during dry periods—so the exact opposite of the flooding—to maintain water flow in the river, where a deficit is forecast. But that doesn't feature in the current draft water resource management plan, which is signed off by Welsh Ministers anyway. So, if that comes forward, it will certainly come to us to look at so that we can be satisfied that that is fit for purpose, both for the Severn catchment area and for the people locally.
Minister, I'm grateful to Cefin Campbell for raising this issue, an issue I've raised a number of times previously, about the frustrations that landowners have downstream as a result of, as they see it—and I would agree—the need for the operational rules to be changed for the Clywedog dam. Now, I understand it's a complex issue—I've raised this many times with your predecessors as well—but can I ask what consideration the Welsh Government has given to the payment to landowners for the managed flooding of land, where that would then help to alleviate flooding of properties perhaps further downstream? And also, Minister, I am aware, or—I attended a meeting with various stakeholders, including NRW, the Environment Agency, with the UK Government Minister Rebecca Pow, earlier this year—I know, from that meeting, the Minister was going to write to you to ask for further collaboration and working together. I wonder, have you received that letter, have you responded, and what are the discussions that you're having with the UK Government Minister Rebecca Pow in terms of coming up with a collaborative approach for the better management, and for reviewing the operating rules, of Clywedog dam?
Yes, I was aware that Minister Pow had visited the reservoir. And in fact, I discussed it with her beforehand, in an inter-ministerial group, but I think she probably mentioned that at the time. We're very keen to work across the border for the catchment areas that flow across the border, and indeed to share good practice where that's effective for the communities on either side of the border. Because, obviously, there are a number of catchments in England that don't cross into the Welsh border, but can nevertheless learn lessons from some of the natural flood protections that we're doing here in Wales, for example. So, we have had that exchange of letters.
And you know probably better than I do, actually, Russell, about the River Severn and its environmental importance as a special area of conservation river for Wales, for a whole series of uses, including drinking water and flood protection, drought protection, and so on. So, part of the long-term plan that I just mentioned in answer to Cefin Campbell is to look at what exactly it is that we're asking of the landowners—the riparian landowners and the adjoining landowners—along the River Severn catchment and around the reservoir, to work out what the long-term plan for that should look like, ought to look like, in collaboration with those landowners, and then to bring forward what we expect will be legislative change in order to bring about the ability to better manage that system. But that's a long-term strategy, which is in progress at the moment, and, obviously, I'm very happy to keep you and Cefin and others informed as we go ahead with that process.
2. What steps is the Welsh Government taking to ensure that new sources of cheap, clean energy for Wales are implemented as quickly as possible? OQ58049
Thank you for the question, Laura. We are using every lever available to us to develop the clean, smart and flexible energy system of the future, with renewable energy generation at its heart. The UK Government's energy strategy was a missed opportunity, we feel, to set a credible path for scaling up all renewables while supporting consumers through the immediate cost-of-living crisis.
Thank you, Minister. Can the Minister confirm that, through the building of new nuclear power plants, in both Wylfa and Trawsfynydd, Wales has a crucial role to play in securing long-term supply for the UK?
It's really nice to see a renewed interest in Wylfa and the development there. We're very keen to work—. We have a centre of excellence nearby for nuclear, and we have some of the world experts here in Wales for that. So, I'm very pleased to see the UK Government's renewed interest in that—maybe should have been a bit faster, quite frankly, over some of the more recent issues we've had, as everybody is aware, up there on Ynys Môn, with that. Having said that, obviously, nuclear is clean and renewable, but there are issues with nuclear, and I don't want to see an over-reliance on nuclear when we have an abundance of other natural resources here in Wales that can be exploited as part of a good, renewable energy system.
Just this morning, I gave evidence to the Welsh Affairs Committee of the Houses of Parliament, in fact, about the need for good grid planning—in our view, devolution of the grid to Wales, so that we can have that plan—and a shift from what's currently a market-led and market-driven approach to grid, which has left us with no transmission in mid Wales, as your colleague Russell George and I have had numerous occasions on the floor of the Senedd and elsewhere about—transmission lines north and south being inadequate, because it's driven by a need for a particular developer to attach to the grid rather than a planned approach, and that, clearly, isn't a sustainable approach for the future. So, I welcome the UK Government's commitment to having an energy strategy. I regret that it includes oil and gas—I think that's a very retrograde step for net zero. But, the really fundamental thing is to get them into the space so they understand the need for a proper plan, and this is a good step on that path, so that we can plan out our future needs, as we are doing here in Wales, for our regional partners and get that grid in place so that we can have what is a fit-for-purpose twenty-first and twenty-second century grid, so we can take advantage here in Wales of the best renewable energy generation, keeping the cost low for people here in Wales and exporting that renewable energy out into the world, because we have easily the capacity to do that.
If David Cameron hadn't, as he put it, 'cut the green crap' a decade ago, we'd be further along on renewable and nuclear and energy efficiency, and households would be paying less for energy, not more. So, I agree that we need to catch up, but the other side of the coin to energy generation is energy efficiency. So, can you say, Minister, how the forthcoming new Warm Homes programme might build on the success of the previous scheme, which delivered free home-efficiency measures like central heating boilers and insulation to more than 4,500 households across Wales?
Thank you very much, Joyce—I couldn't agree more. There's a need for a planned grid; there's a need for a grid planned for a different scale of attachment to that grid as well. One of the things we're very proud of doing here in Wales, of course, is having the Homes as Power Stations initiative. This is about retrofitting homes so that they come up to the best possible standard, reduce fuel poverty, reduce energy demand and consumption—both of those parts of the equation are absolutely essential—and can also be put into a position where they can take advantage of the renewable electricity supplies that the communities of Wales will host, because their homes are able to be retrofitted properly. That comes out of our approach, which is the pptimised retrofit programme, which, as all Members will know, because I've talked about it a lot in this Chamber, is looking at what tech works for what kind of house in Wales, because one size does not fit all by any means. Then, it will enable us to work with the energy companies to use things like community benefits and community ownership to bring those houses up to standard. It's a win-win for the energy companies because then they'll have more customers for their energy that can be used in that clean and efficient way. So, all our programmes—the Warm Homes programme and all the others, our innovative housing programme and our energy programme—are all designed to produce a number of those solutions that make up the fit-for-the-future grid.
Questions now from party spokespeople. The Conservative spokesperson, Natasha Asghar, first of all. These questions are to be answered by the Deputy Minister for Climate Change. Natasha Asghar.
Thank you so much, Presiding Officer. Deputy Minister, the announcement last week that the UK and Welsh Governments have reached an agreement to establish a new free port in Wales is hugely exciting. This multimillion-pound agreement has the potential to deliver thousands of local jobs, driving innovation and boosting business investment, bringing benefits and opportunities to communities that need it the most. Both Governments have agreed that they would be prepared to consider the case for a further additional free port in Wales if a truly exceptional proposal were presented at the bidding stage. What discussions have you had, Deputy Minister, with ministerial colleagues and interested parties about encouraging bids for free-port status, and what support are you personally providing to ensure that these bids are of the best possible quality so that Wales derives the maximum benefit from this £26 million-investment of UK Government funding? Thank you.
We are pleased, clearly, that we've been able to finally reach an agreement with the UK Government on the free ports. It has been a more protracted discussion than it ought to have been, and the way in which it was conducted was not ideal, but I'm pleased that we reached there in the end. My colleague Vaughan Gething showed considerable patience to get us to a satisfactory outcome, and he's been leading those discussions. I was very keen to make sure, as part of our agreement, we had a porous boundary between the different ports in Wales to allow collaboration, particularly for them to exploit the opportunities of marine energy and seeing the ports as a key piece of infrastructure to enable us to take advantage of the economic opportunities as well as the sustainability opportunities of offshore wind in the Celtic sea.
So, there is now agreement that the Treasury and the UK Government will look at bids for co-joining different ports, which could allow Milford and Port Talbot to present a joint bid, and there are words in the agreement that allow us to explore more than one bid. But they are caveated, as Natasha Asghar pointed out, by the UK Government's view of the quality of those bids, but there's been no definition of what a quality bid looks like. So, there's an ongoing conversation. We are keen to seize on the opportunities and we remain to have misgivings about the central thrust of the policy, but we are determined to work together for the best interests of Wales.
Thank you, Deputy Minister. Transport for Wales has warned that the cost of the south Wales metro project is expected to be significantly over its £734 million budget. Although no firm indications of the expected amount of overspend have been given, it is forecast to run into tens of millions of pounds. The south Wales metro project has a complex supply chain, with the availability of construction material being impacted by the pandemic and increasing costs. Once the contingency for any overspend has been exceeded, the extra cost will inevitably have to be met by the Welsh Government. So, Deputy Minister, what discussions have you had regarding making contingency plans for such a situation, and is there a danger that the completion of the south Wales metro will be delayed, with all the environmental and financial implications that it may entail? Thank you.
Members will be aware of today's announcement that UK inflation has hit the 9 per cent mark in April. Inflation within the construction industry is hitting closer to 30 per cent, so any infrastructure project is being hit by increased costs; that, I'm afraid, is inevitable, given the way that inflation is running rampant. So, yes, of course, the metro project is not immune to that, and costs will be impacted. We are looking at that closely to understand the implications on the speed of the deployment and the scale of the deployment. I met with the chief executive of Transport for Wales last week to discuss this. We don't have a clear picture—how can we, given the way that the state of the economy is moving—of the final outcome of this, but we are committed to the metro.
Our position would certainly be helped if the UK Government was able to deliver Wales's share of railway infrastructure spending. Currently, we are funding this entirely by ourselves, with some help from EU funds. But, as we've rehearsed in this Chamber many times, if we had our share of the HS2 project, Wales would have £5 billion into the block grant, which we would be able to draw upon to improve investment. I repeat my call to Natasha Asghar and her colleagues again to please join with us in a cross-party effort to make representations to the UK Government to do what the Tory-led Welsh Affairs Committee said was the right thing to do, which is to Barnettise the spend of HS2 to allow Wales to get our share of UK spend. I would certainly welcome her help in making that case jointly.
Thanks, Deputy Minister. As you know better than anyone, your Government is currently trialling pilot schemes to introduce 20 mph speed limits on all restricted roads in Wales. In Caldicot, in my region of South Wales East, local residents are complaining that congestion has got worse since this limit was introduced, especially at school opening and closing times. Cars are, and I quote, 'crawling along the road at a lower gear causing pollution, and frustration is causing drivers to speed up and exceed limits as soon as they have the opportunity to do so.' In Abergavenny, another part of my region, the imposition of a 20 mph speed limit on Monmouth Road, which carries the A40 from the Hardwick roundabout, has been branded as unworkable and dangerous by local residents.
I have no problem—and I'd like to put this on record—with reduced speed limits on roads where there is large pedestrian activity, such as outside shops, schools, high streets, places of worship et cetera. However, Deputy Minister, it is clear that this blanket 20 mph speed restriction is causing major problems on busy commuter roads. So, Deputy Minister, my question is: are your pilot schemes genuinely intended to inform your proposals, or are they simply a mere smokescreen for plans that are already a done deal? Thank you.
In the last Senedd, we had cross-party support for introducing the policy of 20 mph speed limits on local roads. We set up a taskforce that consulted very widely and involved stakeholders in working through the detail of the best way to design and implement this policy. One of the things it agreed was that we would pilot in eight areas different approaches to making sure that this could be introduced smoothly when it goes live next year. We'll need to come back to the Senedd shortly before that is able to go ahead. The purpose of those pilots is sincere: to understand and learn about the best way to implement it.
The Member mentioned a range of objections that I'm familiar with. Some of them I think are fair, some of them are a consequence of some people simply resisting change and not wanting to adhere to lower speed limits. The survey has shown broadly 80 per cent of people in favour of the policy, 20 per cent of people against. Those 20 per cent of people are making themselves heard, but I don't think we should see that as evidence of a wholesale rejection of the policy—far from it. I think there is broad support, even in those communities that she mentioned. So, there are going to be learning opportunities from the pilots.
She mentioned the issue of a blanket approach to 20 mph. It is not the intention to have a blanket approach to 20 mph. One of the things that's being piloted is the so-called exemptions process. Broadly speaking, Transport for Wales has worked out a formula for which roads it thinks should be captured by the 20. Every community will have a chance to be consulted upon that, and there will be an opportunity for local councils, who are the highway authorities, to say which roads should be excluded—which roads are better kept at 30 mph. In the pilot areas, that process of exemption is being tested. Certainly, we have seen in Buckley in Flintshire a great deal of unease about the way that that has been implemented. I think that there are lots of lessons for councils and for the Welsh Government to learn from that. That is the whole point of piloting it—to try it, learn from it and adapt. That's what we intend to do.
Diolch, Llywydd. Last week, there was a highly critical report that was published by the Office for Environmental Protection. It was warning the UK Government that the progress to deliver on environmental commitments in England is too slow, and it makes recommendations for urgent action. It emphasises the need for legally binding targets.
We have had this discussion, I know, Minister, a number of times before. We know that the plight of the environment is no less serious in Wales, but we still don't have an independent body that can hold the Government to account. I know that people can raise concerns about the functioning of environmental law with the interim environmental protection assessor for Wales, but that interim assessor doesn't have the powers to investigate and take action about perceived failures or breaches of the law by public bodies.
The Office for Environmental Protection has a public-facing website, and it has consulted on a draft strategy on its enforcement policy, but none of that is true at present about the interim assessor's work, in terms of it not being in the public domain. So, do you recognise, Minister, that there is a gap that is unacceptable in terms of environmental governance in Wales? Can you provide reassurance to the Chamber, please, that you will bring forward legislation to establish an independent environmental governance body and nature recovery targets for Wales in the second year of this Senedd?
Yes, we are absolutely going to do that. I'm not going to promise it in the second year, Delyth, because I'm in the hands of the legislative programme to some extent. We have a large number of competing priorities, unfortunately, and it's about what's in the best position to go forward at any point in time and how we can get it through the committee systems, and so on. It's not about whether we think that it's a priority. We do think that it's a priority.
I'm really delighted that we have just started the biodiversity deep dive process. I'm really, really pleased with how that went last week. We have a whole series of them now, running forward. Just to explain, we have the core group for that, but we also have a series of stakeholder meetings involved with that and expert groups involved with that. Then, I will be making a statement to the Senedd. I hope that we'll be able to have something at the Royal Welsh, by way of a public engagement process on that as well, once the process for this initial phase of it has passed.
The whole purpose of that is to tell us how to get to 30x30, what the target should be, and how we should structure that for Wales in a way that really makes a difference on the ground. I think that we share the view that that needs to happen. I absolutely want to put in place an independent body that holds our feet to the fire, but I want to know what they are holding our feet to the fire about, and how we can put them in the best possible position to do that, before we go for it. So, I am really looking forward to the outcome of the deep dive, which will be the first big step on the route to being able to do that.
Then, I hope, Llywydd, that we will be able to have a session in the Senedd that gets us all into the same space about how we should take that forward. There will be difficult decisions along the way. If we are going to protect 30 per cent of our landscape to the level that we want to, that is going to affect people who live in that landscape and who work and want to make a decent home and life out of it. So, it's important to get it right, so that we get that buy-in, as well as just the targets.
Thank you for that, Minister. I certainly welcome the deep dive, and I agree with you about the need to be honest and realistic with ourselves, and with the people of Wales, about how there are going to have to be some difficult decisions being made. I would still press you that, really, unless we have this legislation being brought forward in the second year, I worry about how much it could creep further. But I know that that is something, I trust, that you will keep pushing for within the Government as much as possible. I hope that you will.
You have said previously that you wish to see these nature recovery targets for Wales informed by global targets to be agreed at the COP15 summit. This summit has already been subject to delay. There is continuing uncertainty about when it is going to go ahead. All the while, we are in a nature emergency. One in six species in Wales is at risk of extinction in Wales. I know that we often say that statistic, but really, I think that, sometimes, we need to step outside ourselves, almost, to think how devastating that is really going to be.
Could you confirm that the legislation for nature recovery targets, when it is brought forward—? I take your point about how you don't know yet whether it can be in the second year of the Senedd, although again I really do push you on that, please. Will that be affected by any further delays in the COP15 summit, or are there processes within the Government to make sure that that is not going to be a further hindrance to the introduction, please?
It's a real shame that it's been delayed for a variety of reasons. That really is a shame for the globe, never mind for Wales. One of the pieces of work that I want to see happening, and this is part of the deep dive process as well, to get advice on this, is how we can structure the targets so that they can be tightened but not loosened. It's easy to structure targets that can be changed, but I want to put a process in place where those targets can be accelerated but not relaxed easily. I mean, obviously, any Senedd could overturn the entire legislation and relax them, but we want a process whereby some methodology, statutory instruments, regulations—I don't know, something; it's what I have people working on—can accelerate those targets or add in new ones as appropriate as the evidence comes forward from COP and other processes, but not give us the discretion to be able to row back on them for any reason. That's really easy for me to say, but it's actually quite hard to do. So, part of what we're trying to work on is, with these experts, is that possible, and if so how can we do it.
It's about the initial targets, what the 30x30 thing looks like. Thirty per cent by 2030—that's great to say, but what does that actually mean? What is the 30 per cent? Thirty per cent of what? And is it 30 per cent of Wales or 30 per cent of every local authority area or 30 per cent of every community? What are we actually talking about? And then what are the 30 per cent of species that we're talking about? Or is it 30 per cent across all species or what? I don't know the answer to any of those questions yet. So, part of what we're doing is, 'What is the answer? Is there an answer? What's the consensus view?', and then how can we have an accelerating process to get more and more species and pieces of land protected, because we don't also want a system where we've got 30 per cent of land beautifully preserved and 70 per cent of land that's paved. That's clearly also not what we want.
This is all about the balance, how we use the 30 per cent, perhaps, as exemplars, how do we use that as a showcase for what can be done elsewhere in Wales, how can we get as much of the land mass of Wales included, and as many of the species and so on. So, it's an easy thing to say, but it actually turns out to be really, really complicated to do it in a way that's meaningful and actually holds our feet to the fire in a way that I can't just stand up and say, 'Oh yes, 30 per cent of all the land of Wales is currently protected', because that's not where any of us want to be. So, it's not for want of wanting to do it; it's for want of wanting to get it right that we're carrying on with these processes.
Thank you very much, Carolyn Thomas. We are working very closely with local authorities to tackle the climate and nature emergencies, together with our partnership council, the local government climate change strategy group and the local nature partnership network. Our funding to the Welsh Local Government Association, and through Local Places for Nature, supports our work.
Thank you for the answer, Minister. The Welsh local government elections have shown that there is a clear mandate across Wales for progressive policies to tackle the big issues our society faces, and perhaps the biggest threat is posed by climate change. Minister, how do you plan to ensure that the climate and nature emergency is high on the Cabinet agenda of the new Welsh authorities, as high as it is here in the Senedd and with Welsh Government? I've been really impressed at how much it's talked about here in the Chamber since becoming elected. I know that they are also facing pressures in delivering front-line services as well, so very often they're hitting the ground running all the time to deal with those issues. How can we make sure that it's high up on the agenda as well as tackling those really important front-line services? Thank you.
It's a very good point, isn't it, because we all recognise the challenge of balancing the day-to-day daily grind, if you want to put it like that, with a focus on critical and strategic work that's needed to respond to the climate and nature emergencies. I think I said yesterday in one of my statements that my colleague Rebecca Evans and I will be working with the new leadership teams in local government to work with the newly formed cabinets, the individual cabinet members, to make sure that there is no slacking off of the agenda. Prior to the local government elections, we had really good buy-in across all local authorities on this piece, and I don't anticipate any different result from the outcome now. We had some really interesting conversations with leaders who were leaders before the election, and continue to be leaders now, about structuring their cabinet in a way that has resource efficiency and climate emergency as a very serious part of their Cabinet portfolio work, and I hope to see at least some of those portfolio positions coming through. It's all about making sure that it stays at that strategic leadership level and doesn't slide down the organisation and lose focus.
So, I'm really clear that the political will is there. We'll do some central co-ordination as we always do with the WLGA and through the partnership council to keep this, and it's a standing item on the partnership council agenda, and continues to be. And we've allocated £1.49 million for WLGA to deliver the support programme to help authorities do a once-for-Wales approach with a lot of this. Can I just say, while I'm at it, that the work you've been doing on the verges and No Mow May and so on has been really helpful? I had a really interesting meeting yesterday in Torfaen with a No Mow May piece of amenity ground funded by a Local Places for Nature that's been building on some of the work you've done, which we're hoping to build on very much as we go forward.
Minister, I certainly welcome your continued commitment to work closely with local authorities, particularly in this area of climate and nature emergency. As previously stated, I believe local authorities can play a crucial part in supporting and delivering the ambition for a greener and stronger economy here in Wales, and a prime example of this in my part of the Wales, in north Wales, has been the work of the Mersey Dee Alliance, and with local authorities there, working with local authorities across the border in England and other organisations, to look at delivering thousands of green jobs, such as the work around the hydrogen infrastructure, which will make a huge difference to the economy more broadly. So, in light of that, I wonder if you could outline how you see further opportunities for local authorities to play their part in supporting delivering a stronger economy, such as those green jobs that the Mersey Dee Alliance are looking to deliver, which will of course help to tackle the climate and nature emergency. Thank you.
Yes, absolutely, Sam, and that hits the nail on the head, doesn't it, really? Because this is about the climate and nature emergencies, but it's also about changing the mindset to see that as an opportunity, an economic opportunity, a tourism opportunity and a whole series of services opportunities, as opposed to a barrier to that kind of thing. I think we've worked really hard to do that with our local authorities across Wales, and with the North Wales Economic Ambition Board and its various iterations. I know you played a pivotal part in much of that in your previous role too. So, we continue to work very hard with our local authority partnerships and regions to do some of this work. And then just to give one small example of how these things snowball, I'm very pleased that Wales retains its third-in-the-world on recycling, and we're about to roll that out to businesses in Wales. We've got a lot of positive consultation back from businesses whose mindsets have really changed over the last five years or so; their customers want them to be better in this space, with the whole global view of packaging that's completely changed in the last five years.
But off the back of the recycled material that we're now able to provide in Wales to re-processors, we are getting re-processor requests to come here to Wales and put new plants in Wales for recycled material that we don't even have yet. So, they're saying, 'If you collected this particular material, separately as well, then we could use it in Wales to create jobs and economic opportunities', particularly in places like the Mersey Dee Alliance, because of the wealth of material that would be got from a collection regime there. So, it's just one example, and there are many others, of the snowballing effect economically of doing the right thing for both the climate and nature emergencies, and I really look forward to working with local authorities to identify a lot more.
We must plant 43,000 hectares of new woodland by 2030 if we are to meet UK Climate Change Committee's balanced pathway to get us to net zero. We have opened a new woodland creation planning scheme to support land managers in developing plans to plant trees, and new schemes to support the planting of new woodland will be opened later this year.
It's been six months since you unveiled plans to grant a tree for every household in Wales. In the intervening months, there's been scant detail on this, and I have been inundated with queries from my constituents asking how they can get hold of their trees for planting. So, Deputy Minister, how and when do you plan to inform households on how they can get hold of their trees and how do you plan to maximise the uptake of the scheme?
Well, I think that's rather a daft question, if you don't mind me saying so, because there was plenty of information when we launched the scheme earlier this year. We made very clear that there would be an initial stage. We really wanted to do something in the last financial year, not wait until this financial year, so we had a soft launch where we had a final six different regional hubs open to begin the process, in partnership with the Woodland Trust. But we made clear right from the very beginning—and if the Member takes the trouble to Google this, I'm sure he'll find information—that we would have a fuller launch later this year for the October planting season. We intend to have in the order of 25 different regional hubs where people will be able to come along and collect their free tree.
It is going to be, by definition, a modest but important measure in terms of reaching our target of some 86 million trees. Giving every individual household a tree is an important symbolic gesture to raise people's awareness of the benefits of tree planting, but that's not going to meet our target. We have a comprehensive package of measures to meet that target, and I'm delighted that in the Senedd gallery today are members of the tree deep dive who worked very closely with me, and continue to work closely, on implementing a whole package of measures we identified to break down barriers to meet our target. I think the tree giveaway campaign is a really important initiative, and we'll be seeing more of it in the autumn.
Deputy Minister, just to assist you, you're right: already 5,000 trees have been given away as part of the scheme—5,000 in March; 200,000 are due to be given away in November. However, might I suggest that a rapid review of the terms and conditions to the programme operated by the Woodland Trust is undertaken to ensure that as many trees as possible are distributed this autumn and beyond. Because I have to say that the terms and conditions are rather restrictive and prohibit, for example, third parties collecting trees. That means that, if you have a community where there's a management company, where everybody's agreed to create a community hub, as is the case in one community here in Clwyd South, every single person at the moment would have to drive to one of the regional hubs. So, as part of any sort of review and relaxation, might I suggest that we utilise school estates for the distribution of them, and also, perhaps, not limit households to just one tree either.
Thank you for that supplementary. It's certainly not the intention of the scheme to constrain people who want to plant trees. It's my understanding that the terms and conditions don't do that, and I'd be keen to hear more from you about your particular example to see what might have gone wrong there. In fact, we built into the design of the scheme the ability for the Woodland Trust to deliver to people who are unable to get to a hub, and I certainly want to use schools and other community groups to aggregate demand, if they can use schools as mini distribution centres to pass on trees to families. I certainly want to explore that.
We do need look at the logistics of this. It's a very complex scheme, but we have a limited budget for it, so we have to be pragmatic about what can be done. But I certainly want there to be a permissive approach taken so that we can get as many trees in the ground as possible. And I'd really welcome hearing more about the problems your constituents had.
Our north Wales metro programme will transform rail, bus and active travel services across north Wales. We've also announced a north Wales transport commission, led by Lord Terry Burns, the former Treasury Permanent Secretary, who's done such good work for us around the M4 in Newport. And that is already beginning. It's meeting, I think, today, for the first time, to develop an evidence-led approach that will then develop a pipeline of recommendations for a stream of multimodal and integrated transport solutions for the north.
Electric vehicle charging points will be key to a sustainable transport network in north Wales. In February I wrote to you in support of a constituent who asked for help in finding out why Transport for Wales, TfW, was taking so long to install the 21 rapid electrical vehicle charging points announced last June. In your reply, you stated that the project referred to is a complex one, there'd been delays experienced in obtaining planning permissions, leases and wayleaves, and Transport for Wales have assured your officials that once they've secured the permissions, the sites will quickly move to the construction phase. How, therefore, do you respond to my constituent's subsequent statement that TfW really need to move this along with priority, as visitors driving electric vehicles will come to north Wales and find it unprepared for EV drivers, who will have disposable income, which our local tourism industry would like to be spent here, and that the Rhug estate announced that it's installing eight high-powered car chargers at Corwen—a few weeks to install eight high-powered chargers, when TfW and Welsh Government can only manage one medium-powered charger in 10 months?
I certainly share the Member's frustration that the scheme has hit some snags. Let me say a couple of things in response to the points he raises. First of all, I think he is a great champion of the private sector and I would've thought that, in this case, it is not for Government to be leading the roll-out of e-charging; the Government doesn't provide petrol stations and I don't think it's reasonable to expect Government to be the primary provider of e-charging facilities—that is a role, primarily, for the private sector. And the role of the public sector is to pump prime and deal with those areas that are going to be less likely to be served by the private sector, firstly.
