Plenary

The next item, therefore, is questions to the Minister for Health and Social Services, and the first question is from Jane Dodds.

Thank you, Llywydd. Good afternoon, Minister. I had a good time in September when I visited a clinic—

You need to ask the question on the order paper.

Sorry. You're right.

In August 2022, the chief dental officer published updated guidance on the role of the community dental service. This included the expansion of salaried dental officer posts, to support local communities who have limited or no access to general dental services normally provided by the independent contractor model.

Thank you. I had an excellent time visiting a clinic providing community dental services in Llanelli in September. I'd like to thank everyone who has been working in communities across Wales, particularly during the red period of the pandemic, to ensure that emergency services were available.

In visiting the community dental services in Llanelli, I learned a lot about what they do in meeting the needs of vulnerable people: people who have disabilities, mental health difficulties, and also refugees. But there was a concern around the erosion of community dental services. They were really impacted by the pressure on the general dentistry service, and some of their emergency slots were being filled, actually, from those general dentistry emergencies. This often means that there's no availability for vulnerable patients in need of emergency care. So, I wonder if you would commit to ring-fencing the funding and protecting this provision. I wonder if you would join me on a visit, perhaps to Llanelli in our region, to hear from the wonderful staff in providing the service that they do. Diolch yn fawr iawn.

Thanks very much, and it's very heartening to hear about the work that they are undertaking in those community dental services in Llanelli. The good news is that we have given an additional £2 million worth of recurrent funding since 2022 to improve access, and many of the health boards have used that funding to invest in their community dental services—and that's true, I know, both in Powys and Carmarthenshire, which are in our region. So, they are already using some of that money specifically for what you hoped that they would do.

I guess the other point is that the new dental contract means that we are expecting 112,000 new patient appointments to be possible, and that should free up those slots that you were suggesting are being taken up by people who should really be going elsewhere. So, because of that contractual change, we'll expect more of those community slots to be freed up.

Thank you, Jane Dodds, for raising this question. Yesterday, the First Minister told the Chamber that tens of thousands of new appointments will be made, and that was very welcome. We look forward to where and when these will be made available—when we will start seeing them. I am continuing to receive correspondence from anxious constituents, as we all are here, who are struggling to access NHS dentistry services. Currently just 17 per cent of practices in Monmouthshire are taking on new patients, according to the British Dental Association. Accessing an NHS dentist in Wales as a new patient is currently near impossible, or requires a wait of a couple of years, but if a patient joins a scheme like Denplan, you can almost be seen immediately. Clearly there is something wrong here to allow that to happen. Minister, can you outline today what concrete steps the Welsh Government is taking to help retention and to encourage people to enter the dentist industry? How can you make sure NHS patients aren't disadvantaged by the desire of some dentists to take on more private patients?

Thanks very much. We are already seeing a difference as a result of that new contract. So, 73,000 new patients have already gained access this year, and as I say, we expect that to reach 112,000 new patients during that financial year. So already it is making a difference. We also have the new dental academy in Bangor, which we hope is going to provide access to between 12,000 and 15,000 patients, and that's going to be open for six days a week.

The point is, although there's a lot of noise in the system about NHS dentists leaving, the reality is that only 14 per cent of the contracts have been handed back. Eighty-nine per cent of the total dental contract value has moved on to the new contract. But you don't lose those from the NHS—you redistribute them. So it's not lost just because they go somewhere else. They're just redistributed.

We have been recruiting more dentists, and I'm certainly putting a lot of pressure on Health Education and Improvement Wales to make sure that we drive up the number of dental therapists in future, because I do think we have to get to a new model where we're talking about a team approach rather than everything being reliant on the dentist.

Minister, it's clear that there is a problem in this area. Last Friday I had two e-mails from constituents saying that they were concerned that they couldn't access service for their children. One had been encouraged to go private by the dentist, and the other had been told by their dentist that they would have to wait for their two-year-old child at least two years before they would have an appointment. The dental health of children in Wales is a concern. The evidence shows that we are already behind England in that regard. At the beginning of July last year, you said that dental services would go back to normal once emergency treatments had been dealt with first. When will that happen, Minister?

We are getting to a point now where—. Obviously, we're still in a situation where COVID is a reality. One in 50 people have COVID, so we do have to bear in mind that anywhere where there's an aerosol-generating situation, there's an increased risk of the spread of COVID. So, there is bound to be a slight reduction in the level of activity.

When it comes to children, we're hoping to look at new models of how we can look at that, and there's a lot of work that I've asked my team to look at where we can perhaps consider innovative ways of addressing the issue of child dentistry. Because I am aware that we need to ensure that people get into the right frame of mind, when it comes to teeth health, at a very early age. So, that work is ongoing, and I hope I'll be able to report to you at some point soon on where we're at with that.

While I have a role to set the strategic direction for healthcare services in Wales and to hold the NHS to account, it's Powys health board that is responsible for the planning and delivery of services at a local level and for ensuring they meet the needs of the communities that they serve.

Thank you, Minister. Emergency treatment for acute conditions such as stroke or cardiac arrest is more difficult for those people who live in my constituency in rural areas. With stroke and cardiac events it's the minutes and seconds that make the difference between living and dying, and if you do survive, the time of intervention has a direct result on your recovery. In my constituency people are forced to travel over 45 minutes for care into England or other counties in Wales. I hear repeatedly residents contacting me who are saying they're waiting over seven hours for an ambulance, and they're being told to put their loved ones in a car and drive them to a hospital. These trips are extremely dangerous and distressing for family members. So, Minister, I'd like to know what discussions you have had with Powys Teaching Health Board to ensure timely access to emergency treatments for the residents I have in Brecon and Radnorshire, so that they are not disadvantaged by not having any district hospitals within Powys.

Thanks very much. You're absolutely right; we've got to make sure that equity is something that prevails across Wales. We have a clinical lead for stroke in Wales, and with the support of the stroke implementation group manager and the national allied health professional lead for stroke, we're developing plans for regional stroke services in Wales. That includes how hyperacute stroke services, now referred to as comprehensive regional stroke centres, will be configured to ensure that equitable access. When it comes to Powys, as part of that process, it's clear that arrangements linking those comprehensive regional stroke centres are going to have to fit in and to slot into what happens in England. I know that the population of Powys will be interested to hear that, and they are in liaison with the services in England to make sure that that plan does actually take into consideration the fact that, actually, people cross the border into England.

Questions now from party spokespeople. The Conservative spokesperson, first of all, to ask a question to the Deputy Minister for Mental Health and Well-being. James Evans.

Diolch, Llywydd. Deputy Minister, do you think people who present with a mental health problem should be guaranteed mental health assessment within a month?

Thank you for that question. Clearly, our aim in Wales is to have a 'no wrong door' service. We have targets in place in Wales for primary mental health services and access to other services. Services are under pressure at the moment and we are taking action to recover performance with health boards.

Thank you for that answer, Deputy Minister. Your own UK Labour leader, Keir Starmer, said that a UK Labour Government would guarantee mental health treatment within a month, but your child and adolescent mental health services statistics show that the Government here in Wales is failing. Only 50 per cent of children who are using mental health services get their assessment within a month. In some health boards, three in four children are waiting longer than a month for an assessment, and in Aneurin Bevan, 85 per cent of children are waiting longer than a month