TfW do have a programme of work and this does prove to be very complex, for the range of reasons that he set out, and there have been delays for a whole range of reasons, not least due to supply chains as well as legal hold-ups, and also, as we were discussing in the Senedd earlier, the constraints of the grid. And this is another problem where the grid that we have is not fit for purpose to deal with the climate change emergency. Now, these are not things that are within the control of the Welsh Government. So, it's a complex patchwork of reasons why there have been frustrations.
I would just say that the figures I've seen show that, per head, Wales has as many charging points as other parts of the UK. We have set out an e-charging action plan, which shows—[Inaudible.]—keep pace on that. But I won't deny that the progress to date on the TfW project hasn't been what I would've liked to have seen, but the number of reasons for that are as I've set out.
Minister, sustainable transport networks have to have at the heart of them the interests of the travelling public. They must get people to where they need and want to be, and that means Welsh Government working with partners to build networks that work for people—and it's partners like our wonderful local government colleagues. And, Llywydd, if I may take this opportunity now to congratulate my friend Keith Jones, who has just been appointed to the esteemed position of transport cabinet member in Cardiff, a highly important job for all local authorities.
Minister, if we look across to my constituency, transport routes have to be cross-border, and that means working with partners cross-border, like the metro mayor, Steve Rotheram. Minister, can I commit you today to committing your officials to working with metro mayor Steve Rotheram's officials to ensure that residents in Alyn and Deeside get to their jobs and places of recreation nearest to their homes on sustainable transport networks?
Well, I can reassure Jack Sargeant that one of the consequences of working with Ken Skates for two and half years is that I absolutely understand the need to work cross-border and to work closely with the metro mayor. I can assure you that that's what we're doing. Good relationships were set up when Ken was in charge of the transport portfolio and they have been sustained, I'm pleased to say. In fact, the north Wales transport commission we've set up under Lord Burns has on it a member from Nottinghamshire council, as well as Ashley Rogers, chair of Growth Track 360, to show that we absolutely understand the east-west nature of transport links, particularly in the north-east, and we continue to make sure that that is central to the planning that TfW is doing.
Jack Sargeant is absolutely right, we need a range of networks and they need to make—. The right thing to do and the easiest thing to do—. At the moment, we have a 70-year legacy of a transport system where we've made it easy to drive and more difficult to use public transport. And unless we turn that on its head and make public transport the easy, obvious, pain-free, cost-effective way to make our daily journeys, we're never going to meet our climate targets. And I hope that the Burns commission will do a practical job of work to set up a pipeline of schemes and create the delivery of relationships in the north and that those can then be achieved at pace.
Tackling polluting transport emissions has been a focus of our clean air programme of work. And, as I mentioned, the north Wales transport commission and the roads review panel are both carrying out work that'll help us with this target in mind.
Clean air is not just about the pollution that we have from road traffic, Deputy Minister, it's also pollution from other places, such as industrial plants. The Glasdir estate in Ruthin has been plagued in recent years with poor air quality as a result of the operation of nearby combined heat and power plants by Newbridge Energy Limited. And, regretfully, just very recently, in recent days, Natural Resources Wales has given a permit to operate a second combined heat and power plant from the same location, doubling, effectively, the emissions that go into the local atmosphere. The residents on that estate want to know what action the Welsh Government is going to take in order to make sure that that decision can be either unpicked or that the effective and efficient operation of those plants is properly monitored by Natural Resources Wales to ensure that they don't have to face continuous problems, which they feel are going to impact their health. Given that this is both a public health matter as well, I would like to know what engagement the Welsh Government has between the departments, and with NRW, to make sure that these sorts of schemes, the cumulative impact is considered, and that these sorts of schemes don't proceed where there are already concerns about pollution.
Thank you for the question, and I'm aware of the concerns that he's raised previously on behalf of residents in relation to the facility at the Glasdir estate in Ruthin. It was my understanding that NRW did carry out an investigation alongside Denbighshire County Council last September, which did identify a number of minor issues that then resulted in a notice being served on the operator, and those issues were addressed and the notice was complied with. And since then, as I understand it, there's been a significant reduction in complaints regarding the site and Denbighshire County Council is monitoring closely the area to ensure that air quality remains good. Darren Millar mentioned a permit had been issued, and that is the point of the regulator, to issue permits, but also then to monitor the permits to make sure that they are complied with. Now, I think we've seen an example of where that has been done, and I'm sure NRW will continue to do that, and, if there are concerns by local residents, I'd encourage them to raise them with the local authority and with NRW.
Thank you for the question, Peter Fox. Housing, particularly social housing, is a key priority for this Government. This is reflected in our commitment to deliver 20,000 new low-carbon homes for social rent, and underpinned with record levels of investment. We also provide a range of support for house builders, including schemes specifically for small and medium-sized enterprises across Wales.
Thank you, Minister, for that response. Llywydd, I'm sure everybody across the Chamber here knows the importance of having a good quality stock of housing. Without them, the housing stock will come under even more pressure, pricing people out from being able to own their own home, and we've seen that, sadly, all over. However, a number of new developments in my constituency have stalled as a consequence of the current rules around phosphate levels, with developments close to river catchments required to show how the design will not contribute to increased phosphate levels. Of course, I completely agree that new developments should not have an adverse impact on the environment, however, the current rules seem to have caused a real log jam in the building of much-needed new homes. And in fact, there are concerns that these rules will impact on the potential development of a cancer treatment centre in Nevill Hall in Abergavenny. I note that you will be having a summit at the Royal Welsh Show, which will reflect on not only phosphates but flooding also, but, Minister, how is the Welsh Government balancing environmental considerations with the need to build new homes to tackle the housing crisis? How is the Government working with planning authorities and developers to better understand the current rules, as well as unlocking stalled sites? And we also know that farming isn't the only player in this situation—
Fine. How is the Government working with Welsh Water to upgrade sewage systems in Monmouthshire to ensure that more systems are able to treat phosphates at source and ensuring that new developments can connect to these? Thank you.
Yes, thank you, Peter Fox, for that series of questions, and, absolutely, we understand entirely that the phosphate issue is a really serious issue across Wales. It's affecting the delivery of our 20,000 social homes, it's affecting the delivery of a number of market housing that should have gone ahead for local development plan purposes and so on. It's also affecting a number of other developments across Wales. And, absolutely, there are a number of complexities. Each river catchment has a different set of players, who may or may not be contributing to the phosphate levels there. Phosphate is the headline issue, but we also have nitrates and ammonium, all kinds of other stuff that we've got going into our rivers for various reasons across Wales. We have a number of groups looking at the SAC rivers in particular, so, the Wye has a cross-border one, for example, that I know Peter's aware of.
But the reason for the summit at the Royal Welsh, chaired by the First Minister, is to bring the players together, because there's absolutely no doubt that everyone has to compromise here, because we just cannot have a situation where we can't have anything happening, but nor can we have a situation in which our rivers are visibly dying. What use is that to anyone, frankly? We allow the houses to be built, and then the river's an open sewer—that's clearly not acceptable either. So, this is all about reaching the best possible compromise for both the environment, the rivers and their catchments and the way they flow into the sea and affect our kelp and sea grass forests and all the rest of it, which is vital for climate and nature emergency action, but also the real problem that we have with insufficient housing, particularly in the social sector and so on.
There's a large number of pieces of work going on across the piece on this, it's a very, very difficult and complicated problem, and the reason for the summit is to bring those players together in the spirit of, 'How can we, together, reach the best possible compromise to take this forward in Wales?' Because, let there be no mistake, no-one who comes to that summit is going to go away with their agenda fulfilled 100 per cent and everybody else's put to one side. It's about compromise and reaching that best possible solution for everyone so that we can go forward together as a set of communities.
Yes, thank you, Janet. As I advised in my written question response of 18 March 2022, the Welsh Government is developing a marine energy programme. As part of this work, I am considering what funding will be needed in future years to support marine energy projects.
Thank you, Minister. The UK Government has committed to investing £20 million per year in tidal stream energy—electricity—and the First Minister has informed this Senedd that the Welsh Government is committed to developing a tidal lagoon challenge. However, it seems that tidal range options have been left out at sea. TPGen24 has been designed to operate both in sync with the rise and fall of the tide and, through smart controls, independently of it too. A 24-hour energy generation, a refreshingly simple, turbine-loaded 15 times 7.5 km three lagoon system located at least 1 km offshore, TPGen 24 is a small-impact, low-maintenance and high-yield renewable power plant that can perpetually produce green energy for centuries to come. Clearly, TPGen24 does have some exceptional potential, so will you explain what steps you will take to help to see tidal range projects such as these become a reality here in Wales? As we've said before, it's a cocktail of measures that are needed, and this fits into that cocktail well. Thank you.
Well, I'm not one to be putting down any offer of a cocktail, Janet; let's start from there. [Laughter.] Quite clearly, we need a whole range of measures put in place to ensure not only that we develop a range of tidal energies: tidal range, tidal stream, tidal lagoons, all sorts—. We're very pleased to see the UK Government stepping into this space, but we need to see the action following that up as well. I gave evidence to the Welsh Affairs Committee this morning on this; we're really pleased that the UK Government is making the right noises and coming towards us, but Lee Waters has just written to the Secretary of State asking him again to set out plans for the UK Government supporting funding for the development of tidal range generation in the UK and, frankly, the grid to support it, the interconnectability to support it and a range of other measures that mean that those small demonstrator projects don't bear the burden of the connection into the grid that they need to take their energy off and that we can properly spread out the load of some of the really quite high-risk things that those projects are asked to look at.
But I can assure you—I know she knows already the Morlais project we've already given the grant to—we are very keen to explore this, particularly the innovative projects that Janet has just enthusiastically outlined, because, obviously, one of the big issues for us is to capture the global manufacturing market as well as the global energy market that goes with that and the jobs that go with it. So, I absolutely agree entirely with you, Janet—I don't say that very often—and we really hope that the Secretary of State will work with us to make sure that we have all of that in place going forward.
The next item, therefore, is questions to the Minister for Education and Welsh Language, and the first question this afternoon is from Sioned Williams.
It was an honour to attend the coleg's tenth birthday celebration last week. I'm pleased to be able to commit to providing additional funding to the coleg to increase the proportion of apprenticeships and Welsh-medium further education. This is being done in collaboration with Cefin Campbell, the Plaid Cymru designated Member, as part of the co-operation agreement between the Welsh Government and Plaid Cymru.
Thank you, Minister. In his speech in the Senedd to mark the tenth anniversary of the coleg, Dr Ioan Matthews, the chief executive, referred to the large number of Welsh speakers studying in universities across Wales who still don't make that choice to study part of their degree through the medium of Welsh. It's clear that there's still a challenge in terms of encouraging students to study their subjects through the medium of Welsh, and according to the coleg this is particularly true when it comes to scientific subjects. It appears that one of the main reasons is that the sciences aren't taught through the medium of Welsh in every Welsh-medium school. According to lecturers, once a pupil has changed their language of study to English, it's difficult to convince them to study through the medium of Welsh at university, which, of course, creates a vicious circle in terms of teachers who qualify in the sciences who are able to teach through the medium of Welsh. Does the Minister agree that we need intervention to increase the provision through the medium of Welsh at A-level if we are to increase the number of students who go on to study the sciences through the medium of Welsh at university, and then who are going to train as teachers in secondary schools in the sciences? Will the Minister commit to undertake a survey to find out what the situation is within our Welsh-medium schools in terms of provision in the sciences? Thank you.
Thank you for the question. We know what the situation is. There is a need to recruit more teachers who can teach science subjects through the medium of Welsh, and we have plans to do so through financial incentives to incentivise people and draw people into the profession to teach through the medium of Welsh. So, the question of continuity that the Member talks about is vital, I think, and, of course, there is a further budget going to the coleg Cymraeg that is going to be able to support that to ensure that that happens also. By now, some 34 out of 35 subject areas in our universities are available through the medium of Welsh and the coleg is doing very innovative work, for example, in veterinary sciences, paramedicine and other areas with a science basis. So, I'm looking forward to the next decade of their work and we're ready to do as much as we can to support their work.
Minister, one of the key areas of work that needs to be addressed in our Welsh language strategies is the provision of Welsh-medium medical training, particularly up in north Wales. The Coleg Cymraeg Cenedlaethol have been doing invaluable work here in south Wales supporting doctoral students and providing subject grants to Cardiff and Swansea. Minister, what discussions have you had with the college about the role they play in delivering Welsh-medium medical training at the north Wales medical school to make it a truly national service? Thank you.
Well, we look forward to supporting the coleg Cymraeg in expanding its reach through all parts of the higher education system in Wales, including those to which the Member refers in his question. The resources available to the coleg Cymraeg will be significantly extended as a consequence of the work that we're doing jointly with Plaid Cymru under the co-operation agreement, and it's in many of the areas with medical foundation, if you like, where some of the most innovative work that the coleg has been doing is most evident. So, I mentioned some of them in my answer to Sioned Williams a moment ago.
We are developing the skills of the education workforce and have made additional bilingual resources and guidance available to help practitioners better meet the educational needs of learners with specific learning difficulties, including dyslexia. In addition, the rights are being sought to a new all-age Welsh dyslexia screening test.
One of my constituents in Arfon has undertaken an independent study after finding failings in the dyslexia provision through the medium of Welsh for her daughter. She has been disappointed by the lack of resources and services available through the medium of Welsh, and, although hopefully in the future there will be a dyslexia test through the medium of Welsh, there is no dyslexia test available for someone to take in their mother tongue at the moment. There's not even a Welsh-medium website that could be a valuable information resource. I do understand that there are experts in Bangor University eager to create Welsh-medium resources. So, what support can you and your Government provide to them, and will you provide us with an update regarding the developments to create a bilingual website to support children and young people with neurodiverse conditions?
Well, thank you for that question. Certainly we do need to do more to ensure the availability of resources through the medium of Welsh for dyslexia in general. As part of the plan to ensure that the new legislation is implemented in the most effective way, we are working with a steering group and we will be recruiting people with expertise in this area to implement the additional learning needs system through the medium of Welsh, including mapping what we will need to provide. We're working with local authorities in the context of the Welsh in education strategic plans to ensure that we understand what their analysis is of the need for further resources too.
But as I said briefly in my initial response to the question, we are currently seeking the rights to the test for Welsh language dyslexia screening. We already have it through the medium of English, but we need it in Welsh too and those discussions are ongoing.
The Member for Arfon raised a really important point, because we know that around 10 per cent of our population here in Wales is dyslexic. And I know, personally, that if it is not dealt with or supported properly at a young age, it can cause some difficulties for people later on in life. In addition to this, the signs and symptoms of dyslexia differ from person to person, so it's really important that any plans and support are perhaps done on an individual basis as well as the broader support that can be offered.
So, in light of this, Minister, what assessment have you made of the role of the new curriculum, what role that can play in ensuring that those with dyslexia receive the help and support that they may need as early as possible in order to help them thrive?
Well, the combined effect, I think, of the curriculum reforms and the ALN reforms is—. The focus on literacy will drive improvement in this area, and the training available through the professional learning programme that we've been investing in will specifically equip our teaching workforce to identify dyslexia and support pupils that need additional support. Of course, there is a range of needs within the rubric of dyslexia and some have relatively mild needs, and others have a requirement for more significant intervention. But the ethos of the new curriculum, as well as the ethos of the ALN reforms, are to make sure that that's provided as far as possible in a mainstream setting within the life of the school and in the classroom. And so, I think the combined effect of those two reforms will be a renewed focus on this area.
Diolch, Llywydd. Minister, as you know, in just four years' time, BTECs won't be available for our Welsh learners. Many professionals in colleges I've visited across Wales are getting extremely anxious now that no replacement has been announced. With such a short period of time to go, there has been no clear policy direction from this Welsh Government and, sadly, the response from Qualifications Wales was merely, 'Don't panic.' Minister, our educators need to know the plan and would greatly appreciate it if you could enlighten us today as to what that plan is.
Well, that's an important question that the Member raises in her question. She's right to say that the UK Government is phasing out a number of qualifications in England, which will have an effect on learners in Wales because they're also studied here in Wales. That is a decision that is being taken without reference to the interests of learners in Wales, by the UK Government. What Qualifications Wales has been able to do is secure the extension of some of those key qualifications so that we have additional protection for learners in Wales, which those over the border will not have, as it happens.
She will also know that it's part of the co-operation agreement with Plaid Cymru to undertake a review of vocational qualifications and to see how far we can extend the idea of made-in-Wales qualifications. We have done some of those. There is scope for doing more of those to make sure that learners in Wales don't lose out as a consequence of decisions in Westminster.
Minister, that's not good enough. We need a world-class, high-quality vocational qualification, fit for the next generations, but our educators need time to prepare it and ensure that our students and our learners aren't being failed by the lack of preparation upon introduction. It is quite clear that your own pride and ideological view will mean that we don't follow England with the T-levels, but we aren't being told what the other options are. Minister, will they be made in Wales by our own regulator, like in Scotland, or will this be done through partnership with higher education institutions?
Well, I'm sorry to give the Member the same answer that I gave earlier, but I'm not sure she entirely followed what I was saying. There is a vocational qualifications review under way that will explore the extent to which made-in-Wales qualifications can be extended beyond the existing level of provision. And in the meantime, there is an extension to those most popular qualifications, to provide additional time for that to happen.
One of the challenges that we've faced throughout this process is that the UK Government has proceeded without regard to the needs of other parts of the UK. So, the best way of doing this, in the interest of learners in all parts of the UK, is to do this in a collaborative way. That has not generally been the experience. And so, the position that we find ourselves in is developing alternatives to protect the interests of Welsh learners, and negotiating extensions to those existing qualifications, which Qualifications Wales has been doing. I meet with them regularly. I discussed this question with a number of further education principals recently. And I think it's very important that there's an ongoing dialogue between QW and the colleges, so that, in the interests of learners, which are paramount in all these discussions, there is clarity and an understanding of what lies ahead.
Minister, once again, there is a distinct lack of leadership from you being shown on such an important issue in education for our children and learners in Wales. You are failing to clarify your position on something that you've known about for a long time. This review could have been done a long time ago. People need time to prepare, our colleges need time to prepare these and know the direction that you're going to take. You've left our colleges without this direction, and, as a result, four further education colleges are developing a partnership to award qualification with the University of Wales Trinity Saint David. Will this be the model that you use for all of Wales?
Well, the Member, I think, is conflating two separate things. The review that has been announced by the Welsh Government, in conjunction with Plaid Cymru, is around the made-in-Wales qualifications. There's an existing review that Qualifications Wales has already been undertaking and, as I'm sure she knows, has done a risk analysis of the impact on Welsh learners of the withdrawal of qualifications on a UK-wide basis. We know of the work they've already been doing around made-in-Wales qualifications in some key areas—which I'm sure she's across—and also commissioning additional qualifications for those gaps when they have emerged. So, the work is already under way. As she will know, the designation, the responsibility for managing this lies, as it does in all parts of the UK, outside the direct hands of the Government, in the qualifications regulator, which is what we would all wish to see. And the work that I've been telling you about is work that they are doing together with FE colleges. But it's absolutely important to make sure that that dialogue continues, so that learners know what the options are as those qualifications—many of which have been relied on for a long time—are withdrawn by the UK Government.
Thank you, Llywydd. Minister, on 11 May, Jayne Bryant and I met with members of NEU Wales for a session that focused on raising awareness of the impact of workload on the mental health and well-being of staff in schools. A recent survey of its members found that 95 per cent of educators are working longer hours than those specified in their contracts, and that 44 per cent of educators are seriously considering leaving the education sector. The survey also found that 79 per cent of respondents feel uncertain whether they have a good work-life balance, and 62 per cent of respondents said that their employers aren’t doing anything to lessen their workloads.
Although some support has been given by the Government to support the health and well-being of staff, the clear message that I received from them was that this wasn’t being felt on the ground, and that the most important thing that the Welsh Government could do would be to help to lessen workloads. Do you have any plans to provide further support for the mental health of teachers and school staff through lessening their workloads, and ensuring that we don't lose more teachers?
'Yes' is the answer. There are two things ongoing. We have tripled the budget to provide support to teachers who are under pressure. Part of that is online resources, some of it is one-to-one advice, and some of it is training for leaders and headteachers to identify what more could be done in terms of support within schools. The broader budget is going to enable that service to reach more people. The experience on the whole, I would say, is if you've been to a school where you've had experience of that service, it is a positive thing, but it hasn't been available to enough people. So, that's the intention in increasing the budget: to ensure that it is available for more teachers.
But the basic question is: what does that mean in terms of workload and work pressure? We have a forum with the trade unions and local education authorities looking at what we can do to ensure that we strike the right balance between the requirements and the pressure. So, that process is ongoing. The unions are all part of it, and I hope that that will come to fruition soon.
Thank you, Minister. It is to be welcomed that you are aware and trying to respond to the demand. One of the challenges raised with us was the time that it takes to care for one's health and well-being, because of the pressures. So, it is a challenge.
One of the things that was emphasised to us was that they are still continuing to cope with COVID and those challenges, the additional support for those pupils who need it, and also preparing of course for the developments that are needed with the additional ALN provision and the new curriculum. Certainly, one of the clear messages that we heard regarding the new curriculum, even though they feel excited about it, was that the challenges in terms of preparing for September are very challenging and places additional pressure on them. So, with the Welsh Government intending to introduce this new curriculum from September onwards, what plans are in the pipeline to specifically support those teachers who perhaps are considering leaving the profession because of the current workload, and to ensure that essential transition between the current curriculum and the new curriculum?
I accept the point that one of the challenges is to have the time to look after yourself. That has been very challenging. You're right also to say that the experience of the last two years isn't at an end, and education practitioners, teachers and assistants are under pressure currently. Certainly, that is true. In terms of the further support, you will have seen the statement that about half of the secondary schools have decided to implement the curriculum in September this year rather than wait until next year, which is to be welcomed, of course. Our ability to increase staffing levels as a result of COVID—about 1,800 additional members of staff in the system—I think, provides some extra support. But, of course, the needs are greater as well as a result of the pressure on students and pupils over the last two years.
Perhaps the Member will have seen that back in February I announced a support scheme for teachers over the following months, from the beginning of the year, to ensure that they felt they were ready for September. Teachers may be on different parts of the path of feeling that they're ready, and I'm sure that many may feel they've lost that additional time to prepare for September. But, a lot of work has been ongoing for a long period of time to ensure that the training and the resources are there. And it's not too late; there is a lot of support available to ensure that every teacher feels confident to teach the new curriculum in September.
We discuss this issue regularly. We have most recently discussed a range of areas linked to the issue of addressing skills gaps, including careers and work-related experiences, the young person's guarantee, and the renew and reform project.
Thank you very much, Minister. Firstly, I want to thank you for the entertainment you provided yesterday with you breaking out a beat with the First Minister about your musical programme. I will be asking you a question on that very soon in future. But, for now, Minister, you'll be aware of the concerns that have been expressed by academics about plans to replace physics, chemistry and biology as separate subjects and to replace them with one integrated science award. One academic warned, and I quote, that a 'dumbing down' of science at GCSE level could see Wales
'miss out on some brilliant scientists in the future',
and widen existing skills gap in STEM subjects. Minister, I've spoken to a number of students on various levels and they don't want to have this programme put in front of them. They want to have the option of being able to have one science to study, such as biology, chemistry or physics, whatever their passion is. The Institution of Engineering and Technology has called on the UK Government to address the skills gap in England by embedding engineering and technology skills into primary school education. So, Minister, my question is: what assurance can you provide that changes to the teaching of science do not amount to dumbing down, what do you say to those students who want to specialise in just one science, and will you consider the proposal to embed engineering and technology skills into primary school education? Thank you.
Well, I can assure you that—I know that you've quoted an academic who feels strongly in support of the perspective that you describe—there are plenty of others who take exactly the opposite view. And she will have known that, yesterday, we had the Institute of Physics and the other comparable bodies for chemistry and biology here in the Senedd, and if you took the time to speak with some of those, you would have heard a lot of support for what is being proposed in relation to the new qualifications. Combining the qualifications provides additional space in order to allow learners to take additional exams, including in some of the STEM subjects that she is advocating that they should be encouraged to take up, and some of those in applied contexts, like engineering, as she mentioned in her question. And combining the sciences also enables connections to be made across the sciences, which is four-square with the ethos of the new curriculum—not simply to be learning, but to be understanding and to be understanding the connections between different parts of what you are learning—and I think that will provide the opportunity of doing that.
In relation to the work that she was mentioning in primary school, I think it's really important that we start the learner's journey very early on, understanding what the range of options might be for learners to study, for engineering or other STEM subjects in later life. There are a number of things that we fund which are specifically targeted at young people of primary school age, including in schools themselves, but also opportunities to go outside the world of the school to experience coding, space technology, and a range of other experiences that begin them on that journey, if you like, of understanding the range of options, broadening their horizons and, hopefully, encouraging many of them to take STEM subjects later on.
My officials in the sustainable communities for learning programme team are actively involved in discussions with Bridgend College about this development, and I am delighted, personally, that the college is proposing to accelerate delivery of a future pipeline project, which could both improve its educational offer and support the regeneration of Bridgend town centre.
Well, I really welcome that, and the Minister has been a good friend to the college, and has met Simon Pirotte on several occasions recently, and has seen the STEAM Academy development in Pencoed, which, I have to say, is a Wales leader in bringing together engineering technology, the creative arts and others on one campus, and it is an absolutely superb development for those young people—young people and older people of all ages from throughout the Bridgend area. And, I have to say, Sarah Murphy has visited there with me as well, and others have been there. We've very excited about that, but we're also excited, I have to say, about future plans, including within our biggest local town, which is of course Bridgend, and what that could do not just for the young people of Bridgend, but also for urban renewal as well. So, will he commit to working with Simon Pirotte and the fantastic team that he has, and Bridgend County Borough Council, to bring Welsh Government's heft to that as well so that we make sure that we maximise the impact for young people and old people throughout the area, for lifelong learning and skills but also for town-centre regeneration as well?
Well, I'll take the opportunity, if I may, to compliment Huw Irranca-Davies and Sarah Murphy on their commitment to the work of the college, the support that you both provide for it, and for the further education offer in your constituencies as well. On both occasions I've been to the college in the last year, you've both been there, and it's been fantastic to see the level of community support for the work of the college.
The programme team in Welsh Government are working closely now with the college to identify what the funding requirements would be, and we're very supportive of the strategic proposal that the college has in this area. I believe it's also a brownfield site that they're looking at, so that's also very positive, for obvious reasons. Why I think it's exciting is, obviously, it strengthens the college's education offer, which we would all support, but also, I think, delivers on that mission that is so important to all FE colleges, which is supporting the local economy, encouraging footfall into the centre of the town, providing that local economic halo, if you like, around its activities, and I think that's also an exciting part of the proposal.
'As well as illustrating the ambitious plans of Bridgend College for expanding and improving the quality and range of learning and training opportunities within the county borough, it also demonstrates how the council's regeneration masterplan is trying to work alongside key partners to deliver significant and long-term positive change for the town centre.'
This is an excellent example of major education providers being seen as an anchor in an economic regeneration scheme, so I'm also excited. However, for this to work, the college and the council need to ensure that those students who live beyond the town centre in some of the surrounding Valleys communities are able to access this via public transport. What discussions has the Minister had with the college, Bridgend council and neighbouring councils about the challenge of public transport to maximise the benefits of the campus expansion, not forgetting active travel?
Yes, I think that's a really important point. Everything I know from having visited the college—and I was delighted to be able to officially open the STEAM Academy, actually, in Pencoed campus—is that the college has a real focus, actually, on making sure it's accessible to its students, obviously, but also to the community that it serves at large. There's a strong sense of mission, I think, in relation to that. So, I would expect that the priorities that Altaf Hussain has indicated in his question very much should be heart and centre of their considerations in relation to this. I think the proposed plan is itself a catalyst for economic regeneration, and I think the impact of that will be most broadly felt if the priorities that he's identified in his question are met, as I'm sure they will be.
We are continuing to work with our initial teacher education partnerships and other stakeholders to ensure that recruitment to programmes of initial teacher education meet the desired levels for the future workforce.
Thank you for that answer, Minister. I've been in contact with those working in schools who are concerned about meeting expectations for accountability in terms of Estyn, and delivering the curriculum in Wales while struggling with capacity issues. I know that there's a real concern about the shortages of staff able to teach through the medium of Welsh, especially science teachers, as was mentioned earlier. So may I ask you: what are your long-term plans to improve recruitment and retainment in these specialisms, as well as the immediate support available for schools that are struggling in the short term? Thank you.
Well, thank you for that, and I think it's absolutely an important point, as we've heard already today. I hope the Member will be reassured—I'll be publishing a 10-year plan very soon that will set out the steps we plan to take in partnership with a range of other organisations to increase the number of Welsh-medium teachers generally, but specifically as well in the areas that she has identified in her question as being ones of particular pressure. I think we've laid pretty solid foundations over the recent years, including the Iaith Athrawon Yfory incentive, which provides up to £5,000 for students to train to teach secondary subjects through the medium of Welsh, with additional incentives available for those students if they're teaching in areas of particular shortage, like the ones that she mentioned in her question. But also the employment-based schemes and the conversion schemes from primary to secondary I think all add to the capacity of our teaching workforce to teach these crucial subjects in Welsh. I've also invited schools to apply for grants to support capacity building in some parts of the education workforce through Welsh medium in this financial year, and I hope that that will lead to some innovative ways being used in those schools under particular pressure to look at creative ways of meeting the challenges. We've also set our ITE partnerships a target of ensuring that 30 per cent of their intake are Welsh-medium students, and that will be a target that is increased incrementally. So, I hope that provides the Member with some reassurance that, even without the benefit of a new plan, we're taking action, but that there's a new plan that I'll be shortly publishing for consultation, and I look forward to her views on that.
Minister, the latest available figures for initial teacher education, ITE, qualifiers in Wales show that the numbers of students completing their course in Welsh universities or the Open University fell from 1,740 students in 2010-11 to 1,030 in 2019-20, a drop of some 41 per cent. With that decrease over the 10-year period, the pool of talent available to schools to recruit from has shrunk. Therefore, what's gone wrong, and what's being done to put it right?
The most recent figures that I've seen show acceptances for secondary priority subjects, which is the area of key concern, increasing by 8 per cent, and acceptances to train to teach through the medium of Welsh, including Welsh as a language, increasing by 45 per cent. So, that's the reality on the ground. But, actually, the issue is much bigger than the figures for one or two years; it's a strategic need to increase the supply of people coming into the profession able to teach Welsh and through the medium of Welsh, but also to ensure that we have teaching assistants able to do the important work that they do as well through the medium of Welsh. And I think there's a need for great creativity and I think there's a need to do things differently—to look for financial incentives; to make it easier for people to train, to convert from the work that they might already be doing; also to look at letting young people know as they are going through school what the options are for them to teach in Welsh, and marketing, if you like, teaching in Welsh and through Welsh to them as an option. So, I look forward to the Member's comments on the plan when it's published for consultation very shortly.
We are co-creating an accountability framework to understand the impact of the implementation of the new ALN legislation. This will include assessing the effectiveness of implementation, obviously, but also identifying barriers and also measures to support implementation and exploring the emerging impacts and benefits of the new system.
Diolch. The Additional Learning Needs and Education Tribunal (Wales) Act 2018, or ALN Act, aims to overhaul the current special educational needs system, placing the child or young person's views at the heart of the process and involving them and their families in the planning, intervention and review process from the outset, with schools themselves having more autonomy over their additional learning needs provision. The ALN code of practice states that local authorities should consider at strategic level whether changes to funding arrangements for supporting children and young people with ALN are appropriate. Although the ALN code's children's rights impact assessment states that children and young people currently recorded as having SEN are twice as likely to be eligible for free school meals as those who do not, there is concern that some local authorities are using free school meals as the sole measure to allocate ALN funding to schools, which could leave ALN pupils in schools with lower free school meal levels deprived of the resources they need to fulfil their potential. How is the Minister therefore ensuring that local authority allocation of ALN funding to schools allows the Act's aims to be implemented?
[Inaudible.]—point. I think the additional funding that has been made available to local authorities in order to implement the new reforms has, of course, been significantly enhanced and extended in recent months. In January, I announced an additional £18 million, and I announced a further £4 million for special schools specifically at the beginning of March. But, the point he makes is very important—that we need to ensure that funding is invested in a way that enables the Act's requirements to be met, and that should follow need where it exists in schools in our system. So, one of the key aspects of the implementation review that we will be undertaking is to ensure that the emerging processes, as the Act is implemented, are delivering that outcome, but also ensuring that the co-creation I mentioned in my initial answer is really important, because that enables voices in all parts of the system to have a role in the accountability around the delivery of the Act. And I'm very certain that a key part of that work will be answering the question that he has just identified.
The Welsh Government has provided almost £1.5 million in grant funding this year to support the delivery of science, technology, engineering and mathematics initiatives, with the primary aims of supporting and developing STEM enrichment activities, narrowing the attainment gap and encouraging the take-up of STEM subjects at GCSE and A-level.
I appreciate that answer, Minister. The vast majority of problems facing today's Wales can be addressed by having more scientists, engineers and mathematicians. Mathematicians have devised better surgery scheduling in order to eliminate cancelled operations. We need more doctors, radiographers and lab technicians in order to tackle our horrendous waiting lists, and if we are to address climate change, we need more scientists and engineers working on new battery technology and grid storage. Studying STEM subjects teaches one of life's greatest skills, which is critical thinking, a skill needed above all others in this age of disinformation. Minister, in order to gain the next generation of scientists and engineers, we have to train the next generation of scientists and engineers. How is the Welsh Government working with science outreach projects and science communicators in order to get young people hooked on STEM from a young age?
That's a really good question and a really good point that the Member makes in his question. The £1.5 million in grant funding that I referred to earlier, some of that is—. For example, we've recently invested in Techniquest to explore delivering programmes of work to enhance science and maths in primary and secondary schools, developing that love of science, if you like, at an early age, which I was mentioning to Natasha Asghar a little bit earlier. We fund Engineering Education Scheme Wales, which runs programmes right across Wales to inspire and motivate young people to choose careers in STEM, with a particular focus, as you'd expect with that name, on engineering. We fund computer coding workshops for pupils, we support the further maths support programme with Swansea University, which aims to widen access to further maths, which is obviously critical for some of the STEM disciplines, and we also support the Institute of Physics Stimulating Physics Network programme, amongst other investment. So, I agree wholeheartedly with him that it's really important to encourage our young people who have an aptitude and enthusiasm for STEM subjects to see those as realistic options for them.
I find myself agreeing with Gareth Davies this afternoon in what he says. [Laughter.] Llywydd, last night I had the privilege, as a former engineer myself—I started my career as an apprentice—of speaking alongside the Minister for Economy at the Science and the Senedd event. I spoke about the importance of encouraging young people to take up STEM subjects. Gareth Davies is right; if we are to create the next generation of carbon-neutral products here in Wales, then Wales does need to train its professional engineers and scientists. That simply won't happen, Minister, if we don't get young people engaged in STEM. Can I ask you then, Minister, not only what you're doing in the science industry and the education sector, but how you're working with industry partners and the Minister for Economy to ensure that science is available to everyone, that they can take it up, and that they do realise the world is in their hands when they take up STEM?
The Minister for Economy and I work very closely on this area, because it's a cross-cutting theme and we're both passionate about it. It's really important, I think, to take full advantage of the opportunities that the new curriculum will bring, with a real focus on understanding career options from an early age—an earlier age than perhaps most children and young people currently have an opportunity. But it's those transition points as well, from school into further education, from FE into the world of work or into higher education. At each of those stages it's really important to equip our young people with the skills to get work, obviously, but also an understanding of the options available to them, and, crucially, that aspiration to look at the broadest range of options for them in the world of work, both in terms of their local economy—the kinds of initiatives that Huw Irranca-Davies was referring to in his question—but also globally. We are very committed to that as a Government and we do everything we can to make sure our young people have those opportunities.
Our additional learning needs reforms promote collaborative assessment and planning to facilitate early identification and intervention. Early years ALN lead officers and ALN co-ordinators are helping to ensure that additional learning needs are met, and the child development fund and Flying Start are responding to increased demand for additional developmental support.
Thank you, Minister. It has been great to visit lots of early years settings across my constituency in Bridgend, which I know are pleased to be able to return to pre-COVID routines and activities to benefit the children in their care. For many parents and pupils, schools and early years settings can often be the start of the journey for additional learning needs assessment. As we know, having trained staff and support systems that can identify early signifiers of additional learning needs is key to providing the best support packages for those children to thrive as early as possible. For the last two years, the pandemic has seen periods where children have, unfortunately, not been in school, and this has undoubtedly impacted on the ability of children to be assessed for any additional learning needs. Minister, what is the Welsh Government doing to support schools to be able to catch up on these assessments and ensure that no child falls through the gaps in additional learning needs support due to the pandemic?
Thank you for that supplementary question. We are very aware of the impact that the pandemic has had on the capacity to assess and support the needs of learners with additional learning needs at all parts of their education journey.
Last year, we awarded a £10 million recovery package to local authorities, and the purpose of that was to fund the reintegration, if you like, of pupils with ALN back into the classroom following the pandemic. We have provided grants to local authorities—an implementation grant—to increase the capacity to move children from the SEN system to the ALN system, and to support staff to develop knowledge on how best to do that.
In addition to that, we have committed funding to each local authority in Wales for the next three years to support the provision of online individual development plans, to ensure that the information of pupils with ALN is captured and recorded, so that pupils with ALN are given suitable support.
The Welsh Government undertook the freehold acquisition and short-term leaseback of Gilestone Farm for £4.25 million. The acquisition of the property is being progressed in order to facilitate investment in local businesses, the community and the Welsh economy.
Thank you for your statement, Minister. Over the last week, I have been inundated with phone calls, e-mails and social media comments around the Welsh Labour Government's decision to buy Gilestone Farm in Talybont-on-Usk. I, and many of my constituents, have some very valid questions over the purchase and letting of the farm to the owners of the Green Man Festival. They have some varied points that they would like to put to you, and I am going to do that now.
Minister, you have told us what the purchase price was. So, I'd like to know: was that subject to an independent evaluation by a district valuer? What tendering exercise was carried out to find a suitable tenant for the farm? Was anybody local offered the opportunity to apply for it, and if not, why not? What is the long-term ambition for the farm, given the current food security issues that we have, and why has a productive farm been taken out of use?
What economic exercise was done by the Welsh Labour Government to ensure that the 174 jobs that have been quoted can be realised when farms in my constituency can hardly employ a single person? Finally, Dirprwy Lywydd, is it now the Welsh Labour Government's policy to use taxpayer money to purchase farms and rent them out to private businesses and individuals to deliver on its biodiversity and climate change projects?
There were a range of questions in there. I will try to deal with them as best I can, and as succinctly as I can—I'm looking at the Deputy Presiding Officer. The purchase price was independently certified by our consultant surveyors. You'll be pleased to know that we did not pay above the market value for it. When it comes back to where we are now, it has been leased back to the current owners. They have a range of issues to do to maintain the property, to harvest existing crops and to honour existing bookings on the site.
We are in discussion with the owners of the Green Man Festival about their potential leasing of the site, to give a greater level of certainty for them to invest in the festival, which, as the Member will know, is supported across a range of different sectors. It is one of five major independent festivals that still exist across the UK, with significant economic benefit to Wales, and they have plans and ambitions to be able to expand. We will need to see from them a business plan before going ahead with any further arrangement. We would then be looking at whether to have a short-term lease to manage the entire property for a period of time. But we do need to have further negotiations with them, either to look at the purchase or a further lease arrangement for the site.
The overall ambition is to make sure that one of the most significant economic undertakings in the festival scene, which has a particular group of people who are interested in it for the way that it's run and the values that underpin it as well, has a permanent home in Wales, because there has been significant interest from other festival providers who want to purchase the brand. We're very keen to keep that in Wales, with the significant economic benefit that has already been generated and will be in the future. I'll be more than happy, as those negotiations continue, to further update the Member and indeed other Members who will no doubt have an interest.
Minister, thank you for the answers you've given this afternoon. I think it clarifies that the purchase of Gilestone Farm is more a case of securing an exhibition/festival space rather than an agricultural space. If you could confirm that to be the case, as that was my understanding from the answer you gave. If it was to include an agricultural component to it, are you minded to give significant funding, like you've done with this particular purchase, to other areas in Wales that could release opportunities for agriculture and for new entrants into the business? Obviously, there has been a growing problem in accessing the agricultural industry for new entrants, and to hear that £4.25 million has been spent on one farm in one particular location, I think, would be quite depressing for some farmers, when their own family members are struggling to get their foot on the ladder. So, can you just confirm for me that this is an exhibition space you've secured rather than—[Interruption.] The Royal Welsh was purchased by members of the show, not by Government, I'd point out.
As I say, the purchase price has been independently certified for us, and we're looking at the opportunity that does exist around the long-term future for Green Man. As ever, there are competing interests about land use and about economic benefit. I expect to see in the business plan how the whole estate would potentially be managed. It would be wrong for me to try to set out a land use policy for the entire estate when that's what we're looking to see delivered. We have, as I say, in the agreement that we already have, the leaseback to ensure that the crops that are already growing are harvested and that current bookings are honoured. As I say, I will further update the Chamber and Members as we receive a business plan from the people who own and run Green Man. I think it's important to maintain the independence of that festival and its link to Wales, which does in itself provide significant economic benefit. I'll then be able to provide more detail on answers about the whole land use that exists. I should also say that Powys County Council are supportive of the proposal and what it will allow us to do on that site.
Thank you to James Evans for bringing this important question before us. What we've got here in Gilestone Farm is good agricultural land, and the danger is that we're going to see good agricultural land once again being lost for other commercial purposes. We know that the Welsh Government doesn't have a good record when it comes to buying agricultural land, because we've seen agricultural land being bought by the Government and being turned into forests. So, what assurances can you provide us today for the long term that this land and this farm will be retained and kept for agricultural purposes, namely producing food?
Also, a number of local farmers have got in touch with my office to complain that they haven't had any opportunity to be part of this process to tender for the farm, for the land, and to be tenants. What consultation did you undertake locally in order to ensure that the new tenants would be the best ones for this land, and why were other local farmers not given the opportunity to be tenants on the farm?
And finally, it's good to see that Welsh Government is providing funding for agriculture. Unfortunately, we've seen local authorities having to sell farms over the years. Are we now able to look forward to Welsh Government giving more money to local authorities to rebuy these farms so that there are opportunities for young farmers to return into agriculture again?
With respect, I think we're confusing more than one issue in the series of questions that are being asked. I won't go into the historic matters that the Member invites me to relitigate today. The issue is about the vendors and their desire and willingness to sell, where the festival has currently been based, our ability to keep the festival in Wales with all the significant economic benefit that is returned, including, of course, significant economic benefit within rural Wales, and how we then make sure that this particular event, with a particular importance, isn't taken away and the brand used for an entirely different commercial purpose with all the jobs and the wider benefit disappearing to a different part of Wales. As I've indicated, we expect to receive a business plan. We'll then look at that business plan for the entire land use, but then also about whether this would be an issue where there'd be a longer term lease or purchase. So, when it comes to the amount we've invested in this area, it is about securing the longer term future for Green Man in Wales, and I believe we've made the right choice in doing so, but I will, as I say, happily update Members about the longer term question that Members have raised today about the entire land use for the estate that has been sold by the vendors.
2. Will the Minister make a statement on Healthcare Inspectorate Wales's (HIW) decision that Ysbyty Glan Clwyd's emergency department has been identified as requiring significant improvement? TQ624
Thank you very much. This is a disappointing report, and the failings in care that have been noted are unacceptable. The health board has confirmed to us that stringent arrangements are in place. We expect the health board to work with Healthcare Inspectorate Wales to accelerate improvements, and we will continue to provide support in order to enable change.
Well, how many times have I heard that answer before, Minister? Another scandal, another damning report, another urgent question in the Senedd, and another poor response, I'm afraid, by the Government. We're going around in circles here, aren't we? We are going around in circles. How many times do we have to listen to you promising that things will improve, whilst bodies such as HIW and community health councils and others are telling us a very different story? When will you accept that words like this aren't enough, and that the time has come to consider structural changes to how health services are provided in north Wales?
Patients in north Wales have been promised improvements for years on end, and they just never seem to materialise. You tried special measures, and it failed; you tried all sorts of heightened interventions and they're clearly not delivering. Just a few weeks ago, we were here discussing the serious failings of vascular services in north Wales and the risk that was posing to patient safety. Before that, of course, it was the continued failures in mental health services in north Wales, and the way patients were coming to harm despite warnings from reports published years previously. And today, now, it's Healthcare Inspectorate Wales warning that the emergency department in Ysbyty Glan Clwyd is the worst it has ever seen, and that that, of course, has serious consequences for patient safety.
So, do you not agree, Minister, that the time has now come for the Welsh Government to start a wider conversation around reforming health services in the north of Wales? They say, 'If it ain't broke, don't fix it.' Well, do you know what? It is broke and it needs fixing. So, will you finally accept that this time, it's time up for Betsi?
If you let me finish—it's not acceptable. As soon as I heard there was an issue, I went to spend the whole day in the hospital just to see for myself what was going on and to see the pressures they were under. And I can tell you that I met some staff who had to stop because they were, frankly, in tears because of the pressure they were under. Of course we need to stand by those staff and we need to help them, and the health board now has assured us that they will strengthen operational and executive oversight over Glan Clwyd Hospital's emergency department. If your answer is to restructure at a time when people are waiting for operations, and you want the whole health board to be thrown up in a tizz at this point in time, when, frankly, I want to get on with the job of healing people—
Restructuring at this point in time is not the answer. We will have a tripartite meeting in June and that will provide recommendations to me on the appropriate level of escalation. I have asked to make sure that my officials are ready for any eventuality that comes from that tripartite meeting, and we have different methods now of making sure that we can support and intervene in the most practical way possible to give the support that they need. Now, your answer is always to run down the service and the people—[Interruption.]—and the people working in that service who are on their knees, who are in tears. And, of course, we've got a duty and responsibility to serve the people of that community. If you think that restructuring at this point in time is the answer, I'm afraid I think you're mistaken. That is not what I'll be doing. I am not going to be restructuring in the middle of a pandemic. That is not the way to go about change. We are putting pressure on the health service in the area, we are meeting frequently with the NHS in the area, and we will continue to make sure that we are responding in a productive and in a progressive way, which is constructive. And, of course, this kind of situation is unacceptable, but we will stand by them to make sure that they make improvements.
Minister, we are fed up, frankly, in north Wales, of you telling us that we cannot shine a light on the terrible things that are happening in our health service in north Wales. The report today was not just disappointing, it was, frankly, alarming. It might not be alarming for you, but it's alarming for those people in my constituency who that emergency department serves. People in my constituency depend on that emergency department, and when they read that there are problems in it because of insufficient beds, insufficient staff, poor or non-existent record keeping, patient safety being put at risk time and time again, vulnerable patients who should be seen in 10 minutes who don't get access to a consultant or a specialist for six hours, mental health patients who are suicidal being put in parts of a waiting area where they can't be seen or monitored and sometimes disappearing without the knowledge of anybody in the hospital that they've actually left—. This is a health board that has been in targeted intervention or special measures for its mental health services for over six years. The list goes on and on and on. And if you care to read the report, you'll see that there are echoes of nearly every report that has been brought to the attention of this Senedd while I've be a Senedd Member, well over a decade, as has already been said. And, frankly, I'm sorry to say that it came as no surprise to me, this report, because week in, week out, we get patients, we get their family members and loved ones, in our surgeries, e-mailing us and on the phone telling us that there are problems in these departments. We raise them with the health board and we get this sort of flannel, frankly, that you've just given us today—that they've paid attention to these things, that things are improving, that they've produced a wonderful plan that is on a shelf to be implemented.
And this is just two months after another report on the vascular services. You know, there are just two services in Wales that have been described as services requiring significant improvement by HIW. Both of them are in the Betsi Cadwaladr University Health Board—nowhere else, just the Betsi Cadwaladr University Health Board. This health board needs to improve, Minister. I don't know, frankly, whether a structural change is appropriate. I'm not yet persuaded that that is going to be the case—
I'm going to ask a question, and if you please allow me to ask it, I will. But the fundamental problem that staff tell me that there is in that hospital is that there are not enough in-patient beds, there are not enough members of staff. What are you going to do to make sure that the balance of in-patient beds is right for that local population in Conwy and Denbighshire that rely on that hospital? Because, demographically, it is the oldest population in Wales, and yet there are fewer beds for the number of residents who are served by that hospital than in any other part of the country. And do you accept—do you accept—that the decision that was taken by your predecessor, who's sat right next to you in the Chamber and has been smirking during this question—
Can I—? [Interruption.] Wait. Hang on a second, everyone, please. [Interruption.] Darren, wait a second. We need to be careful of the language being used in this Chamber on all sides, please. So, let's make sure the questions are focused on the issue that has been raised today, and let's keep to those questions on the issue.
The question is on the issue. Do you accept that the person who is sat next to you, your predecessor, took the wrong decision when he decided to remove this health board from special measures in advance of the last Senedd election? That was the wrong decision, Minister, and you need to sort it out.
I'm going to try and calm things down here a little bit, and let's try and get a little bit more constructive. Now, HIW have said exactly what needs to be done in this situation. They've said—they've listed what needs to be done. The response wasn't what it should have been when they went back in; now there has a been response from the health board. So, let me tell you what they are planning to do. They are planning to strengthen operational and executive oversight of Glan Clwyd Hospital's emergency department; they are planning to put more senior leadership input and spot checks in there—that was certainly something that I felt needed to be done on my visit; they are going to be having two-hourly safety meetings so that approaches are strengthened within the emergency quadrant, along with that senior increased visibility; training is going to be increased across a number of areas. You can imagine that training during the pandemic had to be paused because there was so much going on—that training is going to be reinstated. Vulnerable patients will be identified and discussed at the two-hourly safety meetings, and discharge planning will commence on arrival.
And beds, frankly, are not always the answer—that's certainly not what HIW is saying, and I would rather listen to HIW, who are the experts. And let's be clear that, actually, putting people in beds is not the answer. Our proposal and our policy approach is to get people home from hospital as soon as possible. There's going to be a new digital patient tracking system that is going to streamline patient journeys with increased training for staff to use it. So, there are measures in place. They've been very clear about how they intend to respond to this and we, of course, will be looking at this in the tripartite meeting in June.
Minister, we already knew, as local Members, that, Ysbyty Glan Clwyd is not a good-performing emergency department in Wales. I'm just sad, myself, to read the report and learn that it is now the worst-performing emergency department in Wales. In March 2022 only 44.1 per cent of patients were seen within the four-hour target; 62.4 per cent within the eight-hour target; and 1,351 people spent more than half a day, 12 hours, in A&E. Now, our casework does highlight the critical situation at Glan Clwyd, but the HIW report gives us just a glimpse of how bad things really are there. And I do acknowledge that you acknowledge it, and I thank my colleague Llyr Gruffydd, because if you hadn't had raised this as a topical question, I was hoping to raise it as some kind of urgent question.
The comments by Darren Millar I stand by 100 per cent. It is heartbreaking to be a Member when people contact us on a daily basis with things that are going wrong in this health board. And we're not out to put undue criticism on this health board. We've got fantastic staff there working their socks off, but they themselves are becoming very stressed. You're going to lose members of staff, not because of what we say here, but because of the conditions and pressures that they're working under. And, Minister, how do you think I feel when I read this? That the generic environment, clinical room, resuscitation equipment, oxygen suction equipment, manual handling equipment are dirty; that the utility and ward kitchen was found to be dusty or soiled; that patients who require a trolley in the major areas, if available—
They're routinely accommodated in the waiting room; that high-risk patients aren't subject to any consistent or ongoing checks. That could be any one of our relatives or the relatives of our constituents. Compliance with—
I've turned the microphones off, because I've asked several Members to keep their questions—. You are limited in question time, you know that, and therefore you have gone beyond the time already allocated. Please keep to the question.
Minister, when the health board was placed in special measures in 2015, improvements were required in leadership and governance. The HIW report highlighted serious concerns. So, is it the case that, seven years on, these special measure objectives still haven't been fulfilled? That was question 1. And a final question, Deputy Llywydd: Minister, you know well my view on emergency departments in north Wales—in view of the failing of this particular hospital, will you look now to Llandudno General Hospital, and at putting some measures in place there that at least would take pressures off Ysbyty Glan Clwyd and hopefully bring about some safer outcomes for our constituents? Thank you.
Thanks very much. Well, of course, Glan Clwyd, along with other accident and emergency departments, are seeing a massive increase in demand, some of which has come as a result of people not presenting themselves during the pandemic and now coming forward. But the situation in Glan Clwyd is worse than in other hospitals, which is why we do need to make sure we shine a light on Glan Clwyd—and nobody's saying that you shouldn't shine a light; my God, if you don't shine a light, I can tell you I'll be shining a light on it. So, it is important that we understand that that leadership and governance, which was part of special measures but is now part of targeted intervention, which is something we are still monitoring, and needs to be improved, which is why we'll be revisiting this when we have a response and the recommendation from the tripartite meeting in June—we'll see what they've got to say in terms of that. I think it's important that people understand that an enhanced hospital management team and an executive presence will be at the A&E department, and there will be an increased use of spot checks in terms of record keeping. It is utterly unacceptable for a situation to be described as 'dirty' in a hospital, especially in the climate in which we are living. It's not a pretty report, and it is clearly something that we need to make sure that they understand the seriousness of what is happening here.
What I can tell you is that Llandudno is already being used as a place where people go to be discharged. So, that is already being used, and I've been to visit—[Interruption.] I've been to visit it, and it is being—. It's quite successful in terms of taking some of the pressure off. And, obviously, if that needs to be continued for a longer term, I'm sure that the health board will consider that. But I do accept that the situation in Glan Clwyd is really in a very difficult situation, and we will certainly be making sure that the health board understand that there is a real urgency now to improve the situation.
I myself read the HIW quality check report this morning, and what it contained was shocking—truly shocking. And I am deeply concerned for the safety of my constituents in the Vale of Clwyd, and I'm also concerned for my constituents working on the front line in Ysbyty Glan Clwyd. Both patients and staff have been badly let down by the hospital and the health board's leadership over the last few years. The fact that this report highlighted the need for significant cultural change in order to make the department a safe and effective environment for patients and staff is extremely worrying, as is the fact that learning from incidents is not routinely shared across Betsi Cadwaladr University Health Board. Minister, do you believe that the local health board is fit for purpose? And my colleague Darren Millar asked you the question, and I believe you didn't answer the question, so I'll ask you again: do you regret your Government's decision to take the health board out of special measures before the Senedd elections last year? And do you have any plans to review services across the region in order to ensure a safe environment for patients and staff?
Thanks very much. Well, certainly we have seen massive pressure in Glan Clwyd, and it's one of the reasons why, as soon as I saw the first report, I made a beeline for the hospital and spent the day in the hospital, not just a quick visit, but I actually spent time with people on the front line in ED, just watching the kind of pressure they were under, and I can tell you that the pressure was intense. I also met with the trade unions, who talked me through how staff are coping. These are difficult times and difficult situations, but it's clear that Glan Clwyd and Betsi are not coping as well as some other health boards in Wales. And of course, therefore, we do need to look at that, and that's why the tripartite meeting will give us some indication of whether we need to escalate the situation.
I think that my predecessor did the right thing in actually looking at the way that Betsi was running and making sure that he did downgrade them from the intervention that they were on. But, since then, we've had a new chief executive, we've got I think a chair who is active and very engaged with the workforce and is absolutely determined to change the situation. And I think it's really important that we get the balance right here between making sure that we see massive improvements in Betsi, particularly in ED and vascular, but that we also make sure we stand by the staff, who have been under incredible pressure over a very long time.
Thank you. I wasn't going to speak on this, but I will now, so hopefully what I say is okay. I often get asked do I think that the health board is too big. And my commonsense thought about it, gut reaction, would be, 'Yes, it is.' It's a huge region—[Interruption.] Common sense. But I like to ask people, so I asked health professionals, I asked people in social services, what did they really think, you know, do we need to do something now. And they said it would be a costly distraction to do something now, reorganisation is really expensive, and there are immediate things that need to be attended to right now. There are many services that are excellent in Betsi Cadwaladr health board, and I'm so glad that my daughter, who lives just across the border, was able to have her child in Wrexham, because, just across the border in Shropshire, it's really, really bad, the maternity health services there. So, there are really good departments, and I don't want to knock them, but there are some that need investment.
Sorry. Sorry, I did say I wasn't going to—. So, I know that the Royal Alexandra Hospital were hoping to have investment in that, to help take the pressure off minor injuries—[Interruption.] Minor injuries. But I know there is an issue because of a reduction in capital funding from the UK Government by 11 per cent—[Interruption.] No, I'm talking, I'm asking a question.
So, I'm asking the Minister if that lack of capital funding, from UK Government to Welsh Government, does have an implication on us being able to build extra services to take the pressure off certain hospitals. Thank you.
Thanks very much. Well, I would agree with you, Carolyn, that I think that to think about reorganisation in the middle of the pandemic, when we have the longest waiting lists in history, would be a distraction. I think it's really important that we focus on what matters to people, and what they want is to be treated well and to make sure that they get seen in a very timely manner. I think also it's really important that we talk up where Betsi's doing well. They've got the best cancer rates, for example, in Wales.
I think it's important also to recognise that you're absolutely right that, due to the restriction on our capital funding, it is difficult therefore for us to put the investment in that we would have liked. Look, I think it's really important—[Interruption.] I think it's really important that we understand that, as a Government, we are committed to improving the situation in Glan Clwyd, but also more generally across Wales, where, frankly, all of our accident and emergency departments are under intense pressure. They have never seen demand like this before. I've had meetings today with the ambulance service, just to make sure that we understand the kind of pressure that they're under, and I can tell you that they are seeing a month-upon-month increase in terms of the numbers of people calling on their services.
Diolch, Weinidog. Before I move on, can I just remind Members, please, that, when we have a passionate issue such as this—and it does create passion and emotion amongst Members, because you represent your constituents—please respect the Chair when the Chair requests that questions be asked and no long speeches. It is important that we get to the questions so that Members can ask them and the Ministers can answer them. Please keep your focus on that.
3. What assessment has the Welsh Government made of any implications for Wales of the recent announcement by the UK Foreign Secretary regarding the intention to legislate to change the terms of the Northern Ireland protocol? TQ626
Thank you for the question. We need more detail about these proposals in order to assess their impact. We have a direct interest in anything that affects the way in which goods flow between Great Britain and the island of Ireland, and UK Ministers need urgently to engage with us on their proposals.
Counsel General, the announcement by the UK Foreign Secretary raises clear concerns on the flow of goods between Great Britain and the island of Ireland for our west-facing ports, particularly for Holyhead, and for Welsh businesses more widely. And we ignore at our peril the paramount importance of safeguarding and protecting the Good Friday agreement. We note the will of the UK Government to unilaterally rewrite the Northern Ireland protocol. It's a binding international agreement, which they negotiated themselves, they agreed themselves, they sold to the UK Parliament and to the British public as part of the great oven-ready deal, and they also guaranteed no checks between Northern Ireland and the UK at the same time. And of course the undoing of the protocol undermines the reputation of the UK as a trusted international partner. So, Counsel General, was the Welsh Government party to any discussions on the UK Government's announcement to rewrite the Northern Ireland protocol? And, bearing in mind the importance of this directly for Wales as well as for the UK as a whole, has the UK Government agreed with the request from the First Minister to discuss this urgently at a meeting of the inter-ministerial group on UK-EU relations?
Thank you for that supplementary question, and, of course, you do raise some significant issues in respect of potential breaches of international law, and those must not be underestimated. The First Minister wrote to the Prime Minister on Monday 16 May to express his concerns about the proposals to introduce legislation to introduce parts of the protocol. The Minister for Economy had a call with James Cleverly on Monday evening, at which Minister Cleverly provided some information about the statement, but there has been no other substantive discussion. We recognise that the protocol is complex and a sensitive matter, and that is why it is only through dialogue, not through unilateral action, that a mutually agreeable solution can be found.
I think it is also—and it comes out of the supplementary question—essential that the current position is discussed with devolved Governments in relation to Wales specifically. We do have a direct interest in anything that affects the way in which goods flow between Great Britain and the island of Ireland and on matters that might affect Welsh businesses more widely. In particular, we do need to understand what their proposals will mean for imports from the island of Ireland for which we are developing the infrastructure necessary for SPS checks. So, for that reason, the First Minister called in his letter for further ministerial discussions, potentially at a meeting of the inter-ministerial group on UK-EU relations. We've not had a response to that yet. The last thing we really need is for the current cost-of-living crisis, on which the economic impacts of Brexit are already having an impact, to be further exacerbated by a trade dispute between the UK and its most important trading partner.
I think it is important that there's further dialogue between the EU and the UK, and I think it's also very important that the UK Government engages with devolved Governments where there are impacts on people, particularly here in Wales, obviously. No-one wants to see unilateral action. The UK Government has made it clear that it didn't want to be in a position where it had to introduce potential changes to the agreement on just the one side, but it is important that there are pragmatic solutions. I think the Bill that was produced and the proposals that have been put forward by the UK Government yesterday were pragmatic. They were not talking about ripping up an international agreement at all; there were minor changes proposed in order to address some of the significant concerns that have been raised across Northern Ireland, particularly by the business community. Do you accept, Counsel General, that, whilst this matter isn't devolved, the engagement that has to take place with the Welsh Government can only be limited because of course the agreement is between the UK Government and the European Union? And do you accept that the European Union also needs to move and attempt to compromise if we're going to reach an agreement—[Interruption.]—if we're going to reach an agreement that secures the peace in Northern Ireland and upholds the principles of the Good Friday agreement?
Thank you for that question. It is certainly the case that dialogue's important, and I think it's important that you recognise the importance of dialogue with devolved Governments. I don't think it is a minor matter. It is a matter that could involve devolved Governments right from day one, because there are significant economic interests. I think the previous Member, Huw Irranca-Davies, referred to the significant economic impacts for Welsh ports. I think you underestimate the implications of what the Government is proposing, that, within a couple of weeks, it is going to introduce legislation. I think we also do need to be clear about the mess the UK Government has got itself into, through what really is a failure of statesmanship and diplomacy.
Let's be clear: it signed up to an agreement that is legally binding in international law. It is the Prime Minister's agreement. Now, one proposal he put forward was that we should use article 16 of the Northern Ireland protocol. That is only an emergency measure that can be used for temporary scope. It also opens the door too for the EU to use counter-measures. Effectively, the approach the UK Government's adopted is one that opens the door, effectively, to a trade war. There is potentially an independent arbitration process, but the Government hasn't made mention of that. Of course, what the UK Government is doing is opening itself to legal challenge in the Court of Justice of the European Union.
One thing that's very clear is this: however the UK Government wants to go about it, if it legislates, it is still required to comply with article 4 and article 7A of the European Union (Withdrawal) Act 2018, which has primacy. So, even if it introduces its own domestic legislation, it cannot get out of its international obligations. Whatever the UK does at domestic law level, it cannot revoke those international law obligations, so it is in grave danger of destroying its international reputation, its credibility in international law, and we really should be a country that keeps our word, otherwise why would any country ever seek to do business with the UK if it cannot be trusted?
I think two other points that do need to be made in response to your question are, firstly, what is happening: the approach adopted is, firstly, destabilising the political situation in Northern Ireland, and we must not underestimate that, but it also risks some very significant material damage to the British and to the Welsh economies. So, I do hope the UK Government will seriously reconsider its position, that it will engage in dialogue, but, above all, that it will engage with the devolved Governments over issues that have a direct impact on our economic well-being.
Two weeks before the Brexit referendum, Sir John Major predicted that if Brexit happened, the peace process jigsaw would be thrown up in the air and nobody would have a single idea where all the pieces would land. But one man did have the answer, and not any answer, he had an oven-ready answer in 2019, and his Government signed, sealed and delivered that answer through the Northern Ireland protocol. He wants now to backtrack on that international binding agreement, and he's been warned by the US President, by the Irish Taoiseach not to do that. Isn't this the irony here, that the ultra Brexiteers who are so obsessed about Britain's standing in the world, Britain being great again in the world, are doing exactly the opposite? They are undermining Britain's status in the world—
Does the Counsel General agree with me, let's all be honest, that the United Kingdom Government has no answers on how to solve the Northern Ireland border question, they have no answers on how to solve the constitutional issues facing the United Kingdom at the moment, and, in fact, their own actions are fast accelerating the end of their precious union?
The Member makes his point very well. I have two particular concerns. The first one is the undermining of international law, and that is something that any law officer should be concerned with, and I would hope that the other law officers across the UK Governments share those concerns that we have. The other point he makes, of course, is in terms of the destabilising impact. You referred to the US Government and the implications of undermining the Good Friday agreement that this whole process has, but above all it is a gross failure of diplomacy and statesmanship on behalf of the UK Government that's got it to the position it's in. Sabre rattling with the threat of legislation that breaches international law will solve nothing, and I really do hope the UK Government will reconsider. But I also do make, again, this fundamental point that bypassing or not properly engaging with those Governments in the UK that also have significant concerns about the economic impact shows contempt for those Governments. I hope it will reconsider its position and that there will be engagement from the UK Government with the Welsh Government in the very near future.
Diolch, Dirprwy Lywydd. We've already seen, of course, some of the damage from the oven-ready Brexit, or the half-baked idea, as I prefer to call it, on the ports in Wales, because they're bypassing our ports already. So, we've already seen that. It is, of course, Prime Minister Johnson who came up with this grand plan—which is not so grand, apparently, according to him now. So, I want to ask you, Counsel General, beyond the harm that tearing up this agreement will cause to the international standing of Wales and also the UK in the wider world, will you be having discussions with your counterparts in the devolved nations to urge the Prime Minister to reconsider what is going to be the most damaging international situation in terms of trade and trust that he is about to put upon the UK?
Well, thank you for that question. I have absolutely no doubt whatsoever that the Minister for Economy and the First Minister will utilise every opportunity that there is to ensure that those international interests and UK interests, but in particular the Welsh interests, are at the forefront of any discussions and will use every opportunity to try and bring reason to this situation.
You mentioned the economic impact, and, of course, at a time when there is a cost-of-living crisis, perhaps I could just refer to what the director of the Confederation of British Industry in Northern Ireland has said. If the UK Government doesn't listen to the devolved Governments, then maybe it will listen to the CBI, the voice of business in Northern Ireland, who said that
'Politicians everywhere should be focused on helping the most vulnerable in society amid the worst cost of living crisis in decades.
'With firms already reeling from the rising cost of doing business, the last thing they want is further uncertainty in trading arrangements amid global supply chain challenges.'
Diolch, Dirprwy Lywydd. Today is International Museum Day. First celebrated in 1977, last year over 37,000 museums in over 150 countries took part. The day aims to raise awareness of museums as arenas for cultural exchange, where we enrich our understanding of ourselves and others. This year's theme, the power of museums, taps into this transformative potential. It explores how museums benefit their communities by disseminating ideas around sustainability and the social economy; innovating and improving digitalisation to expand access; and, community building through a democratic, social fabric that provides lifelong learning opportunities. Truly, museums can be powerful tools of social change.
National museums in Wales remain free to enter. This is really important, ensuring that all can engage with our shared heritage. Pre pandemic, 1.8 million visits were made annually under this scheme. Today's announcement from the Deputy Minister for culture shows Welsh Government's continued commitment to invest in our museums. I welcome the pledges in the programme for government to support museums and also to ensure that other stories, such as the experiences of BAME people in Wales, are told.
To close, I want to mention Cynon Valley Museum. This is a real gem, well worth a visit at its site in front of the remains of the historic Gadlys ironwork furnaces. Thanks to the staff and volunteers at the museum for their work, not just on International Museum Day, but all year round.
This week is Dementia Action Week. I wanted to put on record my thanks to those communities and services for the work they do to support individuals and families living with dementia, particularly those in my own region of Mid and West Wales. We have Brecon dementia-friendly family community, who won an award for their work in 2016; Llanelli market was the first dementia-friendly market in Wales; the Alzheimer's Society runs services in Pembrokeshire; Age Cymru Dyfed's support services; Dementia Matters in Powys; and, Crickhowell, a dementia-friendly town. There are so many of them around not just my region, but many others as well. The theme of this year's campaign is early diagnosis. Only 53 per cent of people living with dementia in Wales have a diagnosis, meaning that many go without the support they need to live with dignity.
I have my own personal experiences. My dad had Alzheimer's and my mum had dementia. Once they had been diagnosed, of course we got the services they needed, but before that we struggled as a family, particularly with the shame and stigma. So, I want to take the opportunity to ask the Senedd to put on record our thanks to all the volunteers, carers, and services that raised awareness of dementia to aid early diagnosis and improve the quality of life for those people affected by dementia. Diolch yn fawr iawn.
This week is Wales Tourism Week, and Wales Tourism Week 2022 is an opportunity for businesses and communities across Wales to raise awareness of the sector and showcase the quality of Wales's tourism offer to both UK and international tourists. Visitors spend over £6 billion a year, and tourism in Wales is responsible for the employment of nearly 10 per cent of the Welsh workforce. And to mark Wales Tourism Week 2022, the Wales Tourism Alliance theme supports the tourism and hospitality skills and recruitment campaign, 'the Experience makers'. And in partnership with the industry-led Wales tourism and skills partnership, in 2021 Visit Wales launched 'the Experience makers', which is a skills and recruitment campaign to support the sector by raising awareness of the high numbers of vacancies and of the variety of career opportunities available. The campaign targets young people, school leavers, students, those unsure about their future career, or young adults who might be looking for flexible working around, for example, childcare, and other older adults looking for part-time work or even a career change. The message of the campaign this year is to join the experience makers. So, wherever your tourism business is in Wales, I know that this Senedd will want to thank you for all of your continued efforts in showcasing Wales on a local, national and international level.
The next item is the debate on the Climate Change, Environment, and Infrastructure Committee report, which is the report on the Welsh Government's marine policies, and I call on the Chair of the committee to move the motion. Llyr Gruffydd.
Notes the Climate Change, Environment, and Infrastructure Committee report: ‘Report on the Welsh Government’s marine policies’ laid on 22 February 2022.
Thank you very much, Deputy Presiding Officer, and thank you for the opportunity to discuss the content of the Climate Change, Environment, and Infrastructure Committee's report on the marine policies of the Welsh Government, because, early in this Senedd term, the committee agreed that marine policies should be a priority area for us in our work over the next few years. The intention was that this short inquiry would be an initial look, a snapshot of the current situation in terms of the marine policies we have in Wales. And even though we didn't have much time to take this initial snapshot, we did succeed in covering a lot of ground. The committee, of course, is grateful to all stakeholders who contributed to our work, and to RSPB Cymru and the Marine Conservation Society in particular for also providing the committee with further information in advance of this debate this afternoon.
Now, the Welsh coastline, of course, is over 2,000 km in length, and much of it is the envy of the world. It provides huge marine energy opportunities—enough to help reach our decarbonisation targets—and this in turn can lead to jobs, economic growth and the regeneration of our coastal communities—some of those communities, of course, that need our support as things stand today.
And our marine environment is also home to some of the most biologically diverse and important habitats and species that we have in Europe, and that is also something to be appreciated and to protect at the same time. The key theme of our report, of course, was the balance between these two priorities. We welcome proposals to ramp up marine energy development over the next decade, but we must strike the right balance between those developments and the element of conservation and protecting what we have in terms of marine ecosystems and biodiversity.
Our report starts by focusing on marine planning. Now, currently, in Wales, we have a national marine plan, and environmental non-governmental organisations told us that one of the main drawbacks of the plan is that it isn't a spatial one. And because of this, it doesn't set out, for example, where developments should be sited or how many developments would be sustainable. It doesn't allow us to consider the cumulative effect of developments on the marine environment.
Stakeholders from the renewables sector firmly believed that the next decade must be focused on delivery of renewable energy developments, rather than redesigning strategies. They were worried that a new approach or policy would risk further delay. Having considered both arguments and these perspectives, the committee concluded that the best solution in the first place would be for the Welsh Government to commission an external review of the Wales national marine plan. Now is the time to consider whether the current plans and strategies in place currently will continue to be fit for purpose in the light of the expected increase in marine developments.
Even though the Minister has accepted the recommendation in principle—and I have a problem sometimes in accepting things in principle, as I don't always understand what that means—I am disappointed that her response shows that the external analysis won’t be commissioned in time for this year’s review, but for the next review, which isn't being undertaken until 2025, of course. Minister, this is a missed opportunity and means that any necessary changes won't be seen for many years to come.
A second focus for the committee was the progress of the marine renewable energy sector. I should say here that we welcome the efforts of Ministers, through the deep dive into renewable energy, to remove some of the barriers to development. Members will have heard the Minister for Economy’s statement yesterday on progress in this area, and there is much to be welcomed, but the Minister’s comments would have done little to reassure some of the contributors to our committee work. Members will have heard the Minister for Economy saying that he expects offshore wind generation to increase from current levels of 726 MW to 2.8 GW by 2030, and a potential 6.8 GW by 2035. That is a significant increase in little more than a decade from now.
It's no wonder, in that context, that stakeholders again questioned how fit for purpose existing Welsh Government plans are. The marine energy plan was published back in 2016. It does not explain the Welsh Government’s ambitions for marine energy over the short and longer term. So, we think this needs to be looked at again. We need a route map for where we are going, and this would then provide certainty for developers and build confidence in the sector's long-term potential. Again, the Minister has agreed in principle to review the marine energy plan, but there’s no hint of a timetable for that work. [Interruption.] Of course, yes.
Thank you, Llyr, for giving way on that, and for the way you've introduced this debate today. Would you recognise that some of those organisations, like WWF, the Marine Conservation Society, the RSPB, the Wildlife Trusts and others, do actually get the need to drive forward on renewables, but they want to make sure that we protect some of those valuable species, including migratory birds and wildlife, but also cetaceans? We just need to get this right, and data and evidence are key.
That leads seamlessly on to the next part of my contribution. You are right; it isn't a binary choice of one or the other, but it's making sure that we have the frameworks and the strategies and the policies in place to make sure that these developments, which all of us, frankly, want to happen, and indeed need to happen in terms of the challenges that we face in relation to climate change, are done on the right terms, and within the right parameters.
You mentioned data and evidence gaps, and that was the third area covered in our work. Marine plans and strategies are only as good as the data that underpins them. We all know that. The lack of a robust evidence base to underpin those development decisions means, actually, that there are inherent risks in ramping up the development that many of us want to see. We recommended that the Welsh marine evidence strategy should be reviewed and updated in light of the deep dive, which committed to identifying priority marine evidence gaps and identifying mechanisms to fill them. So, we were surprised to read the Minister’s response to our recommendation, which says, and I quote, that
'Officials are content that the overarching strategic evidence priorities still represent the high-level evidence needs including those identified by the deep dive.'
So, apparently everything is okay, there’s nothing to worry about. Minister, the lack of evidence, as we've heard, is a real problem. Everybody told us that as part of the inquiry. And if the strategy is right, then something else isn't working, clearly, so maybe you can tell us what it is and what, more importantly, you’re going to do about it. And you are nodding, so I'm looking forward to your contribution. I always look forward to your contribution, but particularly now.
On marine protected areas, I am pleased that the Minister has accepted our recommendations, but delve a little deeper and there are still some areas of concern here. Recommendation 16 called for the Welsh Government to set out its latest plans for the designation of highly protected marine areas. The Minister says that the Welsh Government will look at this after the MPA network completion programme. But, the truth is that the consultation on that programme isn't due to take place until 2023. So, again, we may be looking at years of delay here. Where is the urgency?
The Minister's response to the committee's report does seem to raise more questions than answers. Anyone reading it would rightly feel that there are no problems in this policy area, no weaknesses that need to be strengthened, and no need for urgency. They might even think that the Minister is trying to kick these issues into the long sea grass. Take another example. We asked the Minister for a timeline for a consultation on the future of bottom trawling and dredging in marine protected areas. I know this is something that many Members have raised here in the Chamber in the past, and I know the Petitions Committee as well has considered this. The Welsh Government has yet to consult on the management of towed gear, including bottom trawling, within marine protected areas. In contrast, of course, the UK administrations have progressed to the introduction of management measures for all fisheries gears in marine protected areas. In her response, the Minister tells us that, and I quote again,
It's a pleasure to follow Llyr, our Chair on this committee, and to say a few words. I'll try not to replicate what he said, but I want to touch on a few points, including in the Welsh Government's response as well, before I come to what I think is the critical issue of data and evidence, which I'm going to major on, if that's okay.
First of all, in terms of recommendation 1, that an external analysis of the Wales national marine plan should be commissioned, we note that there's an agreement in principle there, but it is to inform the next statutory report. I think the committee would feel strongly that we'd like to see it earlier than that because of the urgency that the Chair has laid out so much. So, we would still, I think, push hard on that and I'm sure we'll return to it.
On the stakeholder engagement in recommendation 2, just to say to the Minister that it isn't that there aren't the structures in place to do the stakeholder engagement, it's actually the quality of the stakeholder engagement. The feeling from some—and I will confess and admit that it's from some particularly in the environmental sector—is that whilst they're engaged, and they stretch themselves to engage on the various stakeholder groups, they're not clear that they're being listened to in the way that we face the nature crisis and the biodiversity crisis. The baseline that they want to start from is not the baseline, always, that Government wants to start from. They want to see a picture of the sea bed and the flora and fauna as it should be, not as it is now, and so on. So, it would simply be an encouragement, on recommendation 2, Minister, to see that recommendation in the way that the subtext behind it is that it's the quality of the engagement and the listening. You do an enormous amount of stakeholder engagement, but it's actually the engagement and the detail to follow through as well. So, take that in the spirit it's meant. And I know I'm the worst nightmare of any Minister sitting in that position—[Interruption.] I know I am; thank you for a 'yes' there. As a former fisheries and marine Minister myself, I am the worst nightmare.
On recommendation 4, setting out the plans for the devolution of the management of the Crown Estate, I'm just wondering, Minister, if we have a contradiction, because you have accepted that, and that's wonderful, it really is wonderful, but then it talks about
'looking at the implications of devolution.... Once this task has been completed we will be able to finalise our plans for the Crown Estate.'
You've accepted the recommendation about the devolution of the management, setting out the plans, and so on. I guess you can't go any further yet, but it would be interesting if you could get on your feet today and say, 'Well, actually, it makes sense now to just move ahead with this and move to the devolution of it.' I'm not underplaying, by the way, the role that they have and the work that they are currently doing, but it would be interesting to have some of the levers of control here.
I'm pleased that the report has been tabled for debate today. Fifteen of the recommendations have been accepted, and five accepted in principle. That does sound good, but I'm afraid the marine sector could be described as being let down when considering the detail.
In response to recommendation 1, the Welsh Government has committed to report on the effectiveness of the Welsh national marine plan. However, the Marine Conservation Society are very correct in highlighting that you should confirm that the review will consider the need for a statutory spatial and holistic marine development plan. I think the Minister and the Senedd have heard me mention this a few times. What I'm very concerned about—and I think it's something that my colleague Huw Irranca has mentioned—is that we need progressive renewable energy, but we've got to look after our ecological systems as well. I am very worried about this ad hoc approach—that developers come in and they seem to identify where they want to develop, but how does that then sit within an overall plan, a strategic plan?
You've heard me speak about the need for a Welsh marine development plan on a number of occasions. Nonetheless, it is what we need. For example, RSPB Cymru highlighted a lack of a spatial component or development control policies, which means the existing plan does not embed strategic forward planning or seek to proactively address conflict, and that can then cause delays to schemes. So, I would be pleased if the Minister could explain why she's willing for her Deputy Minister to pursue strategic resource areas, but isn't prepared to create a detailed marine development plan.
Similarly, we need greater ambition on the measures being taken to protect the marine environment. Already, you have acknowledged that there are evidence gaps in relation to interaction between the technology and the environment. This is despite the Welsh national marine plan encouraging the sharing of evidence. As the committee said in our report on the Welsh Government's draft budget 2022-23, the lack of a robust evidence base to underpin development decisions means that there are inherent risks in ramping up this marine development.
Emily Williams of Wales Environment Link advises that developers collect huge amounts of marine data when they are developing projects, but that a lot of those are then often cited as being commercially sensitive. So, I hope, Minister, that you will agree with me that we do need to reach a point where marine development licences require pre and post-construction monitoring and information sharing, so that developers do make a greater contribution to the evidence base that underpins marine planning.
I was surprised recently to learn that the Gwynt y Môr scheme, and this came from our local fishermen, actually—. Thirteen species of fish disappeared, and there are five species of fish that have never returned, and that was years ago. So, we need to see progress with the designation of future MPAs too. Successive Welsh Governments have delayed on this, despite it being a tool to address the dual threats of the climate and nature crises. In fact, there is no doubt that the Welsh Government consultation in 2012 was a disaster. Clare Trotman referred to it—and Clare did work for the Marine Conservation Society—as failing. Sue Burton called it woefully inadequate, and Dr Richard Unsworth advised that the consultation had failed to look at the experience of successful marine parks and marine protected areas anywhere else around the world. So, while you have confirmed, in response to recommendation 16, that you aim to assess the MPA network, it would be helpful if you could provide a target date for the completion of this work.
I'm really pleased to speak in this debate today, and I thank Llyr for his expert chairing, and my fellow committee members for bringing forward the report and the recommendations. There's a lot to unpack, but the clear message we received was about the need for the national marine plan to consider the cumulative impacts of developments. I think that the economy Minister's statement yesterday on offshore marine energy underlined how the Welsh Government is determined that economic benefits and renewable energy benefits should deliver environmental benefits too. So, I trust that that approach will guide the forthcoming review of the Welsh national marine plan.
I was part of the predecessor committee that looked into the management of marine protected areas in the previous Senedd. Five years on from that initial inquiry, our recommendation regarding the identification and designation of marine conservation zones remain broadly unaddressed—which the Welsh Government has acknowledged. So, I look forward to receiving updates on the next phase of the work in the coming months. But I would welcome some clarity on what a marine conservation zone is. What happens within it? What can't possibly happen within it? There seems to be a lot of conflicting messages on that front. One of them, clearly, going forward, is going to be the licensing of renewable energy. So, we really need some clarity there.
I want to turn to blue carbon. I wouldn't miss an opportunity, of course, to talk about blue carbon. Our sea grass, saltmarsh and seaweed habitats, and all the carbon that is stored and absorbed by the Welsh marine environment is far more than that which is stored in our woodlands or on land. And there was a distressing story, wasn't there, about Bangor University laying sea grass and then someone coming along and destroying it in a very short time. So, maybe that fits with my earlier question about what is a marine protected zone.
I'm very pleased that the Welsh Government has accepted the recommendation to explore how our blue carbon habitats can be maintained and enhanced. The Minister cites the nature networks programme as a mechanism through which to do that, so it would be very useful to have an update on that programme soon. I'm also looking forward to an update on the shared blue carbon evidence plan, and I understand that's currently under development.
Finally, we did ask the Government to set out the purpose and timeline for the public consultation on dredging and bottom trawling in Welsh MPAs. I note the Petitions Committee recently considered a plea to 'Stop bulldozing our seas!' and I certainly sympathise with the petitioner's view. The Minister has accepted the recommendation, which is good news, but the timescales seem to be just a little bit hazy. Again, I should say that I've sat on previous Senedd committees that urged progress on this matter. I recall a draft consultation on towed gear in 2018. But to me there is something fundamentally wrong with being able to drag anything along the sea bed, taking out everything that exists there. And I'm sure, if this happened on land, if we went along just bulldozing the land and everybody could see it, there would be uproar, and I'm just concerned that people aren't at all in any way understanding what sea dredging really means and the damage that it does. So, I'd be grateful for a specific commitment and timeline on that. Thank you.
I welcome the report from the committee and thank them for all their work, and important work it is, as we move forward, because due to Wales's predominantly coastal geography, the marine sector is a huge contributor to the Welsh economy. Marine policy has a direct impact on people's livelihoods as well as on wildlife and ecosystems—many, often conflicting, demands on Wales's seas and coasts. The marine environment is used to secure clean renewable energy, sustainable food and for recreational purposes, as well as being crucial to Wales's biodiversity. For this reason, it is essential that the Welsh Government prioritises marine policy and gets the policy right, as well as ensures that it is protected and the biodiversity of our seas is protected.
Renewable energy is vital, and a growing sector, and is key in delivering on our commitment to addressing the climate and nature emergencies. However, it presents both opportunities and risks when not planned for comprehensively. Potential impacts to marine animals from marine developments include wildlife collision, disturbance, marine noise, habitat loss and loss of access to preferred feeding grounds. Any decisions on renewable development in Welsh seas should recognise that we are in a marine nature crisis and that marine wildlife has for too long been out of sight and out of mind.
In my view, and in the view of many others, up until now the Welsh Government has sadly failed to deliver upon its legal duty to achieve good environment status of marine habitats and species. Marine biodiversity continues to decline, and many marine protected areas are in unfavourable conditions. Admittedly, and to be fair, this is true of governments across the globe, but it is a particular sticking point for us Members who are species champions for marine wildlife—I, myself, being the species champion for the basking shark. It does boil down to this, in my view: the marine renewable sector is currently being driven by unencumbered market forces, resulting in incremental applications. As Welsh seas become more crowded, the marine planning system must operate at a strategic level to guide the siting of developments away from the most ecologically sensitive areas, as well as minimise the cumulative impacts on vulnerable habitats and species, and provide greater certainty to developers in the long term.
I welcome the recommendations made by the committee and I'd like to also echo as well some of the Marine Conservation Society's additional recommendations. Those include the Welsh national marine plan review, considering the need for a statutory marine development plan to complement the existing efforts the Welsh Government is taking to implement a more holistic approach. Furthermore, the deep dive must take into consideration the impacts of human activities on the marine environment and consider the interactions between all elements of the Welsh Government's marine work programme, for example fishing and marine planning, and not report on these elements in isolation. And finally, we need the Welsh Government to deliver a marine protected areas strategy that should include clear management actions for the existing network and, where feasible, any sites considered in the forthcoming MCZ process.
Diolch, Dirprwy Lywydd. I'd just also like to add my voice to thanking members of the committee and particularly the Chair for the review and the recent focus on the marine environment, absolutely recognising the vital role it plays in tackling both the climate and the nature emergencies. And just to say, Llyr, I think you did an amazing job of getting through what you got through in a short amount of time, and it's been really valuable to us that the committee does that work for us. They can collect a lot of evidence that will help inform our process. So, I'm genuinely really grateful for the work of the committee.
To state the sort of blindingly obvious, our seas are a priceless natural asset, and I absolutely am fully committed to seas that are clean, safe, productive and biologically diverse for future generations to enjoy. As all Members have pointed out, resilient seas play a vital role in addressing the climate change and nature emergencies, and I very much welcome this report and the debate we're having today.
Despite Llyr's evident disappointment, the Welsh Government's written response was absolutely trying to reflect the positive spirit in which we received the report, and our commitment in continuing to develop our marine policies and strengthen our approach. The committee highlighted the growing potential for marine renewable energy in particular, and many Members have highlighted it, and I absolutely agree that it's very important to get that sweet spot of balance between development and conservation and to ensure that all the developments in the sea are fit for purpose and enhance, where at all possible, both biodiversity and the environment that they find themselves within. So, I absolutely—[Interruption.]—certainly, Huw.
Could I genuinely on a note of optimism say we are a world away from where we were 12 or 15 years ago? We actually have in place now all the things that are referred to in this report that the Welsh Government is working on—the marine planning, the ambition to deliver marine conservation zones, to have that balance rightly done to develop the evidence et cetera. So, there's a note of optimism there, but would she agree with me that, actually, this is the moment, when faced with both the cost-of-living crisis with runaway prices where we need to deal with renewables, and also a biodiversity crisis and a climate crisis—this is the moment where Wales could actually be the leader, take all those things we've had in place for a decade, and actually really bed them down, and show the UK, actually, what we can do here in Wales?
I'm never going to avoid the opportunity to do that, Huw, so I very much hope we will be able to do that.
Just to digress from my script just for a moment, I was giving evidence to the Welsh Affairs Committee this morning about the grid and the energy network for Wales, and one of the real frustrations for us is not to have all the levers that we need. So, encouraging the UK Government to work with our distribution network operators, in particular the transmission operators for energy, to translate the jargon, to make sure that the onshoring of energy in the Celtic sea, for example, comes onshore in the right way, enhances our coastal communities and then helps us with our energy network through Wales. It will be absolutely pivotal to that, so we're working closely with the UK Government and with the Crown Estate.
I was making again the point this morning about the need for devolution of the Crown Estate in order to get the levers in place for us to be able to make sure that we have that balance between the planning. So, the committee asked me this morning if it was about the revenue, and I said, 'Well, of course the revenue would be lovely', but actually it's much more about having control of the planning levers to make sure that we can get the rounds of leasing and licensing quite right for Wales in exactly the right place, in exactly the right way. So, I think that's an important intervention, Huw, which allowed me to make that point.
Coming back to my script, we do actually have, of course, as everyone has acknowledged, the Wales national marine plan, and it is the first time—I introduced it in 2019—that we've had that strategic policy framework to guide the sustainable management of our seas. I agree with everyone who's set out the need for a spatial plan for Wales for the seas. Everyone will know that I'm very keen on spatial planning for land, and the sea is no exception. The fact that we can't see what's going on underneath it makes it all the more important that we have that kind of strategic plan.
So, the plan sets a framework for development that respects the environment and already established activity and it sets an agenda to secure lasting benefit from the opportunities. Our focus is on implementing the plan and, later this year, I will lay the first three-year annual report on the performance of the plan. To ensure a range of voices are heard, we are currently undertaking a stakeholder survey to inform the report that reports on the plan for that first three years. It's obviously been a very odd three years, with the pandemic and everything else, so I hope we'll be able to build on that.
Taking that spatial approach to marine planning, including identification of strategic resource areas, will help guide the right development to the right place, supporting our ambition for a thriving marine biodiversity alongside those renewables. And as everyone has said, the urgency of addressing climate change is clear; nobody is arguing with that. The deep dive into renewable energy reaffirmed our commitment to developing sustainable renewable marine energy.
Thank you for giving way. Really, really quickly—it's a proper debate here—just two things: one is, in taking stakeholders with you, don't be afraid of actually being radical as well. The Lyme Bay issue is quite an instructive one. It was totally contested, but it led to massive replenishment of nature, and the fishermen now like it because of what it's done. So, please don't be afraid of doing that in taking stakeholders along.
I'm not renowned for being afraid of that kind of thing, Huw.[Laughter.] So, I don't think I'll start any time soon.
By 'taking them with us', I mean making sure that everyone fully understands the implications of what we're proposing and doesn't regard them as a negative to be fought, but actually as something to get on board with to enhance their own particular economic status and actually their own particular need to have the seas and their coastal communities be the way we'd all like them to be. So, I'm sure we can get those stakeholders on board. It's not just fishermen either; it’s a lot of other people that we need to talk to. Lots of fisherfolk have a full appreciation of this.
And then, just to accelerate, as the Deputy Llywydd is going to cut me off in my prime otherwise, events in Ukraine have clearly reinforced the need for a resilient energy supply, and green energy is clearly a hugely important part of that. I was delighted that the committee recognised our efforts in addressing the barriers to that development.
We’re also commissioning an independent review of the marine licensing process, as part of the deep dive follow-up, to improve the customer experience, ensuring works progress as effectively as they can, that it's agile for future demand. The review is under way. Part of that review is to make sure that, in deploying marine energy, we actually get cameras and so on out there to get the data that we need live on the ground so that we can continue to replenish our data source, rather than waiting until we've got it until we can do anything. So, I’m really keen to do that; happy to update Members as that goes ahead.
The next revision of the marine evidence strategy will set out how we can work even closer with the industry to make those kinds of provisions very much part of the licensing regime and make sure that the existing evidence is improved through data sharing. Huw Irranca and a number of other Members highlighted the need for that kind of data sharing all the way through. That robust evidence is critical to our planned strategies and policy decisions and I absolutely accept that action is needed to improve that evidence base. Just to be really clear, Llyr, we absolutely do accept that. We’re not complacent in any way. We’re working with a range of partners to identify and fill the evidence gaps that we know exist.
We have marine protected areas—139 of them; 50 per cent of all Welsh waters—long-term frameworks in place. The UK marine strategy and nature networks programme are important tools for understanding this as well. But, as Joyce Watson and others highlighted: what does that mean? The deep dive will be looking at that with me: what does it mean, a 'marine protected area'? What can you do and not do?
I know; that's fine. I'm now gabbling, but I'll just turn to that last bit, which is, as Joyce Watson highlighted, the blue carbon piece. That's a hugely important role in our journey to net zero. We recognise the need to protect and restore sea grass, salt marsh restorations and habitats. The biodiversity deep dive specifically has a Professor from Swansea University on sea grass on it for that reason, and we're accelerating that all the way through.
So, finishing up, Deputy Presiding Officer—and thank you for your patience—I really welcome the committee's report. I assure you we are not dragging our feet, we are going as fast as humanly possible, and I very much welcome the recommendations, which we will look forward to reporting back with you on as we implement them.
Thank you very much, Deputy Presiding Officer. I won't repeat the points that have been made, just thank the Minister and everybody else for their contributions. I think the nature of the discussion reflects how broad are the areas that this short inquiry tried to address and, clearly, how broad is the work that needs to be done by us as a committee, and the Government, of course, in that context.
Just a few points, perhaps, that were raised and that I didn't touch on in my introduction. Clearly, the Crown Estate is key. There is a completely central role there, and I'm pleased to see that the Government now is on the same page as a number of us when it comes to devolving some of those powers. I know that the majority view, perhaps, in the committee would be that, but certainly it's an opportunity for us to see a real difference. And I look forward to welcoming the new chief executive of the Crown Estate here to the Senedd next week, and hopefully it'll be an opportunity to develop some of the points and these discussions.
On bottom trawling, again, a number of Members raised that, and I think it is something that we've been grappling with for a long, long time, and we would all wish to be further ahead than we are at the moment. I'm glad to hear that the Minister's pledging to change gear on towed gear and bottom trawling, so let's move as swiftly as we can on that. Joyce Watson is absolutely right: five years on from our predecessor committee report on marine policies, nothing's changed, frankly, or at least we're still waiting for the recommendations to really be addressed.
The blue carbon agenda is a huge agenda, significant in locking in carbon—more so than terrestrial carbon stores. There are many fledgling schemes around Wales that I think deserve our support, and certainly deserve greater attention from us as a committee, and I hope that that is one of the areas that we will choose to pursue in detail.
Species champions were always going to come up, I thought, in this debate. And just to let you know, I'm at the—. Am I at the top or the bottom of your food chain? I can never remember. But, you know, without the sand eel, there wouldn't be basking sharks, okay. So, just keep that in mind. [Interruption.] Oh, yes. Well, the oyster is the Minister's. There we are. Okay.
And I think the point on spatial planning is important—terrestrial spatial planning, and then we have marine spatial planning. Well, surely there shouldn't be a disconnect either. We need that seamless spatial planning for terrestrial and marine, as far as I'm concerned. Using the work that we're now seeing accelerate in terms of developing renewable energy to enrich our data, to fill some of those evidence gaps, I think, is absolutely something that needs to happen.
So, this report, as I said, is very much a starter for 10. It's a snapshot of where we are. It's a snapshot of, I think, what we all know needs doing, but, if I was to simplistically sum up our message to Government, really it's, 'Get on with it.'
1. Regrets the lack of mention of women’s health—including maternity provision—in the Welsh Government’s existing long-term plan for health and social services, ‘A Healthier Wales’, despite the stated aim of becoming a 'feminist government'.
2. Notes that health conditions which solely affect women and those assigned female at birth, such as endometriosis, menopause, and diseases which disproportionately impact females, including auto-immune and cardiovascular diseases, osteoporosis, and dementia, incur a significant cost burden.
3. Notes that the ONS details that women live fewer years in good health than men and are more likely to be in poverty, requiring both social and financial support.
4. Calls on the Welsh Government to:
a) develop a bespoke Women’s Health Strategy for Wales which should focus on life-long women’s health;
b) provide consistent high-quality services, including specialist tertiary care, accessible to residents the length and breadth of Wales;
c) invest in high quality research into women’s health and treatment;
d) invest in enhanced training for healthcare professionals in Wales on women’s health areas.
Diolch, Dirprwy Lywydd. I could open this debate by reeling off the statistics that clearly show the need for action on health inequalities and the reason why we have tabled this motion before Members today, and that the lack of a women's health strategy merits scrutiny and debate, especially given the Government's own stated aim of becoming a feminist Government. But I'll save my own words this afternoon and let others speak for me, because I want to share accounts and experiences of women who will put the case for our motion powerfully and overwhelmingly. In fact, giving them the platform of this Senedd Chamber, ensuring that we all hear their voices this afternoon, is vital. Because the sad truth is that the stigmatisation of women's health conditions such as endometriosis, menopause, polycystic ovary syndrome, premenstrual dysphoric disorder and others restrict conversation and isolate women when, in fact, they're experiences that should unite us and spur us into action. These voices are not heard, nor their pleas for more support, for the attention they deserve, for better treatment, because, historically, with limited investment in research into women's health in general, there's been so little research into conditions such as endometriosis that we don't even know what causes it. And without knowing the cause, a cure cannot, of course, be found.
Kate Laska from Gwynedd suffers from endometriosis. She had to travel outside of Wales to get specialist help and pay privately for treatment, after waiting years to get a diagnosis and even longer to get treatment. And she's still in chronic pain now. These are her words:
'Imagine that, for years, you live in a lot of physical pain. You try to get help but you are told that the pain you are feeling is normal. In the meantime, you lose your job, your income and your partner. After changing my doctor, I finally had my diagnosis, but I had no idea that, for the next seven years, I would spend fighting for my right to treatment. Due to very often suboptimal care and a lack of awareness amongst the healthcare workers as well as society, including myself, endometriosis in my case progressed to stage 4 and required numerous complex surgeries. Now imagine you do not find much support around you in times when you mostly need it, because there is a belief in society that women are destined to experience pain. Women with endometriosis suffer in silence and very often alone, because no-one around them can imagine their pain. There is only one specialist clinic in Cardiff where women like myself can hope for relief. However, this clinic is currently overwhelmed with patients. Time is crucial with this chronic condition. This is why there is an urgent need for a local service based in north Wales.'
The lack of investment in treatment for women's health conditions like endometriosis has resulted in cross-border agreements for treatment—for example, women like Kate, who live in north Wales, attend the endometriosis specialist centre in Liverpool. But this does not always happen. One of my own constituents, Becci Smart, has been living with PMDD, premenstrual dysphoric disorder, since the age of 14, but wasn't diagnosed with the condition until age 30. PMDD is a very severe form of premenstrual syndrome, which can cause a range of emotional and physical symptoms every month during the week or two before your period. In her own experience, and from the experiences of others she has spoken to with PMDD, she says that there is a severe lack of mental health support available and a lack of understanding of the condition among GPs. Indeed, she says that sufferers of PMDD are being turned away from mental health services, as they are incorrectly told that it's a purely gynaecological condition, rather than a mental health one. It is, of course, both these things. They are told instead to see their GPs, who are not experts on mental health, every time PMDD severely affects their mental health, which is a week or two every month.
1. Acknowledges that women’s health is not specifically mentioned in the Welsh Government’s existing long-term plan for health and social services, ‘A Healthier Wales’, as this is a high-level strategy setting out the framework and key principles for ensuring person-centred care for everyone in Wales and, as such, does not focus on particular groups or conditions.
2. Notes that health conditions which solely affect women and those assigned female at birth, such as endometriosis, menopause, and diseases which disproportionately impact females, including auto-immune and cardiovascular diseases, osteoporosis, and dementia, incur a significant cost burden.
3. Notes that the ONS details that women live fewer years in good health than men and are more likely to be in poverty, requiring both social and financial support.
4. Notes that the Welsh Government have committed to publish a Quality Statement and NHS plan in the summer with a focus on providing consistent high-quality services across all areas of women’s health.
Can I thank Plaid for tabling this important debate today? When the health committee formed last year, as lots of committees do, it sent out a consultation to relevant stakeholders, and that was one overwhelming response that came back, the need to focus on women's health issues, and, as a result, all committee members agreed that this would be a priority for the health committee in this Senedd. So, can I thank Plaid Cymru for bringing forward the debate? And we will be supporting, as Welsh Conservatives, the Plaid motion as it's laid today as well.
As part of our work as a committee, we asked the Women's Health Wales Coalition to come and speak to us, to give us their perspectives in a public evidence session back in March, so I'm going to outline some of the issues that they raised. And from that, we also took up some of the issues with the Minister, but the evidence that we took on that day will help us to undertake some of our other work as well, across the rest of this term. What the coalition did tell us is that women are more likely to experience poorer health than men, and often symptoms go misdiagnosed or untreated. They said that women experience delays in diagnosis and care as well.
A report published back in December 2019 told all four UK nations that we need a women's healthcare plan, and in Scotland, in fact, they're leading the way, in fairness to Scotland. Their plan came forward in August 2021. The UK Government for England, their plan is currently out for consultation, so, of course, we're concerned that Wales is not left behind in this regard.
One of the issues that the coalition raised with us is the lack of data. One possible reason for this could be the under-representation of women on trials, often an issue that will lead to that lack of information, that lack of data.
Access to specialist services was another issue raised with us. The existing models of healthcare provision in Wales have historically not worked for women because they're being centred or not tailored to specific needs—an issue that the coalition specifically raised with us. Those requiring different specialists that they can find are not adequately being joined up, and the lack of collaboration as well between health boards in developing specialist services and making them universally available.
Information and communication is another issue that was raised strongly with us, as well. Of course, the example there was the recent miscommunication about the cervical screening programme. That's highlighted the importance of clear and accurate communications.
Mental health was, of course, another issue raised with us as a committee by the coalition. A report by the UK women's mental health taskforce found that women are more likely to experience common mental health conditions such as anxiety and depression than men, and they say that this, especially in young women, particularly in younger groups of women, is mainly because their anxiety builds up about their conditions not being identified correctly.
I'll focus my remarks on something that Sioned Williams has mentioned: the normalisation of pain for women in medical procedures and the ways in which girls and women are brought up to expect and tolerate discomfort as part of their daily lives. Perhaps most worryingly, when women complain about experiencing pain, as we've heard, there's ample research to suggest that they are routinely ignored or not taken as seriously as men in medical settings. In January, the cross-party group on women's health held a discussion about pain experienced in gynaecological out-patient settings, and, Llywydd, we heard truly harrowing stories about how some women feel they can't complain when they're in pain. We heard about a resistance amongst some practitioners to introducing more widespread pain relief and about a disconnect between patients and clinicians in terms of how they estimate pain.
On this question in terms of how we estimate pain, the disconnect seems to come about because women and girls are very often told that a level of discomfort will be something like period pain, and there's a significant problem here because period pain will be drastically different for different individuals, and the assumption that period pain will be a constant will mean that some clinicians either give patients an unrealistically low expectation about the kind of pain they should expect or they don't understand how some women's bodies work. And why should women be expected as a matter of course to tolerate pain similar to period pain? Why should there be an assumption that women's tolerance for pain will be higher because of childbirth? Why should that be normal?
Our motion talks about the cost of women's health. The monetary cost is well rehearsed: sanitary products that until relatively awfully recently were taxed as luxuries; over-the-counter pain medication. But, again, what about mental health? It's been mentioned already, the mental health impact of a failure to acknowledge women's health issues, the cost to society and the economy of sustaining a taboo, a veil of shame when it comes to talking about some conditions. How many women feel that they can't tell their employer that they can't go into work because their period pains are debilitating? How many women suffer in silence or can't tell their colleagues that they've had a miscarriage and that they need time off to get over it? How many women are summoned by HR to explain why their sickness record is so long, when, in fact, they're going through the menopause? Society both normalises women's pain and expects us to shut it away, not to mention it, not to consider it as appropriate for polite conversation. That is a double injustice, an intensified injury and a wrong that's wrought upon women.
Now, research suggests that women in acute pain go longer without being treated in hospitals than men suffering from similar conditions. They're also, as we've heard, more likely to be misdiagnosed with mental health problems and given anti-anxiety medication rather than having their pain or the cause of that pain treated. The tendency to dismiss women's pain is rooted in a centuries-old bias. The words for hysterectomy and hysteria have the same root, and this medieval notion that women were made mad or unbalanced because of their wombs, that still has aftershocks today—an ancient, outdated prejudice upheld by modern medical practices.
I'm always pleased to take part in any debate about women's health, but I think that the way the motion has been phrased is a little unfortunate because it isn't either timely nor is it strategic in its approach, so it's going to have limited impact. This is because the health Minister has already announced in the Senedd a few weeks ago that she was working on an equality statement on women's health that she was going to deliver before the summer recess, and she's also told us in the Chamber that she's conducting line-by-line scrutiny of health boards' intermediate development plans. I'm confident that she's looking through the lens of women's health as well as the more general efficiency and effectiveness with which they are deploying their obligations towards women.
Having said that, obviously, all the points that have been made by other Members are really important. It's always going to be a good idea to be focusing the lens on women's health, because women have traditionally never had the same care as men. We have to remember that, before the NHS was founded by the post-war Labour Government, women next to never had any healthcare, because they always put their children and their husband, who was then supposedly the main breadwinner, before them in getting paid-for healthcare. So, the beginning of the NHS was a really, really important event in women's lives.
Focusing on 'A Healthier Wales', published in 2021, that didn't quite do it for me either, because you've got a new Senedd, a new health Minister and several really important plans that I feel we really do need to stay focused on. However, having said all that, we clearly need to focus on these issues. It really shouldn't take eight years to correctly diagnose endometriosis. It was a delight to meet Suzy Davies upstairs today—she's here for her work with the tourism board—because she, above all, put this on the agenda. And now, as a result of Suzy's interventions particularly, we have menstrual well-being education for boys and girls in all our schools so that girls are not suffering in silence about something they don't realise is not normal in the way they menstruate. And boys will be able to support girls in that when they're having those intimate conversations about the person they're in a close relationship with.
We do hope that the appointment of specialist endo nurses in each health board will improve the performance of GPs and, more worryingly, some gynaecologists' understanding of the presenting symptoms of endometriosis, because for me it is inexplicable that something that effects one in 10 women—. It's not some rare disease that only a specialist physician understands, this is one in 10 women. How is it possible that gynaecologists can't see endometriosis symptoms when they come through the door? So, there's clearly a lot of work to do for those endo nurses.
Jane Dodds referred to dementia and her personal experience of that earlier this afternoon. We have to remember that dementia, I read, is the biggest killer of women these days, and that's, obviously, something we really do need to reflect on, because some of it will be to do with loneliness, some of it will be to do with the quality of women's food, exercise, and all manner of other things that we really do need to understand, because this is a veritable pandemic.
On telemedical abortions, Wales has led the way in ensuring that what we developed during the pandemic has now become a permanent feature, so that women can get a telemedical abortion without having to leave the house, safely be able to do it in the privacy of their own home, and not delay getting treatment and have to then have a surgical abortion. So, well done the health Minister for having the guts to do that, because the UK Government has certainly sold the pass.
I’m pleased that we’re having this very important discussion today. Although we've had a commitment from the Minister, I think the fact that so many constituents continue to contact us demonstrates the importance of raising awareness with every opportunity that we have with regard to women's health, and the health of those assigned female at birth. I know that plans are afoot in this area, but people are living in pain, and knowing that they perhaps have to suffer that pain for years to come whilst a plan emerges is very difficult, because it has a detrimental impact on your ability to live on a daily basis.
References have been made to endometriosis already, and this is a subject that I raised recently having been contacted by a constituent after she was told by Cwm Taf health board that the vital treatment that she needed, which was supposed to take place before the first lockdown back in 2020, hadn’t just been postponed, but had been cancelled entirely. Since then, she has contacted me again to let me know that she has refused the only option she was given, namely treatment to bring on early menopause, because she also has a bone condition, which could deteriorate severely with menopause medication. Instead of being supportive, the nurse became very angry with her and threatened to release her from the gynaecologist’s care if she wasn’t willing to take the medication, rather than continuing to call for the treatment and surgery that she needs. All this despite the fact that she is in such pain that it is having an impact on her work and personal life. Unfortunately, cases of this kind are far too common, and it isn’t good enough that we expect women to suffer like this.
I would also, in my contribution today, like to focus on pregnancy and the problems that a strategy must tackle. Although pregnancy in the United Kingdom is, on the whole, considered to be safe, women and babies are still dying unnecessarily as a direct result of complications with pregnancy that could be prevented. Every year, around 5,000 babies in the UK are either stillborn or die soon after birth, and 70 mothers die as a result of specific pregnancy-related conditions. We know that black women are four times more likely to die from complications during pregnancy than white women, and Asian women twice as likely. Older mothers, mothers from deprived backgrounds and women of mixed ethnicity are also more likely to die during pregnancy or soon afterwards. Care for women is being seriously hampered by a lack of suitable medications that we know for certain are safe and effective during pregnancy or while breastfeeding. Over the past 40 years, only two new forms of medication have been approved for use during pregnancy.
Another subject that demands attention, and which builds on Jenny Rathbone's point, is the injuries that women suffer during childbirth, which have a detrimental and long-term impact on a person’s ability to work, leave the house and have sexual intercourse, due to bowel incontinence. They also lose touch with their children, and this has a major psychological impact. This issue is rarely discussed. On Monday I was pleased to be able to attend the launch of a pelvic health hub at Barry Hospital. Led by Julie Cornish, this is the only hub in Wales that supports women with injuries of this kind. I spoke to the MASIC charity about this, and I was told that one in 20 women or people who give birth for the first time suffers a serious injury. Whilst praising to the skies the work of this new hub, the charity said how unacceptable it is that there wasn’t a hub of this kind in every health board area, and that the majority of women in Wales cannot access any support with this issue. This cannot go on.
I'm pleased to be speaking in this hugely important debate today. We've heard about the number of diseases that are unique to women and also a whole host of other diseases that disproportionately impact women's health and well-being. One of the key focuses of the Welsh Government's 'A Healthier Wales: our Plan for Health and Social Care' is preventative healthcare, and a number of the diseases that impact women's health are largely preventable or have much better outcomes if they're diagnosed at an early stage.
Cardiovascular disease is an example. Despite cardiovascular disease being the leading cause of death in women, there is often an assumption by some health professionals and the general public that women are at a lower risk of this disease. Whilst this is true to some extent, this difference diminishes with age, particularly over the age of 50, and potentially even earlier in women who experience early menopause. So, here again, the menopause is significant in women's health. That is backed up, of course, by research, and it shows that, when it comes to cardiovascular disease, women are more likely to be diagnosed more slowly or completely misdiagnosed when compared to men. This, of course, can have devastating impacts on the individual's mortality and morbidity. Some of the risk factors associated with cardiovascular disease are preventable, including lifestyle choices, diet, high blood pressure and cholesterol. With that in mind, I believe that health screening can also play an important role in preventing disease in the first place. As I understand it, we were all supposed to, in Wales, receive an annual screening at the age of 50—everybody. And I somehow think that that hasn't happened, first of all because of COVID, but hasn't actually happened after COVID because of the pressures that has brought to bear. That clearly is part of a preventative course of action, and I just hope that we can get that back on track.
Education, of course, is a major factor in helping to prevent disease and diagnose it at an earlier age. How many women, for example, are aware of cardiovascular disease being the biggest threat to their health? I chose this deliberately because I almost anticipated what everybody else would speak about. It's interesting, isn't it, that it isn't one of the things that has been spoken about. I wasn't aware of this until I started looking for those things that people weren't talking about affecting most women. So, I think those messages need to get out. Of course, there are a number of other relevant illnesses, and ovarian cancer is one of those. That has a number of non-specific symptoms, like abdominal bloating, feeling full after eating, changes in urination and bowel habits, extreme fatigue and tiredness, amongst others. But, many of the symptoms are similar to less serious health conditions, like irritable bowel syndrome, and they go unnoticed. So, education is absolutely vital, because we know that ovarian cancer is called the silent killer. And my question is this: why is it called the silent killer? Is it because people don't know about it and don't recognise it, or is it because people aren't talking about it? So, I think we need a real focus on that.
Women's health is something that we all need to understand. There is a duty on us to ensure improved awareness, and that there's better care provision available for the various conditions suffered by women of all ages, very often in silence and without sufficient support, as we heard earlier from Sioned Williams.
In the last few months, a number of constituents have contacted me regarding one specific condition, namely endometriosis. It's a condition that causes chronic pain for one in 10 women in Wales—about 300,000 in total. Although I'm aware that the Government has already announced that every health board will employ specialist nurses to care for women suffering from endometriosis—and I welcome that very much—the health gap in gender terms, however, continues. As we've already heard, in Wales it takes nine years to have a diagnosis of the condition, the longest in the whole of the United Kingdom.
I want to share with you the story of one of my constituents, Emily from Carmarthenshire. She is now 23 years old, but Emily knew things weren't quite right when she started having her periods at the age of 12. Every month, she had unbearable pain. However, for years, her doctor didn't believe the severity of her condition. It was only after Emily collapsed and was rushed to hospital with sepsis in August 2019 that her condition was taken seriously.
Emily has written in harrowing terms the experience she has endured in a recent edition of Glamour magazine, and I quote: 'Doctors told me I was trying to find answers that weren't there, that I was being dramatic, that they were more concerned about my mental health; basically, it was all in my head. I was prescribed antidepressants, which, of course, I knew I didn't need. I had more mental health referrals than I had scans on my ovaries.'
When she was eventually admitted to hospital, a 25 cm cyst was found on her ovaries, and a diagnosis of stage 4 endometriosis—the most advanced stage of all. Emily also suffers from adenomyosis, a condition that goes hand in hand with severe endometriosis, and can cause the womb to swell to three times its normal size.
Emily has proven how inadequate the care available is for young women suffering from this condition through the years she took to get a diagnosis on the NHS. After further pain and severe discomfort, she eventually had to pay for private care across the border in England. This is a sad indictment of the way we support women's health in Wales, in particular the treatment of this debilitating condition. In the three years since the initial diagnosis, she has received several surgeries to alleviate her symptoms, and is now experiencing chemically induced menopause. Yes, sorry, I'll give way.
Thank you very much. I wanted to intervene earlier. It is with regard to the pain, and regarding endometriosis, which does not involve only one organ—it is a multi-organ problem. Pain is just a pointer. It points that you have to see the patient as a whole, which is not happening over the last so many years. We have been treating the symptoms. That is why I have been very vocal about it over the last 15 or 20 years—that we kindly see the patient as a whole, prioritise treatment and the continuation of treatment. These are very important things, and this is not happening. That's why we are suffering, and that is why we are not getting anywhere with these diagnoses, especially in women. My heart goes out. I have a wife, I have a daughter, I have a grand-daughter. Why should they suffer? This is mainly because we don't see them as a whole. Thank you.
Well, I thank you for that, and I think that we've heard already how the symptoms are treated, not the root cause of the problem. Can I just quote Emily once again? I remind you that she's only 23 years of age:
'I live in everyday pain and try to manage as best I can. My fertility isn't looking great. I just hope all the time for some sort of relief. But because my endometriosis was left to develop to such a severe state, my chances of living a normal, pain-free life are slim. My advice to any other women out there who are being let down by the gender health gap is to not take "no" for an answer. Listen to your body, and don't let anyone gaslight you into thinking that it's all in your head. You know your body better than anyone else. Fight for its right to be heard.'
Listing her concerns regarding the care available to sufferers, Emily's mother was clear in her view that there is a need for more endometriosis centres across the whole of Wales to provide specialist care that is completely necessary for patients. While there is a specialist centre in Cardiff, she is of the view that there needs to be an improvement in the care provided.
Secondly, and I finish with this, the family raised concerns regarding the general awareness of this condition, whether that's in society or in the medical field, and which, unfortunately, leads to a nine-year wait for a diagnosis. The evidence of so many women suggests that too many GPs disregard the seriousness of the condition. Suggesting that 'this is normal for women of your age, and take a few paracetamols' isn't good enough.
And I am finishing with this, sorry, if I could just have one more second—
Diolch, Llywydd. I want to thank you, Plaid Cymru, for bringing this incredibly important debate to the Chamber today. On Monday night, I attended a local menopause cafe event run by Sarah Williams from Equality Counts, where women and those dealing with similar health-related issues came to discuss their experiences. Open spaces like menopause cafes and events like this in my community are undoubtedly so empowering.
At the cafe, women discussed the lack of awareness around menopause. The constituents have asked for a specialty clinic and for more flexible ways to access HRT for those suffering from menopause symptoms. Sarah has said to me that evidence suggests that women from lower socioeconomic backgrounds are less likely to even take up HRT treatment, and that this is perpetuating health inequalities for the most vulnerable. The session also explored how menopause experiences are individual and nuanced. This is why we need compassionate cultural practitioners that practice without assumption of sexual orientation or gender identity, because this type of bias is deterring people from accessing support and treatment.
I want to emphasise that our experience of undiagnosed conditions, unexplained pain, the lack of treatment options are never about us as individuals. They are about a system that has always put the healthcare of heterosexual, straight, white males front and centre. And that's why, via social media, I asked women to share their experiences so I can share their voices here today, just as you have said, Sioned Williams. It is a wonderful opportunity to be able to do that.
One constituent said she wished that she could just feel listened to. Another told me about their experience of going to the GP regarding a chronic urinary tract infection, where they were told that there was nothing that can be done, and that the only thing to do is take paracetamol and have a bath. I have spoken to other women in my constituency who have undergone a late assessment for neurodivergence such as autism and ADHD. The current waiting list for that assessment is two years. Women in their late 30s and 40s have been denied the right to support their entire lifetime, simply because the signals for an assessment have been constructed around the way that young boys display signs of neurodivergence.
On another point, my constituent Samantha said that, 'There is no gynaecology ward at our local hospital.' To hear about a woman going through a late-term miscarriage next to people delivering their full-term babies, on the same ward as people going through an abortion, is not only heartbreaking but unacceptable.
Another constituent told me that she passed out from the pain of an intrauterine device insertion for endometriosis. She was told that the pain would be like a slight period cramp. It was only after attending a meeting with other women facing these same issues that she realised there is pain relief that she could have been administered during the procedure; she was just never told about it. She said to me, 'If you go to the dentist to have a tooth removed, no matter how wobbly, they will numb your gums. My procedure to have an IUD, through my cervix, came with no pain relief. I was so angry to realise that I could have just asked.'
Diolch yn fawr, Llywydd. Many thanks for allowing me to reply to this opposition debate around women's health, which I know most people in the Chamber are aware is an issue that I'm passionate about addressing, and it's great to see that there is absolute consensus on the issue, if not on the motion itself.
Now, women, as we know, make up just over half of our population and account for 47 per cent of the workforce. But that evidence is mounting that women don't always receive the health support needed to deliver the improved outcomes we expect. Gender inequalities in terms of health remain very significant. For example, with heart diseases, as we've heard, women are less likely to be aware of their risks and symptoms, less likely to be diagnosed quickly, less likely to be given optimal treatment, and less likely to access rehabilitation. I'm really grateful to the British Heart Foundation for drawing my attention to this in a briefing, which led me to commission a quality statement on women very shortly after I was appointed last year.
Women, we know, are under-represented in clinical trials, and these inequalities come at a huge cost. Research suggests that the deaths of at least 8,000 women could have been prevented through equitable cardiac treatment over a 10-year period in England and Wales.
People have mentioned different responses of women, for example to autism, to mental health. But, crucially, I think also something that is not talked about is, in an ageing population, the huge impact of incontinence on older women—disproportionately, once again, affecting women rather than men. There is a particular approach taken in 'A Healthier Wales', and that's our long-term plan for health and social services, and the whole ethos of the programme is for the services to be equitable, designed around the individual and around groups of people, based on their unique needs and what matters to them.
But, when it comes to women's health, all too often in the NHS women's healthcare is confined to reproductive health issues. Now, I want a health service in Wales that supports and nurtures women's wider health and well-being, and I've instructed officials to take this broader approach when it comes to developing that quality statement.
Thank you, Minister, for giving way, and I welcome and I commend your efforts in creating a women's health plan. I think it's a fantastic step forward in what you're trying to do. You mentioned about broadening the plan to meet everything—it reminds me of a petition on improving endometriosis healthcare and the petitioner, Beth Hales; we'll be reviewing that again on Monday. But a comment she made to me: this is not just a gender health gap, it's not just a health inequality, it's actually a social justice issue. Would you agree with that?
Absolutely. I think there is an injustice that has been going on for way too long, and the very fact that women are not in trials, that there's a disproportionate amount of money invested in certain research areas rather than others—it's women who lose out almost every time. That has got to be something that we address. It is a social justice issue, absolutely.
In 2019, the Royal College of Obstetricians and Gynaecologists published 'Better for women: Improving the health and wellbeing of girls and women'. Now, this report argues that a strategic approach across the life course of a woman is necessary to prevent predictable morbidity and mortality and to address the determinants of health specific to women. I absolutely agree that our health services need to provide advice and care to girls and women across their whole life course. The NHS in Wales must deliver a model of care that enables women to live healthy and productive lives, and not simply be a service that intervenes when women experience problems.
In recent years, much of our response to addressing issues in women's health has been delivered through the work of the women's health implementation group, which has focused on reproductive issues. Since its establishment, the WHIG has been allocated £1 million per year from the Welsh Government, and this funding has been used to establish a network of pelvic health and well-being co-ordinators in each health board. More recently, this funding has allowed for the recruitment of a network of specialist endometriosis nurses in each health board, and that's to develop national pathways, to reduce diagnostic times and to support women living with endometriosis. And I can assure you in this Chamber today that I've spent more time on the need to improve our response to endometriosis than I have on almost any other health condition.
We have to put a stop to the harrowing experiences of people like Emily, and, I imagine, Beth, and other petitioners as well. We know that taboos and a lack of education about menstruation have tangible negative effects on girls' and women's lives, and, last year, we launched Bloody Brilliant, our online resource and educational platform. It was designed with significant input from young people to help break taboos and enable open conversations about period health, including what is normal and when they should seek help. Welsh Government is also working to help improve services to support women experiencing menopause. A task and finish group is being established, looking to share local best practice and establish an improved care pathway. We're also participating in the UK menopause taskforce, which is taking a four-nations approach to improve knowledge about the menopause and better support women experiencing it.
The recovery plan for planned care has been published and this sets out a number of challenging targets for health boards to achieve across all specialisms, including secondary gynaecological care services. The gynaecological board that has just been formed will develop plans to reach these targets. This will include a variety of actions, including e-advice, better referral and discharge pathways, introducing one-stop shops, responses to symptoms, and responding to patients' concerns.
Now, as Members are aware, I have agreed on a two-step plan to ensure that women receive the best possible care and assistance to remain healthy throughout their lives. As I have noted, the Welsh Government is developing a quality statement for women's health that will enable us to provide a strategic picture of our expectations in terms of the provision of women's healthcare services across Wales. This will describe what good provision should look like, not just in terms of reproductive health for women, but also to tackle the gender bias in our mainstream system at present. Now, this will be published this term, and we will be discussing and debating that statement, I believe in July, in the Senedd.
Secondly, the health service collaborative will lead the work of developing a 10-year plan for women's health. This will outline the steps that the service will take to meet the expectations in the quality statement. The plan will follow the same whole-life course outlined and recommended by the Royal College of Obstetricians and Gynaecologists in their 'Better for Women' report, and the intention is to decrease inequalities in health, to improve the fairness of services and to improve the health outcomes for women in Wales. The plan will include short-term actions and long-term actions, and I will present that in the autumn. I'm eager that service users should be able to contribute significantly to the plan to ensure that the voices of women are at the heart of the plan. So, engagement will take place with stakeholders throughout the process of developing the plan, as well as the usual consultation. I'm very grateful to the Women's Health Alliance for the work that they have done to raise the profile of women's health, and I look forward to meeting and working with them as we develop the plans. I'm aware that there's a great deal to do yet, but I'm certain that the statement and the quality plan, together with the work that is in the pipeline already, will lead to far better care for women across Wales.
Thank you very much, Llywydd. Thank you for every contribution to this important debate today and for the Minister's response. This is an area that has been neglected for far too long, and it's remarkable that it has been neglected for so long. There has been, I think, some sort of awakening—and I'm not talking about Wales specifically there, but more generally. I note the work in England, for example, on the women's health strategy, which has been welcomed there. We, as the health committee, as we've heard already, are doing work in this area, and I'm grateful to Joyce Watson for pushing to ensure that that happens. Here in Wales, we've heard the Minister today talking about the range of steps that she intends to take. We see in the Government's amendment a reference to the quality statement and the NHS plan that is to come. If I heard correctly, from a Member who has left the Chamber now, we were accused of grandstanding. I was hoping to ask her to explain if that's what she had said, but she's not here to do that.
I understand that Senedd.tv has crashed this afternoon, possibly because so many people are viewing this session—that's how important this is. And the truth is, hearing words from the Minister in itself isn't enough. I welcome the words, but what's important is what's going to happen from now on.
The Member, again who is absent, had suggested that our debate today wasn't timely because the Minister had made comments recently about the plans that she is going to develop. But do you know what? I will take advantage, we'll all take advantage, of those positive messages. There are Labour Ministers in place since 1999, so you can't find fault with us for doubting what's happening under the Ministers here. But what's important is that this is the right opportunity to push a Minister who says that she is determined to make a difference in this field. I know that the Deputy Minister with responsibility for mental health is very keen to make a difference in that field, and that's why I'm pushing so hard on her to do so, because I think that there is an open door there. It is up to you, as a Government, to prove that your words are words that can be turned into reality.
There are so many elements to what we've discussed and heard about this afternoon. We have the conditions that affect women only, and where there have been terrible weaknesses in research and in investment—endometriosis we've heard about already, which means that so many women are living in pain every day. And we haven't even given them the respect of investing in the research that could discover what exactly is causing this so that we can make an investment in finding a way of treating endometriosis.
We can draw attention to support for women who are going through the menopause: half of our population—half of our population—go through the menopause. And until recently, there was not much mention of it, and at best, at best, the provision available in Wales is inconsistent—and that's being kind. There are women in all parts of Wales who cannot access the care that they require.
The gender gap in heart disease we've heard about today. It's costing women's lives. And that groundbreaking report in 2019, 'Bias and biology: The heart attack gender gap', by the British Heart Foundation, really opened my eyes to what was happening, or what was not happening, in the treatment of heart disease in women: heart attacks in women being misdiagnosed as anxiety or panic attacks. It was spelt out to me in this way: cardiac specialists have traditionally been overwhelmingly men, so the needs of women amongst the speciality itself have been overlooked for too long.
Migraine—I was talking to a group interested in pushing the agenda forward on migraine recently. It's far more common in women than in men; perhaps a third of women will experience migraine, compared with 13 per cent of men. There may be some underreporting by men, but the higher level among women is likely to be as a result of hormonal factors, genetic differences and so on.
One hundred and eighty thousand women in Wales have asthma. Figures suggest that asthma kills twice as many women as men. This is a women's health issue that needs addressing. One charity has said that women have been failed by a lack of research into links between hormone changes and asthma. Asthma + Lung UK said that women are stuck in a cycle of being in and out of hospital and, in some cases, losing their lives because of a lack of research. Research in itself is an area where there needs to be a new focus on women. Russell George touched on this. Clinical trials have traditionally been focused at men, older men, and not enough women taking part.
I can see that time is running out. We as parliamentarians today are making this demand to Government. Despite what it's promised, we're making that demand to insist that the promises made now are put into action. I know that a coalition of organisations has come together to put together its case for a women's health strategy, as we're calling for today. It's time to take action on this. We've talked a lot about health inequalities recently in this Senedd. This is yet another example of inequality, perhaps the most glaring of inequalities that we simply have to stamp out.
The proposal is to agree the motion without amendment. Does any Member object? [Objection.] There is an objection, therefore I defer voting until voting time.
7. Welsh Conservatives Debate: Child and adolescent mental health
The following amendments have been selected: amendment 1 in the name of Lesley Griffiths, and amendment 2 in the name of Siân Gwenllian. If amendment 1 is agreed, amendment 2 will be deselected.
1. Notes the impact of the COVID-19 pandemic on the mental health of children and young people.
2. Regrets that child and adolescent mental health waiting times continue to be poor, with less than one in two under 18s receiving a local primary mental health support services assessment within 28 days of referral.
3. Expresses its concern about the number of section 136 detentions of children and young people under the age of 18.
4. Calls on the Welsh Government to:
a) conduct an urgent review into the viability of child and adolescent mental health services;
b) ensure a 24 hour crisis service is available for children and young people across Wales; and
c) consider the feasibility of opening an eating disorders unit in Wales.
Thank you, Llywydd. This vital debate today on the mental health of children and young people, I think, is one of the most important debates we've had in the Senedd, and it is a shame that so many Members have just left the Chamber when we are debating such an important topic.
A lot of people in this Chamber have personal experience of dealing with mental health problems. I have suffered with mental health problems myself in the past, and I think it's very important that more people come forward to talk about mental health issues, so that we can destigmatise mental health and allow people to come forward to seek the help and support they need.
Young people today have far different issues facing them than those of previous generations. Today's youth live in both the real world and the digital world. They can be influenced and contacted by organisations and businesses that they've never heard of, on social media and online forums, creating, for them, a warped perception of what life is. Many young people are vulnerable and susceptible to being influenced in this way, and if they are sucked down the wrong path, they could struggle to find a way out or seek the help that they need.
I speak with young people regularly. I even consider myself a young person, Deputy Llywydd, so I understand the struggles that many of my generation are going through. There is huge concern by many that they can't earn enough money to meet the standards they think society has for them. Many try to portray that they live a glamorous life on social media in order to impress others on platforms. Sadly, this has become very common, with people only sharing the good times and not wanting to show the bad, while they sit at home suffering in silence. A survey by Mind Cymru found that 75 per cent of young people said their mental health had worsened in the early months of the pandemic. I would say that this is due to the media and political choices and the resulting lockdowns, which saw a huge surge in people's mental health declining.
This led to a growth in people suffering with eating disorders, with support services very nearly being cut off overnight and many left to suffer on their own. We need to ensure that more staff are trained to identify and support children who are suffering with eating disorders. Currently, medical students receive less than two hours of training on eating disorders, and that's over four to six years of undergraduate study. Many young people who need specialist services are removed from their communities, away from their family with no support network. So, we need to explore the possibility of setting up an eating disorder unit here in Wales.
Our schools also play a major role in preventing and dealing with this issue. Schools should be building an emotionally resilient population of young people. Sadly, UNICEF estimates that more than one in seven adolescents aged 10 to 19 live with a diagnosed mental health disorder. If we then add those who are undiagnosed, this is an extremely worrying picture going forward. Our child and adolescent mental health services also play a major role in this area. Sadly, after being the shadow Minister for mental health for over a year now, I've been told by many young people that they have been let down by these services, with too many left waiting for an appointment with nowhere else to turn, and feeling isolated and alone. So, we need urgent reform to CAMHS to make sure that their support is there when they need it.
I have selected the two amendments to the motion. If amendment 1 is agreed, amendment 2 will be deselected. I call on the Deputy Minister for Mental Health and Well-being to formally move amendment 1, tabled in the name of Lesley Griffiths.
1. Notes the impact of the pandemic on the mental health and emotional wellbeing of children and young people.
2. Recognises the impact of the pandemic on waiting times for CAMHS.
3. Welcomes the Welsh Government's focus on supporting services to improve as they recover and continued work with partners to prevent escalation to crisis and provide an appropriate, multi-agency response.
4. Notes the NHS Delivery Unit’s review of CAMHS services, commissioned by Welsh Government, due to report by the end 2022.
5. Welcomes the continued roll-out of 111, press 2 for mental health for adults and young people across Wales.
6. Notes the current Welsh Health Specialised Services Committee: Mental Health Specialised Service Strategy for Wales consultation with key stakeholders, which includes scoping the feasibility of an Eating Disorder Unit for Wales.
Add as new point after point (2) and renumber accordingly:
Notes the planned pilot project to establish community-based facilities, for young people to easily access mental health and wellbeing support, in order to offer early intervention and avoid escalation, and urges the rollout of early intervention facilities to the whole of Wales.
Thank you very much, Dirprwy Lywydd. I'm very pleased to be able to contribute to this debate, and I'm very grateful that it has been proposed. Mental health is an issue that we discuss often in the Senedd now, and that's good to see, as opposed to the situation in the past where mental health had next to no attention and was swept under the carpet. But, as I said, it's good to have an opportunity once again today, because it's by diligent work that we'll ensure that actions are taken that will, hopefully, assist people with their mental health, and I'm pleased that we once again are giving attention to mental health amongst young people in particular.
We'll support the motion today. We agree with regard to the impact that the pandemic had on the mental health of children and young people. It was an unprecedented period of anxiety about missing school work, of loneliness, of missing out on those experiences that are so important to young people, of losing support networks and so on. I'm a father to three children, and I saw that for myself amongst them. We also regret the time that far too many children and young people are having to wait for support and treatment.
The third point, then, with regard to the use of section 136 powers takes us to an area that we haven't been giving as much attention to, namely serious mental health issues and the implications of those. Looking back on the past two years while researching for today, I don't see that Ministers in Welsh Government have spoken about serious mental illness at all, and it's very important that that is given due attention.
Serious mental illnesses, SMIs, such as schizophrenia, bipolar disorder, often first develop between the ages of 14 and 25. It's a critical stage for young people, because of the neurological, biological and cognitive changes of adolescence to young adulthood. It's a time of big change in their lives, reaching major educational milestones.
We often talk, don't we, about the need for early intervention to avoid mental health issues deteriorating. Plaid Cymru's long championed early intervention, including in more informal ways, or perhaps in less formal ways: the one-stop-shop drop-in centres, you'll have heard us promote, along the New Zealand model, and our amendment today refers to pilot schemes being introduced under the co-operation agreement, which I look forward to seeing develop, and they must develop. But these less formal interventions can affect clinical outcomes. Being aware of early signs of serious mental illness is a crucial first step in people getting the help they need, and clinical prevention is important. For many, it's the intervention of clinical teams that prevents further deterioration and illness. Early intervention and preventative strategies offer the opportunity to mitigate the stressors that impact on physical, emotional and psychological well-being at this really vulnerable time in a young person's life.
Psychosis affects one in 100 people. The first episode is most likely to happen between the ages of 18 and 24, but recent research says that fewer than one in five young people would be confident in spotting early signs—a quarter had never heard of it. So, Welsh Government has to meaningfully invest in specialist psychiatric medical provision in Wales, both now and in the long term.
We've spoken a great deal about health inequalities recently. We spoke about them in the context of women's health a few minutes ago. The inequalities that people with serious mental illness face are very significant. They're more likely to face physical health issues and they die, on average, 15 to 20 years younger. It's estimated that two out of three people with serious mental illnesses die as a result of preventable physical conditions. So, we have to ensure that there's careful monitoring of the physical health of people who are suffering.
Part 2 of the Mental Health (Wales) Measure 2010 says that every young person receiving healthcare from a specialist child and adolescent mental health service should have a comprehensive care and treatment plan to help them to recover. It appears that many young people don't even know about that.
Dirprwy Lywydd, in closing, we can't support the Government's amendment today. Even though there is good work being done in some areas, we can't just accept things as they are. It would be a mistake to do that. Even though we have our own amendment and I have explained the importance of what is mentioned there, it's possible that we might not even get to that stage, so what we will do today is we will support the original motion as it is laid out to increase the chance of receiving support for some of those core principles that are in that original motion.
There are so many things that we could touch on when we talk about mental health, but I'm pleased to be able to make those few comments there.
I'd like to start by thanking James Evans for bringing this debate to our Senedd today. It is a very, very important subject to discuss, but as the Member for Ynys Môn said, it's wonderful to see that we are talking about it now and that these conversations are real, because the situation that we face is very real, and it's nice to see that it's no longer a taboo subject, as you said, Rhun.
As James said, mental health is something that affects us all in one way or another, most recently, as has been said already, with our youngest in society with the struggles and pressures that they faced in education and growing up during the pandemic. Sadly, despite Welsh Labour continually claiming that the mental health and well-being of our children and young people is a priority, as James said, the reality is very different. Children and young people are waiting longer for mental health services and, in some health boards, well over nine in 10 are waiting longer than the target time for assessments. Clearly, these problems are historic. Before COVID-19 hit in Wales, waiting times for children and young people were already long, and concerns had been raised by the Children, Young People and Education Committee nearly four years ago now about these problems within the child and adolescent mental health services.
I'm not sure whether you recall the numerous reports the Children, Young People and Education Committee did in this area, but our landmark one, 'Mind over matter', recognised that, actually, waiting times had significantly improved and that the focus needed to go to early intervention. Maybe you ought to have a look at some of those reports.
Nearly four years ago we were talking about these problems, and still a lot of action has not been taken, Deputy Minister. I find it staggering looking at the latest figures, which show that less than two thirds of young people are receiving their assessments within 28 days and, on average, over the last six months, 48.5 per cent—less than one in two—were seen within this time period. In my own region in South Wales East, we see waiting times for specialist CAMHS is in a bad way, with over 14 per cent of young people waiting over four weeks for that first appointment. It is clear now that this isn't good enough and that our current services cannot deal with the pressure it's facing. We're now nearly three years since the joint thematic review in 2019, and more than two years after the fifth Senedd's Health, Social Care and Sport Committee's report into section 135 and 136 detentions. The committee at this time noted that improving crisis care services, particularly out-of-hours services, is a key to both reducing the overall use of section 136 and ensuring those discharged from section 136 following assessment go on to achieve adequate care and support in their community. As waiting times get longer, more and more children and young people are needing crisis support, with 30 under-18s being detained under the Mental Health Act. Simply detaining children and young people won't provide the specialist support they need, so it's crucial that a 24-hour crisis service is made available so that they are treated in a safe and appropriate environment, something which, of course, is a debate on its own.
It is clear to me and others on these benches that proposed mental health crisis centres must be set up so that we can ensure people who have mental health issues have a safe place to be assessed and treated, simultaneously lowering the number of people who are detained and transferred.
Sadly, we also see this with autism waiting times. There are an estimated 30,000 or more autistic people in Wales, and although everyone has heard of autism, too few people understand what it's actually like to be autistic and how hard life can be if autistic people don't receive that right support. Thousands of children are waiting many months or even years for assessment. A recent study found that 28 per cent of autistic pupils in Wales felt their teachers understood autism, and new Office for National Statistics data suggests that just 29 per cent of autistic people are in any form of work. Without support, many autistic people develop mental health problems, sometimes to the point of crisis.
The time for talking is over. The longer we wait to tackle the true root and causes of the mental health crisis and its treatment, the worse the situation will get. We need clear action and regular updates in this Senedd, outlining just how this Government plan to tackle the crisis and if their methods are working.
I want to start by thanking you for bringing this debate to the Chamber today. Child and adolescent mental health is one of the key issues that young people raise with me across Bridgend and Porthcawl. In Bridgend last week, it was great to host our young person's fair on this very topic with Bridgend Youth Council, where schools, pupils and local support groups came together to discuss how we can make mental health provision better for young people in our community. Because, as with a lot of issues, or all issues related to young people, there are often very well-meaning adults who assume what is best, and this shouldn't be the case. Any decisions that impact young people should at least have the consultation and engagement to ensure that we provide support that will make a difference. I know that our Deputy Minister is absolutely committed to this. I also wanted to add in that one of our Youth Parliament Members from Bridgend, Ollie, who represents the Carers Trust Wales, did also want to say that people's voices and opinions sometimes are overlooked and undervalued in decision making, so we do want to make sure that that is always a priority.
I believe it is worth as well remembering the integral role that I think young people have played in bringing the conversation around depression and anxiety into our daily lives. We owe much of the work that has been done to break down barriers and the shame of talking about mental health to young people across our communities, and I know this is a priority for our Youth Parliament Member for Bridgend, Ewan Bodilly, who said that, since the pandemic, it has been easy for young people to feel alienated, and it is only through engaging with young people that things will improve. And at the mental health fair, our youth mayor, Xander, said young people have been calling for mental health to be a priority for too long, but the pandemic has shown how important it is that we make sure services are available and mental health is a priority, going forward.
I also want to say that I am thankful to the Welsh Government for their commitment to prioritise mental health for young people through schools with the whole-school approach. There are already schools across my constituency doing this work, with Porthcawl Comprehensive School working with local mental health support groups to destigmatise reaching out and ensuring that all young people know where to turn to if they need to. But this should be standardised, and every child and young person should know where to reach out to. Every child should be given the tools to have access to support when and if they need it, for whatever the circumstance is.
I want to end by saying I didn't actually plan to speak on this today, but, James, I want to say this in support of your call for an eating disorder unit in Wales, and preferably a residential eating disorder unit. I myself had anorexia nervosa when I was 14. It was absolutely terrifying for me and my family, and for my friends and my teachers, and I actually had a chat with my mum about it a couple of months ago—I think it was weeks ago, sorry—when we were doing the debate on eating disorders, because I wanted to speak on it. And my mum actually told me something that she'd never told me before, which was that my paediatric consultant at the time wrote to my counsellor, and didn't even tell my parents this—didn't give them the heads-up—that I was two days away from them admitting me to the adult psychiatric ward at east Glamorgan hospital, when I was 14. They would have locked me up in an adult psychiatric ward at east Glamorgan hospital. I would never have come out. I would never have come out. So, the only other option at the time was a residential unit, which was in Bristol, and it was full, and my parents were just so scared. I think, to be honest, I was so unwell I don't even think I was scared anymore; I didn't know what was going on.
I don't think any apologies should be made for this debate this afternoon being not a comfortable one, and every contribution we hear is incredibly pertinent to this debate. I'd like to pay tribute to Sarah Murphy for sharing with us her incredibly personal story. Thank you for taking the time to share that with us.
I don't believe this debate is to shame the Welsh Government or whip up disgust; rather, as the Member for Brecon and Radnor rightly said, it's to hold the Government to account, and it's to draw attention to the real entrenched failures within Wales's child and adolescent mental health services. These failures have seen the lives of children and young people torn apart and thrown into turmoil. However, I do wish to use my contribution this afternoon to draw Members' attentions to the situation in rural communities right across Wales, one that has seen our mental health services under-resourced and lacking in funding.
Now, it is true that growing up in rural Wales is a blessing, and that's not to say it isn't without its challenges and difficulties—a situation that is especially the case when it comes to our young people. Rural isolation is an issue that transcends every societal group, but it's often our young people who are left without the support network they need to develop relationships and emotional growth. Lacking these networks and without the required support and the preventative measures, our young people are often left to battle depression and other mental health illnesses, a situation that then requires the professional intervention of child and adolescent mental health services. Looking around this Chamber, how many of us have to deal with directly and intervene directly in an individual CAMHS case because resources were not available to get a child or young person the vital help they need? One of the very first cases I dealt with after last May's election was that of a young girl with an eating disorder. And for me, representing a rural constituency, interventions such as this are all too common and far too familiar.
The latest CAMHS waiting list figures show that less than two thirds of young people are receiving the required local primary mental health support service assessment within 28 days. In the Hywel Dda University Health Board region, which includes my own constituency of Carmarthen West and South Pembrokeshire, just 3.2 per cent of CAMHS referrals are seen within 28 days—3.2 per cent. In comparison, Cardiff and Vale University Health Board conduct 91.3 per cent of their local primary mental health support service assessments within that 28-day window, a difference that, for many, could be the difference between getting the support and access that these young people need or a further darkening of the clouds around them.
Can I thank James for bringing this debate forward? Diolch yn fawr iawn, James. I'm very grateful to you. I speak as a former child protection social worker who worked for around 25 years with children and young people. Part of the battle for me was actually getting those children and their families into CAMHS services.
I just want to recognise a few things in Wales that I think have gone well. I'm really pleased to see the whole-school approach to mental health continue to be rolled out, because a focus on prevention and trauma-informed school environments are incredibly important in nurturing positive mental health among children and young people. But we are in a really difficult place. I'm going to listen to the rest of the debate to decide how I vote this evening, because it really does concern me that there are two major issues. One is the CAMHS waiting time. It is far too long, and I'm looking forward to hearing from the Minister what the figures are around the waiting times, because I'm a little bit unclear what they are. And we heard some from Laura Anne Jones in the debate, but I read some different figures this morning, so I would ask the Minister just to clarify what the waiting times are for four weeks or more.
My own view is that we need a panoply of services. I'm not sure it needs a whole new service. We've got some really good services. The crisis resolution and home treatment service provide a rapid, community-based service 24 hours a day, seven days a week, 365 days a year, but it's only for young people over the age of 18. We're talking here about getting to those situations long before.
I think there are two important issues. One is, as I've said, that waiting list. In my experience as a child protection social worker, it is far too long. If you can get in early, you can prevent those children and young people and their families struggling with those mental health issues, and potentially becoming looked-after children, which is a terrible state, to think that's what happens to many children and young people.
Secondly, I would like to pay tribute to the voluntary and third sector services across Wales. There are some amazing ones, and in my experience, young people actually prefer to go to those volunteer services much more than they do to statutory services. They feel much safer going to a service that doesn't have 'NHS' over it. We actually need to work much closer with those volunteer services. There are many, like Youth Shedz in Blaenau Ffestiniog, which I visited last summer, Brecon Mind, the Amethyst project in Aberteifi, and the Sanctuary in Pembrokeshire. My view is that the Welsh Government needs to look at these services, and map them out for us to see how we can create further capacity for them to meet the needs of children and young people who are experiencing mental health difficulties, and to give them sustainable long-term funding and to see whether they can provide the 24/7 approach, which I believe is absolutely invaluable.
Thank you for the opportunity to contribute to this debate. Delivering high-quality and effective mental health services for children and young people must be a greater priority. There needs to be a greater focus on prevention, not just reactive provisions, supporting good mental health as part of a programme that ensures measures are put in place to reduce the likelihood of ill-health occurring in the first place.
There have been calls for a review into the transition phase between young person and adult services within the NHS. The ITV news recently covered the story of a young woman with autism. She called for a change in the system, so young people moved into adult care don't experience a significant drop in the services they receive. It was suggested that psychiatric sessions were reduced from one hour to just 10 minutes. This can be significant for young people at such a vulnerable period. In response, the Welsh Government announced an additional £50 million for mental health services in the period 2022-23. But what is the strategy to make sure this money is used effectively to allow young people to make a smooth transition into adult services? And how confident are Ministers that they are doing all they can to reduce the risk of harm to those moving from child to adult care?
I want to turn to the challenges and the impact on young people. The YoungMinds survey report found that 80 per cent of children and young people with existing mental health problems agreed their mental health had deteriorated during the lockdowns. This figure does not include new cases of mental health decline. Ninety-one per cent of young people have accessed a mental health service at some point. Young people from low-income households seem to be particularly affected. Isolation from friends and family, and the shutdown of vital services, have contributed to this.
Worryingly, nearly half of young people experiencing mental health declines have used negative coping techniques such as self-harm. Some have experienced significant dietary changes. Even though isolation is a major contributory factor to mental health deteriorations, over half now feel anxious about returning to normal life. It is clear that the impact of the pandemic will be felt for a significant time. These facts are concerning and must be considered by the Minister planning for the future of mental health. In February 2022, a Senedd report found that 60 per cent of children and adolescents who required specialist care had to wait more than four weeks for a first appointment.
I have a few suggestions, which I hope the Minister will consider. The Welsh Government need to consider a new mental health Act, which would update current legislation and would include the latest thinking about mental health provisions in Wales. The UK Government are currently making changes to the Mental Health Act 1983, which must be considered when changing the mental health legislation here in Wales.
Thank you, Deputy Presiding Officer, and thanks to all Members today for their contributions. There is nothing more important to me than improving, protecting and supporting the mental and emotional well-being of children and young people in Wales. I have stated and restated my commitment many times in this Chamber, and I remain determined for us to make the progress needed to transform their lives for the better. It is, in fact, the very reason I came into Government, following five years of campaigning on this in the last Senedd.
We all have a role to play in this. Young people have said to us, 'Don't medicalise growing up.' We can all help to challenge the narrative that all young people need specialist support when they are struggling. Most young people won't need it, and every one of us in this Chamber should be raising awareness and supporting young people to access the appropriate level of services, when and where they need them.
I absolutely recognise the impact the pandemic has had on mental health and mental health services, and as I said in my intervention to Laura Anne Jones, we were in compliance with the waiting time targets prior to the pandemic, which is precisely why the previous children's committee called for a renewed focus on early intervention, because they—the committee I chaired—recognised the progress that had been made on waiting times.
Waiting time performance has deteriorated significantly from pre-pandemic levels, but this is in the context of increased referrals and patients presenting with higher acuity and complexity to a dedicated but pressurised workforce. Whilst waiting times in some areas have increased, health boards provide assurance that waiting lists are clinically reviewed on a regular basis, with patients prioritised based on clinical needs.
The latest data published this morning does show steady improvement in waiting times since December, which I cautiously welcome, but I'm in no way complacent about the ongoing challenges we face. And can I say to Jane Dodds that all the data on waiting times is published every month? I'm pleased to say that in Powys, we are meeting the target to see 80 per cent of young people within four weeks, but there is variation in Wales, particularly with Cardiff and Vale distorting the picture, with more than 50 per cent of the young people waiting being in Cardiff and Vale. I'll give way to Darren Millar.
Thank you, Minister. I know how committed you are to this cause and you've been very passionate about it for many years. It's not just about the 80 per cent target, though, is it? It's about making sure that people get access to the talking therapies, in particular, that they're currently having to wait very long times for, even after they've been assessed as requiring them within the target time. Can you tell us what progress is being made to address that particular issue?
Thank you, Darren. As you say, it's not just about the waiting times. I have myself called for there to be more of a focus on outcomes and what happens to young people once they have that assessment. We are currently working on validating the data so that we can provide more public information on access to psychological treatments. But I think what you've just said, really, shows that it has to be a whole-system approach, which is what we are trying to do.
We've strengthened our arrangements to monitor both the quality and performance of NHS mental health services by meetings with the NHS delivery unit on a monthly basis. Given the variance in waiting times performance, we've also commissioned the NHS delivery unit to undertake a review of both primary and specialist CAMHS. This will help us understand the variance, and will support our improvement programme, because we have to have the correct data.
As we emerge from the pandemic, our services need time to recover and to develop models that can meet the changing needs of individuals, and do it sustainably, without destabilising other parts of the service. My focus is on prevention, early intervention and strengthening specialist services for those young people that need that level of support. This includes our joint ministerial whole-system approach which has our schools at the centre of improving the emotional well-being of young people. Our approach includes supporting good mental health through the curriculum, helping schools to identify and support young people who need help sooner, but also linking to advice and support from CAMHS with the roll-out of the CAMHS inreach service. So, indeed, James, we are actually doing all the things that you have referred to.
We continue to drive implementation of our NEST/NYTH framework across Wales via regional partnership boards, and we're supporting the framework implementation in a systematic and integrated way. All young people need safe, nurturing relationships, with trusted adults wherever they live their lives. This is at the very heart of our NEST framework. Crucially, this will help provide early emotional and mental health support for those who do not need clinical support or intervention. I've been pleased to hear first-hand from RPBs of some of the new and expanded services implemented as a result of the NEST framework, a framework that has been co-produced with a wide range of stakeholders, but crucially with young people themselves.
We continue to strengthen our tier 0/1 offer for young people, providing easy access to a range of support without the need for referral. We've updated the young persons mental health toolkit, which links young people aged 11 to 25 to websites, apps and helplines that deal with anxiety, low mood, bereavement, advice on keeping well and building resilience. We've extended our roll-out of online cognitive behavioural therapy via SilverCloud to include a new model for young people.
Thank you very much, Deputy Llywydd. I'd like to thank everyone who's taken part in the debate this afternoon on such a vitally important topic. Childhood and adolescent mental health services have been severely stretched for many years, but the problems have been compounded by the pandemic, which has been widely referred to during today's debate, both in terms of waiting times, but also in terms of increasing the numbers needing support. Barnardo's Cymru staff are reporting there has been an increase in mental health and well-being issues amongst the children and young people they work with. As a member of the health committee, I was able to take evidence from witnesses on the state of mental health services during our inquiry into waiting times. We heard from the Royal College of Psychiatrists, amongst others, who highlighted how mental health services were struggling well before the pandemic. They said that waits and barriers to access would be unacceptable in any other area of medicine. And we heard from stakeholders the very real costs of these waits, as delays in treatments have significant consequences for young people, not only intensifying their suffering, but often leading to more complex needs and increasing treatment costs. We are forcing more young people into mental health crisis because of our lack of early intervention.
The fact that half of young people receive an assessment within 28 days of referral should be a matter of national shame, particularly when we have been aware of the issues facing CAMHS for many years. It is past time we had an urgent review of CAMHS provision in Wales, as James Evans outlined in opening the debate. He was very brave to stand up and talk about some of his personal—
Did you actually listen to what I said when I explained that we are having a review, a delivery unit review, of CAMHS services in Wales? So, we are actually doing what you've now stood up and called for. Maybe it would help if you paid attention.
Yes, I was actually paying attention, but it was to highlight the actual need for the review into CAMHS services, which has been long delayed and is well overdue. So, Minister, I'd really welcome some urgency on that CAMHS review, and be keen to hear a statement from yourself in due course as to how you're getting on with that.
As mentioned, James mentioned personal experiences, which was very brave of him to stand up in here and say that, and we need more people to come forward to raise the profile of mental health and tackle some of the stigmas around it. Some of the social media, the modern platforms and the grandiose nature of some of the social media platforms often portray a false view of life that can feed into some anxieties around some social situations. And, of course, the COVID-19 pandemic, and calling for the need for an eating disorders unit, which is all great progress, and the need, indeed, for 24-hour crisis centres for children and young people—.
Then we heard from Rhun ap Iorwerth who, again, mentioned the COVID-19 pandemic and school pupils missing out on school work and contact with peer groups, which is all too important with young people growing up. A main point he raised was the serious mental health issues, because we hear too often in the media about anxiety and depression, which do play a big part in mental health, but it's also the recognition of the more serious mental issues, sometimes, like bipolar, schizophrenia, psychosis and the need for the first-episode prevention in psychosis, to treat people as they're coming in to services, and rather than spending a lifetime in services, it's nipping that in the bud when they're quite young. And I think that that was a really good point that you raised today, Rhun.
We heard from Laura Anne Jones about the disparities of some of the Welsh Government provision and what's actually the reality. And the point I made that two thirds of people aren't being seen within the 28-day period, which we really do need to see improvements on, and getting the right support for children with autism and learning disabilities in schools and in the general public.
And then we heard the personal case from Sarah Murphy. I'd really like to applaud you, again, on showing that bravery, because it takes a hell of a lot of bottle to get up in here and talk about something that you've really suffered with as a young girl, and I really take my hat off to you. And you've come, obviously, a long way from that and regardless of party politics, the good people of Bridgend and Porthcawl have put their trust in you to represent them here and I applaud you for that, and you're doing really well.
And then we heard from Sam Kurtz about holding the Welsh Government to account, and the variations in rural communities in comparison to larger cities and urban areas, which we know all too well about. We heard from Jane Dodds about her experience in the social work profession and seeking clarification on those waiting times, which the Deputy Minister was able to respond to you on—I was listening, Deputy Minister, just for clarity—and the positive stories coming out of some of the services in terms of home treatment teams and the voluntary and third sector support that's available as well, which, you rightly say, is a preferred method of seeking care for some people, particularly younger people and children, who we're speaking about today.
The proposal is to agree the motion without amendment. Does any Member object? [Objection.] I heard an objection, so I defer voting on the motion until voting time.
The first vote is on the Plaid Cymru debate on women's health. I call for a vote on the motion, tabled in the name of Siân Gwenllian. If the proposal is not agreed, we will vote on the amendment tabled to the motion. Open the vote. Close the vote. In favour 24, no abstentions, 24 against. As is required by Standing Order 6.20, I exercise my casting vote against. Therefore, the motion is not agreed.
I call for a vote on amendment 1, tabled in the name of Lesley Griffiths. Open the vote. Close the vote. In favour 24, no abstentions, 24 against. As required by Standing Order 6.20, I exercise my casting vote against the amendment.
As the Senedd has not agreed the motion without amendment and has not agreed the amendment tabled to the motion, the motion is therefore not agreed.
Next we vote on the Welsh Conservative debate, on child and adolescent mental health. I call for a vote on the motion tabled in the name of Darren Millar. If the proposal is not agreed, we will vote on the amendments tabled to the motion. Open the vote. Close the vote. In favour 24, no abstentions, 24 against. And as required by Standing Order 6.20, I exercise my casting vote to vote against the motion. The motion was not agreed in that vote.
I now call for a vote on amendment 1. If amendment 1 is agreed, amendment 2 will be deselected. I call for a vote on amendment 1, tabled in the name of Lesley Griffiths. Open the vote. Close the vote. In favour 24, no abstentions, and 24 against. And as required by Standing Order 6.20, I exercise my casting vote to vote against the amendment, and amendment 1 is not agreed.
I now call for a vote on amendment 2, tabled in the name of Siân Gwenllian. Open the vote. In favour 48, no abstentions, none against. Therefore, amendment 2 is agreed.
1. Notes the impact of the COVID-19 pandemic on the mental health of children and young people.
2. Regrets that child and adolescent mental health waiting times continue to be poor, with less than one in two under 18s receiving a local primary mental health support services assessment within 28 days of referral.
3. Notes the planned pilot project to establish community-based facilities, for young people to easily access mental health and wellbeing support, in order to offer early intervention and avoid escalation, and urges the rollout of early intervention facilities to the whole of Wales.
4. Expresses its concern about the number of section 136 detentions of children and young people under the age of 18.
5. Calls on the Welsh Government to:
a) conduct an urgent review into the viability of child and adolescent mental health services;
b) ensure a 24 hour crisis service is available for children and young people across Wales; and
c) consider the feasibility of opening an eating disorders unit in Wales.
Diolch yn fawr iawn, Deputy Llywydd, and it's me again. I've agreed to give a minute of my time to Samuel Kurtz tonight.
Over the past few months, I've been surveying my constituents in the Vale of Clwyd to ascertain their biggest concerns, as well as their key priorities for the Senedd as we emerge from the pandemic. One of the most startling themes to emerge was the sheer number of respondents who listed access to healthcare as their No. 1 issue.
The pandemic has certainly put our health and care systems under enormous pressure, but we knew access to healthcare was a problem before COVID. Well before the novel coronavirus made an appearance in the Wuhan region of China in early 2020, our citizens were struggling to see their GPs, driving hundreds of miles to get dental treatment, or waiting years to get a hip replacement. We became used to seeing lines of ambulances stacked up outside our hospitals. Winter pressures had become year-round pressures; we were as likely to see ambulances queuing outside emergency departments on August bank holiday as we were on New Year's Day.
As someone who worked on the front line of our NHS for over a decade, I can personally attest to the enormous strain our health and care systems have been under. And when a deadly virus has thrown into the mix, it's a sheer miracle that the system didn't break. But that’s only thanks to the dedication of my former colleagues in the NHS, not because of any leadership from the top.
The vast majority of the problems facing our NHS are down to an absence of leadership. The reason why my constituents and yours cannot see their GP, get an NHS dentist, or have had their surgery cancelled multiple times, is due to one simple fact: successive Governments have failed to do proper integrated workforce planning. The royal colleges and the professional bodies have been warning for at least the past decade that we are not training or recruiting enough front-line staff. And Welsh Government are very good at creating managers, bureaucrats and red tape, but are absolutely useless when it comes to creating doctors, nurses and healthcare professionals.
Things have improved somewhat—I do give credit where it's due—and, with the creation of Health Education and Improvement Wales, we now at least have a workforce plan, but I fear its too little too late. Just last week the Royal College of Nursing released their report on nursing staff levels, and it was a sobering read, because the sheer numbers of nurses leaving the profession should worry us all. There are at least 1,719 nursing vacancies across Welsh health boards, and, over the past five years, we've spent around £0.75 billion on agency staff. The RCN report shows how we are losing almost as many staff as we are recruiting, and last year the workforce only grew by 0.1 per cent. We gained a handful of nurses last year when we need thousands. We lost 6 per cent of the district nursing workforce between June 2020 and June 2021 and, in a survey of its members, the RCN highlights that a third of nurses are strongly considering leaving the profession early, all due to chronic workforce pressures. We are in real danger of creating a negative feedback loop—people leaving healthcare because of the pressures of not having enough staff. And it's not just nurses feeling this pressure; it perpetuates across the health and social care system. General practitioners are also leaving the profession in their droves. GPs are retiring early and some are even surrendering their medical licence, meaning that they can't be called out of retirement in times of crisis.
We were warned by the British Medical Association nearly 10 years ago that we needed to recruit around 200 GPs a year in Wales. For the majority of the intervening years we were lucky if we managed half of that. And because we failed to address the recruitment problems, we created a retention problem. In 2019, before the pandemic, nearly a quarter of practices surveyed were considering handing back their general medical services contracts. Since the pandemic, things have got much worse. GPs are warning that the strain could overwhelm the system, that pressures are putting people off the profession all together, and one in eight GP trainees say they do not intend to work in general practice after qualifying as doctors, according to a recent BMA poll.
I'm grateful to the Member from the Vale of Clwyd for bringing forward this short debate, and the Minister won't be surprised that I'm bringing forth the Argyle Medical Group and Argyle Street surgery as my example this evening. This is one of Wales's largest GP surgeries, with a patient ratio of approximately 2,506 patients per GP. This is a real burning issue in my mailbag, as constituents cannot get access to healthcare services. I understand the need to move away from just seeking GP services, and we can move away to looking at nurses, physiotherapists and pharmacists, but there are still real issues within this GP practice in Argyle Street. I do pay tribute to Judith Scourfield, the practice manager, and the staff of Argyle Street; they are working incredibly hard. But I do feel there needs to be something targeted here to really support them in what they're trying to deliver in my part of the constituency. Diolch, Dirprwy Lywydd.
Diolch yn fawr. I'm grateful for the opportunity of this short debate today to discuss the important topic of access to health services. Now, under a Labour Government here in Wales there are now more doctors, nurses and other healthcare professionals working in the NHS in Wales than ever before: over 104,000 people and 89,000 full-time equivalents—3,600 more staff than at the same time last year. And far from being absolutely useless, since 2016 the number of medical and dental staff has increased by 21 per cent. We've got nursing, midwifery and health visiting staff up by 9 per cent, scientific, therapeutic and technical staff up by 24 per cent, and ambulance staff up by 39 per cent. We are training 69 per cent more nurses than we were before 2016, and last week I hope you noted that we recruited 400 new international nurses.
We're not, however, complacent, and it's not just numbers alone that are going to guarantee the success. It's about how health professionals collaborate and use their skills, including their Welsh language skills, in the most effective way for patients. We therefore have a programme for government commitment to deliver better access to doctors, nurses, dentists and other health professionals that builds on previous commitments. Action is centred around the primary care model for Wales, which is about people accessing the right care from the right professional or service for their specific needs, at or as close to home as possible.
Now, this means increasingly people will only travel to hospitals for those services that should only be delivered in those settings. As the national clinical framework programme drives national clinical pathways, we'll make faster progress with rebalancing services, funding the workforce away from illness and hospitals towards wellness and care closer to home.
Now, in the time I've got today, I can't do justice to the huge range of policy and activity through our national programmes for primary care, for planned care, for urgent and emergency care and for mental health to support this rebalancing of the system, so I'm going to highlight the action to improve access to those services that most people frequent and are most familiar with, and these are our primary and community services.
To improve access to GPs, we've introduced a change through the general medical services contract to remove the bottleneck at the start of the day. I have provided extra funding of £4 million annually over the next three years to build capacity in GP practices. The primary care model is about increasing the range of services and health professionals accessible in the community. GPs and practice nurses are not always the right health professional for someone's needs, and as a physiotherapist, I'm sure you're well aware of that. For example, an optometrist is the right person to treat eye problems like red eye; community pharmacists offer an increasing range of services, from hay fever to emergency contraception; ear wax causing hearing loss is a common problem, and we're increasing the availability of community audiologists.
As part of the strategic programme for primary care, there is also a specific workstream on prevention and well-being. This workstream sets out a national primary proposal for mental health and well-being that will be the basis for planning and local provision. There are also other commitments under the programme for government for community services, and developing a national framework for social prescribing is one of them.
The new regional integration fund, which is worth £144.7 million, continues to move us closer to realising our vision in 'A Healthier Wales', a vision where Wales has one integrated health and care system, that concentrates on health and well-being and on preventing illness—a system that enables people to benefit easily from a wide range of services and facilities in their communities.
To close, I think we can agree that a wide variety of measures are being developed to improve access to healthcare, but there is more yet to come. As well as improving access for individuals, I want to see these improvements making a positive difference to those who provide the services. Their commitment is constant, and it's important that we support individuals in their communities. And the support that they have provided to the public has been exceptional. Thank you very much.
'The timescale for any consultation will be determined alongside other Welsh Government priorities at the time.'
What does that mean? No detail, no dates. We're already behind other parts of the UK and we might still be years away from seeing changes on that particular issue.
Minister, at the start of my speech, I said that this inquiry was a snapshot of the health of marine policies, so what was the committee's verdict? Well, we all expect a significant ramping up of marine energy development during this decade, yet all the while, our marine environment is under threat. So, to tackle this, we need a holistic system that considers the effects of cumulative development on the marine environment, whilst doing what it can, of course, to remove any unnecessary barriers that are identified to the utilisation of natural resources. The committee believes we are a long way from that right now. So, we need the Minister and the Government to accept that business as usual isn’t enough to respond to the climate change crisis and the biodiversity loss that we are facing. We need to do more and we need to do it sooner. Diolch.
On recommendations 9, 10 and 11, on evidence and data—. Well, let me come back to that in a moment, because I do want to spend a couple of minutes going over it. Let me just skip ahead here. On recommendation 13, where we look at the lack of progress on the designation of marine protected areas and MCZs, and ask you to set out a timetable, you have accepted this, and you've said that this will be in the next phase of work to be launched in the coming months, which is great to hear. Subsequently, in recommendation 16, we go on to the slow progress on highly protected marine areas, and again, you accept that. You accept that
'The need, and appropriateness, for areas of higher protection should be considered as part of this process.'
We get all of that. All I would say to you—and I know you get this, Minister, I really know you get this—is that there is a real hunger out there to get on not only with the designation of those, but also, then, because that enables us to get on with the effective management of those areas as well, because that's the other thing. We've got a recommendation in here to do with trawling—that's the only other one I wanted to touch on before the issues over data and evidence. It's on dredging and bottom trawling. Again, you've accepted our recommendation, and you've said—and it's very well written—that you'll undertake
'a structured evaluation of potential fishing gear interactions with features of Welsh Marine Protected Areas (MPAs) referred to as the Assessing Welsh Fishing Activities project'
and that it'll be completed in summer 2022. That's really great, but we actually know the damage that these activities do to some of the most highly sensitive areas. And I know this is tricky for people involved in the fishing industry, but, actually, this is one of the areas we're going to have to make a decision on, ultimately, for that aspiration of returning these areas to what we know they should be as opposed to what they are now, and how they're being damaged.
I've run out of time already. I would ask you particularly, then, without referring to my notes, to look at this issue of evidence and data. There's a lot of good evidence that we took here. A lot of people said we are not at the point we need to be at with data and evidence, and unless we can actually see what is there in that great blue zone below the waves, and so on, it's going to be limited as to what we can do. I think, Minister, this has been going on for a decade and more, trying to pull together the evidence base. I know there are commercial sensitivities, and as my five minutes comes up, I would simply say, Minister, we need to go further with the marine science strategies and the work that the Welsh Government is doing to break down the barriers about sharing information between academia, commercial interests and NRW. Everybody should be pooling that, even if it's anonymised, so we can map more accurately what is actually happening out there now. Diolch yn fawr.
An October 2020 report in The Guardian said that 97 per cent of UK offshore MPAs were subject to bottom trawling in 2019. Now, we have heard NRW claim that those headline statistics don't really apply to Wales, but that their comments were based on an anecdotal understanding. Now, that would set alarm bells off with me, when even NRW are informing us that they cannot reach clear conclusions as to what is actually happening in our Welsh waters. As I have said before, NRW does have—what do they call it—a poacher/gamekeeper role here, because they issue the marine licences, and then they're responsible for the enforcement, and I know that there are issues there. So, this issue cannot be ignored.
Finally, you will be aware that COP15 is on the horizon. So, I think it appropriate to conclude with a question as to whether the Minister considers the current approach to implementing the WNMP as putting the nature emergency on an equal footing to the climate emergency. Diolch.
And one final point before I close, Dirprwy Lywydd: we can't tackle the climate crisis unless we have a healthy marine environment. That means finding cleaner ways of producing energy, not polluting the marine environment, and protecting its biodiversity. All life came from the sea, but life can't flourish without it. Again, thank you to the committee for its work and I genuinely look forward to seeing where the Government takes this.
I've just started the biodiversity deep dive, which will be looking at the whole issue of what protection means—so, the point that Joyce Watson made about what does it actually mean, a 'marine protection zone' or a 'marine conservation zone' or a 'highly protected marine area'? What does that actually mean? Does that mean that you can or can't do certain things in it? What does it mean for bottom trawling and so on? So, the review will be helping me to come to some conclusions on that. We will obviously need to take our stakeholders along with us. We've tried before; we really didn't get it right last time. It's important to get those communities on board as part of this and to make sure they understand it.
I’m also doing the deep dive overall. Thirty per cent of our land and sea by 2030 should be in good condition. We had a discussion during questions earlier on that Delyth started on that, and I think we’re all in the same place there.
We are supporting the MPA network with a management framework supported grant scheme, which includes blue carbon potential, climate change on protected features and a bilingual app called Wales Coast Explorer to inform and help plan visits to the marine environment. I've also allocated budget to fund five actions this year, including the development of citizen science programmes to help identify non-native species and further research to understand pressures the network faces, particularly marine litter, particularly plastic pollution. I hope many of you are doing the Big Plastic Count that's under way at the moment—I certainly am. We want to be—. Following the success of the first year collecting recycling—1.2 tonnes of end-of-life fishing gear; extraordinary success—we want to continue that scheme and spread it out to all the ports in Wales as fast as we possibly can. It reduces the risk of gear lost at sea potentially harming the environment, and we've all seen the terrible photographs of wildlife caught up in that.
We absolutely agree as well that we want to accelerate the review of so-called bottom trawling. That's clearly fundamental and I'm not putting that off at all; I absolutely see the need for that. And that will be part of this issue about what can you or can't you do in particular bits of the sea and so on. We'll also be setting out ambitions for a marine conservation zone designation process as part of the MPA network—again, what does that mean, how does it enhance resilience?
And then, turning just lastly, Dirprwy Lywydd—I know I'm testing your patience—
Currently, there are no blood or saliva tests or scans to diagnose PMDD. The only way to diagnose it is to track symptoms alongside the menstrual cycle for at least two full months. There is no cure, only symptom management. Diagnosis takes, on average, 12 years and approaching, on average, six different healthcare professionals. This, while PMDD affects one in 20 menstruators of reproductive age, and those with PMDD are at a 7 per cent increased risk of suicide than those without premenstrual disorders. Seventy-two per cent have active suicidal ideation during every PMDD cycle. That's each menstrual cycle. Thirty-four per cent have made active suicide attempts during PMDD weeks. Fifty-one per cent have self-injured in a non-suicidal way during PMDD weeks. I'm sure we will hear many more of these harrowing accounts as part of Members' contributions this afternoon. I'm glad that our motion means they will be heard, because this suffering is inexcusable, because there can be no doubt that there is gender inequality at play here.
While women in Wales have a longer life expectancy than men, it is clear that they are spending less of their life in good health, and this arises from a lack of medical research into women's health, which means researchers do not have the opportunity to identify and study sex differences in diseases. And it creates assumptions that similar medical treatments will work for both males and females. For example, diabetes, heart attacks, autism are all conditions that can present differently for males and females. There's also still this pervasive belief in parts of the medical community that stems from societal patriarchy and, to some extent, misogyny, that when a woman complains about her health, it's either hormonal, emotional or irrational and is often framed around their reproductive functions as women.
There is a gender health gap that must be better addressed. Why else has there been five times the amount of research into male erectile dysfunction, which afflicts 19 per cent of men, than there has been into premenstrual syndrome, which affects 90 per cent of women? What else can explain why, when there are concerns that some women across the UK were unable to obtain their prescriptions due to shortages of HRT products two years ago, there was a failure to deal with the shortages? And this, coupled with the impact of COVID-related global supply problems, means around 1 million women in the UK, who use HRT to relieve the symptoms of menopause, will be affected, and so will many women in Wales who rely on this treatment.
It is vital that we address the failures within women's health, so that we can open up the conversation and change its constricted culture. To do this, the Welsh Government needs to develop a bespoke women's health strategy for Wales, which should focus on lifelong women's health; high-quality services, including specialist tertiary care; and investment in high-quality and enhanced training for healthcare professionals. I look forward to Members' contributions to this important debate, and I urge all Members to support the motion. We owe it to the women who have told us of their pain and frustration to listen and to act. Diolch.
Education and training was another issue raised. What the coalition highlighted to us there was the priority need for improved training for healthcare professionals. Again, they suggested areas of improvement, including improved medical training specifically on women's health to be prioritised in foundation doctors' training, to address unconscious bias and to raise awareness as well.
And then the last point I'd raise is preventative health. I'm sure we all agree with that and the Minister will agree with that as well. But the coalition suggested that, in many cases, alcohol consumption, smoking, et cetera, were quite common mechanisms for dealing with issues in life, including chronic illness as well. What they said is that without better understanding of what is driving girls and women to engage in these behaviours, it would be very difficult to design services to meet those particular needs. So, I hope—.
Thanks very much. My time's run out, I notice, but thanks to Plaid for bringing forward this debate today, and I look forward to the rest of the contributions from Members.
Chronic pain conditions that affect women, like fibromyalgia and endometriosis, are treated with a lack of seriousness and urgency. Women wait longer to receive pain medication; they face longer waits before being diagnosed with cancer; they're less likely to receive CPR because their symptoms are so often ignored or dismissed. And this isn't just a cognitive bias that we're battling; it's the fact that textbooks tend to focus on the male anatomy. The norm is always male, and not enough funding is put into conditions that affect women. These failures, Llywydd, result in unacceptable numbers of women dying, and before that, horrendously high numbers of women thinking that the level of pain they're going through is normal when it isn't. That's the cost of a lack of attention to women's health: you can count it in bodies or prescription scripts.
So, in closing, Llywydd, instead of normalising women's pain, we should be normalising talking about how we experience pain, talking about gynaecological conditions, improving training, because this gender pain gap has to be closed once and for all.
But there are many more things we need to learn from other countries. For example, in France, you get 10 free sessions of physiotherapy after the birth of a child. That's not because they're very keen to give people free sessions—it's because it's a preventative intervention to ensure that women are not having prolapses, back problems, incontinence, and all the other things that can go with pregnancy. For those of you who've never done it, I can tell you that it is quite a physical as well as mental exercise. So, I think that that is one thing that I would certainly want to come back to.
This cannot be about grandstanding. We need to really have this adult discussion and have it backed by all stakeholders. It's great that Sioned and others have brought the views of stakeholders into the Chamber. There will be an opportunity for anybody else who's interested in this subject to hear from Fair Treatment for the Women of Wales and the British Heart Foundation Cymru in the cross-party group on women's health tomorrow lunchtime, which is being held virtually, so, wherever you happen to be, you can join. Because this is the way we have to go about having this women's health strategy—to ensure that all women are included, and girls. I look forward to having a path-breaking plan, which I'm sure the Minister will be producing in due course.
And this isn’t the only area where improvement is needed. Sixty-five per cent of people living with dementia are women, but 60 to 70 per cent of carers of people with dementia are also women. Also, 20 per cent of female carers have gone from full-time to part-time employment due to their caring responsibilities, and 17 per cent felt that they were being penalised at work.
We also know that there is a whole host of statistics with regard to heart disease, and these are very powerful figures in terms of the fact that women aren't receiving the recognition that they have coronary heart disease. Women are 40 per cent more likely than a man of having an incorrect initial diagnosis of heart attack. So, there are anomalies here in terms of women and men with conditions that are very common. This can be very disheartening in terms of all of the things that we face as challenges. But, the more we talk about these challenges and encourage women to attend surgeries, rather than suffering in silence—I think about the fact that we have whispered about these conditions in the past—the more we will be talking about them and making progress in these areas. I'm pleased that we have an opportunity like this debate and we would, of course, welcome this new strategy, but also the action taken on the ground to support women in Wales.
I'm really pleased, Minister, that you did announce that you're bringing forward a women's health plan, and I really do welcome that move. I hope that you're able to tell us your indication as to when we might be able to debate that in the Senedd. I'm really pleased that we do have a Minister who has committed herself to women's health, to bringing forward what I believe will be the first women's health plan, and I've sat here a few times—others have been here since 1999. So, it's a huge step forward, and I can see by today—and I do welcome this debate being brought forward today—that you have huge support in delivering it.
The British Heart Foundation Cymru has found that women sometimes do not realise that they are having a heart attack because the pain of their period is worse than their symptoms—going into what you were saying earlier on, Delyth—because, as we have heard many times today, when you are a woman you are told that pain is something that you just have to live with.
So, whilst I applaud the societal changes that allow us to talk about health more openly, we must be aware that historic shame and bias still haunt our experiences of healthcare. And in addition, women's healthcare has always been seen as a single issue. Consequently, the complexity and diversity of many issues, like we've heard about today that have been raised, are often clustered together into one area, and this has led to that lack of research, awareness and investment, and we must do more to change this.
But I do also want to echo my colleagues today—Jenny Rathbone and Joyce Watson. I do believe that our Welsh Government health Minister gets this. I do believe that you don't see it as a single issue. I do believe that what you're trying to do is really to address this inequality. And I also want to say that we have some fantastic work already taking place across our communities. I don't want to lose sight of that. I am fortunate to have Wings Cymru in Bridgend, which is working to destigmatise period dignity. We have the wonderful menopause cafes, as I've mentioned. They are revolutionising the workplaces to be more inclusive.
I want to end my contribution by thanking all those healthcare professionals—GPs, nurses, midwives and specialists—who are working tirelessly to listen and support women in these circumstances. We are up against a system, but that does not mean the system cannot change, and women are shouting loud enough. We must listen and we must act. Diolch.
Three in every four pregnant women take some form of medication during their pregnancy—where is the research in finding out what's safe to take as medication during pregnancy and while breastfeeding? There is a need for investment in that.
Those are some issues that are specific to women. And then you have issues that are relevant to the whole population, but where there is a bigger impact on women, because of lack of attention, lack of investment, lack of taking it seriously, lack of consideration of the specific needs of women—inequality between women and men, as simple as that.
One of those reforms could be increasing the number of support teams in schools, and I believe, and I know the Deputy Minister believes, that every school should have a dedicated member of staff who deals with mental health within schools, to make sure that they're supported. Another thing that the Deputy Minister and I agree on is utilising the third sector so that the void between referral and appointment is filled, so that that young person gets seen straightaway and is not left waiting to suffer at home.
Filling historic vacancies in specialist CAMHS posts is also an issue that I'm sure everyone is well aware of, and it's one that now needs to be urgently addressed. For the last year, I've been told on a number of occasions that this is a priority, but things are not getting better; they're getting worse. This is an issue too great for politicians to just simply declare that it's a priority yet fail to deliver the resources needed to match the statements. More money has been welcomed and is welcome, but we need to make sure that that money is delivering the outcomes that we want for our young people in Wales.
There are many challenges facing young people in Wales, and, sadly, those challenges will continue to get worse unless politicians in here do more. There are many triggers that can cause detrimental mental health in children and young people, whether it be bullying in school, forms of actually not knowing where you want to be in life, not being able to get appropriate housing, school pressures. It goes on and on, and I could talk about that for hours. We must ensure that appropriate support is available for children and young people, but also take steps to address the triggers that can cause detrimental mental health. So, we need to set up 24-hour crisis services for children and young people right across Wales, so that when they reach out for help that help can be provided. Too many young people are waiting far too long for an appointment and many are getting to a crisis point before anything is done, and this simply cannot continue.
I do look forward to hearing many Members' contributions to this debate today. It's a shame that the Government did their standard—as they do every week—'delete all' to our motion. We will be supporting the Plaid Cymru amendment today. This is not a day to pat the Welsh Government on the back, but to do our jobs in this place, to hold the Government to account and get an urgent review under way into the viability of child and adolescent mental health services here in Wales. It's time to act, and I urge all Members right across this Chamber to support our motion today.
I did recover, and I'm very rare. If you look at the statistics, it's very rare to recover from this, and I did. And I can't even really tell you how I did, even now. But I just wanted to say that that was 20 years ago, and we still don't have a unit in Wales. And in my community of Bridgend, we do have Mental Health Matters Wales, and it was only, actually, a couple of years ago I met Michaela at Mental Health Matters Wales, and she had an eating disorder group where people who are suffering with it, but also their families, can come together to get support. And I'd never really talked about this, and I went in and it all just came out, and we laughed, which I know sounds really strange, but there are just things that are sometimes bizarre, especially some of the things you do when you're going through this. And she just made me feel so—. I just thought to myself, 'God, I wish I'd had you when I was that age. I wish I'd had you, I wish my parents had had you at that age'.
So, I know, Minister, you're doing so much on this. I know that we've talked about it before as well, and I always really appreciate your support, but if there is any way that we can have a residential eating disorder unit in Wales so that people—just so that there's more space—don't have to move away from their home. Again, at 14, I don't know how I would have gone off to Bristol like that. So, yes—thank you.
I just want to end by saying to any and all young people out there, as I always say to you, you are not alone—there is nothing wrong with you, there is help available, and you can get through this. [Applause.]
But let us be clear, these problems aren't a result of the pandemic; they are unfortunately a symptom of a historic trend of limited access and diminishing resource. It's where failures such as this occur that our local communities and, as the Member for Brecon and Radnorshire rightly pointed out, the third sector pull together and provide the support that is needed. And nowhere better has this been done than through Wales's young farmers community. As I've said on a number of occasions in this Chamber, Wales's young farmers clubs provide more than just an opportunity to develop agricultural skills and knowledge; they also provide a number of life skills, but also a sense of companionship and support. Lifelong friendships are developed and support networks created, both on a local level and throughout YFC. It's not easy to quantify the value that these relationships have in supporting those members who may be experiencing mental health issues, but, on an informal basis, to have a confidant who understands the challenges and uncertainties that many young people have growing up should not be undervalued. I'd like to take this opportunity to draw attention to a Llys-y-frân member in Pembrokeshire YFC, Hannah Rees, who off her own back brought forward to Wales YFC a plan to provide further assistance to young YFC members, through competition days. Given the fact that this is a young person knowing that there is a gap there and looking to fill that gap herself, I do pay testament to Hannah Rees for the work that she is doing.
But these organisations shouldn't be alone, and it isn't always enough. That's why ensuring that our children and adolescent mental health services are equipped with the resources they need is so important. Regardless of our political affiliations, we have a duty in this Siambr to ensure that every child has access to the health services they need. But, as you've heard this afternoon, that sadly isn't occurring. Waiting lists are exacerbated, demand is too high and staffing numbers too low. This motion before us is our opportunity to change the way in which our CAMHS services operate, making sure our children have access to the mental health services that they need and deserve. Diolch, Dirprwy Lywydd.
I'm going to end with a quote I heard from a young person: 'It's always the ones who are making others laugh and smile who are struggling the most.' We have to take that into account, and we have to see that young people are really suffering in silence. We need to reach in there and help them. I believe that is through a form of 24-hour, seven-days-a-week service that really helps those children and families at the time that they need it, before it's too late. Thank you. Diolch yn fawr iawn.
To ensure a new mental health Bill is fit for purpose, the overarching principles should be: ensuring patients' views and choices are respected; ensuring that the Act is used in the least restrictive way possible; ensuring parity between mental and physical health; and lastly, that the patient should be treated as an individual. Additionally, the Welsh Government should consider changes to section 136 of the 1983 Act, which could help significantly reduce the number of detentions. For someone to be detained, it must be clear that the best interest of the patient can only be achieved through detention. This principle will reduce 'warehousing' of patients, allowing for better care for those who need to be detained, and remove undue stress for those who don't need it.
The Welsh Conservatives welcome dialogue between Westminster and Cardiff. However, mental health is devolved, and this provides an excellent opportunity to deliver a mental health Act that not only includes the benefits of the UK Government proposals, and that ensures parity between mental and physical health, but that is also fit for Wales. We also need to ensure collaboration with mental health charities such as YoungMinds, who, with additional funding from the Welsh Government, can provide specialist support for children and young people. This will address the prevention agenda. For children, a poor experience can be life-changing, so let us up our game. Thank you.
To progress our transformation of specialist services, we are implementing single points of contact for CAMHS services in each health board, ensuring easier access to the right level of support. To improve how services respond to mental health crisis, health boards are working towards the full roll-out of '111, press 2' for mental health for all ages. This will provide immediate access to a mental health practitioner over the phone, 24 hours a day, to provide advice, support and referral. Health boards are phasing in this service, and the early evaluation is promising.
We will be supporting Plaid Cymru's amendment today and it's reflection of the joint commitment we have made in the co-operation agreement, but I want to be crystal clear that our commitment is to pilot community facilities to support young people in crisis. They will provide an alternative to hospital admission, but will also be able to provide clear referrals into NHS services if needed, and will be available on weekends and evenings. We are in the early stages of four pilots in Llanelli, Aberystwyth, Wrexham and Swansea to test sanctuary provision for young people. These models will aim to support the young person and prevent the need for escalation. If successful, this model could also provide an alternative to section 136 detentions when appropriate. But I also want to emphasise that this Welsh Labour Government is already taking an approach to protect the mental health and emotional well-being of children and young people, which has early intervention and prevention as its very core. Our whole-school approach, NEST, CAMHS inreach and improved access to tier 0/1 services are already being funded and rolled out across the country to ensure we make progress on this agenda.
Having a sustainable, multiprofessional mental health workforce is, of course, fundamental to the improvements I've talked about, and I met Health Education and Improvement Wales and Social Care Wales yesterday to receive an update on their new mental health workforce strategy following their extensive consultation. And, of course, the approach I have set out today is supported by our continued additional investment in mental health services, with £50 million additional funding this year, rising to £75 million next year and £90 million in 2024-25. Over £21 million of this extra funding this year will go directly to the NHS to support priority areas, including CAMHS, eating disorders and crisis care. This is significant and recurrent investment that underpins the whole-system approach we are taking to supporting the mental and emotional health of all children and young people in Wales. Diolch yn fawr.
Altaf Hussain mentioned the transfer between the children and adult mental health service, the smooth transition, and I think if those reassessments were more prevalent between those transitions, and between those services, we could see a more seamless transportation between those systems, which I'd be keen to see progress on, and, of course, the mental health Act in Wales, and what that can mean for Wales itself in a UK context.
I thank the Deputy Minister, also, for your response today and updating the Senedd today on some of those initiatives that the Welsh Government are working on. I'd like to see regular updates to the Senedd about, like I mentioned, how you're getting on with that, as it's such an emotive and personal issue for a lot of Members and people across Wales. So, we'll be keeping a good eye on that. I'll just end my contribution in urging Members that if you do feel passionate about this and agree with the points that have been put forward by the Welsh Conservatives today, then I'd urge you to support our motion today. Thank you very much.
All this is having a devastating effect on patients, many of whom are becoming sicker because of a lack of early intervention. My constituents tell me that it can take them weeks to get an appointment with their GP and practices cannot cope with the numbers of people on their lists. And when patients do manage to navigate their way through primary care, they face the same challenges in secondary care. Referral-to-treatment times were already astronomical prior to COVID and have skyrocketed since. The latest figures show that one in five of us are on a list awaiting NHS treatment, two thirds of a million people are waiting years for treatment to end their pain and suffering, and 691,000 Welsh citizens are left in limbo not knowing when their treatment will begin. How many of those one in five will die because they didn’t get a cancer treated soon enough? How many will be forced to give up work because their condition deteriorated to such an extreme that they are unable to function in the workplace?
These are the real impacts treatment delays are having on people's lives. Patients are dying, going blind and losing mobility because they can't be treated soon enough. And they can’t be treated early enough because we don’t have the staff. There are currently over 3,000 vacancies in our NHS and many in my health board, in Betsi Cadwaladr, in north Wales. We have 10,000 fewer beds than we did at the beginning of the century, yet we have frequently breached safe staffing levels over recent months. In recent weeks we saw accident and emergency departments with fewer than a third of the required staff, and if we are to recover adequately from this pandemic and be prepared for the next one, if we're unfortunate to have another one come around, we have to get to grips with the training, recruitment and retention of staff.
We need true integrated workforce planning that anticipates future service demands, and let’s not forget that the parliamentary review of health and social care warned us of the challenges we face as our demographics change. We aren’t planning to meet today’s needs, let alone to respond to future challenges. We need root and branch reform of our recruitment and retention policies, and it would help if we actually had retention policies in the first place.
We need to make working and staying in health and care a more attractive proposition. We need to encourage more young Welsh people to pursue careers in health and care. We need a workforce plan that looks at the whole picture, from science teaching to retirement planning and everything in between. It's time to join up the dots, and that requires leadership. It requires a Welsh Government that can plan for the future. I urge the Minister to grasp this nettle now and make workforce planning her No. 1 priority, otherwise my mailbag and yours will continue to overflow with complaints about not being able to get a face-to-face appointment with a GP, about not being able to see an NHS dentist, or about not being able to get a suitable care package for an elderly relative. We can’t afford to lose any more NHS staff, and my constituents can’t wait any longer for treatment. Diolch yn fawr.
I'm very aware that one of the biggest areas of concern for people in terms of access is dentists. Managing the infection control requirements of COVID has meant a lot less capacity in dental practices. Reforming the dental contract is our main policy driver to deliver that better access, and we will create more capacity for new patients by moving away from the historic six-monthly checks for all to a service based on individual need and prevention. For many people whose oral health is good, they only need to have a check-up once every two years. We do need to communicate this better to the public, and I welcome Members' support in conveying that message.
Last month, I launched our new six goals for urgent and emergency care programme, and I'm supporting this with £25 million of investment. Key developments enabling better access are the eight new urgent primary care centres across Wales, with two more opening shortly. And our 111 telephone service is now available across the whole of Wales. The '111, press 2', directs people to mental health well-being support. Also in April, I published our programme for transforming and modernising planned hospital care and reducing waiting lists. Now, importantly, the plan also signals the transformation of community-based services to offer different options designed to support a person to do what matters to them. We are moving steadily into a new phase of the primary care model. This phase is about increasing the visibility and development of community services, where the focus of leadership and investment is on wellness, independence and the integration of health and care.
A recent King's Fund paper on what we could learn from the pandemic states that a successful and sustainable recovery is possible if there is investment in the resilience of communities and community-led approaches, with individuals and communities in the best possible health to cope with what comes next.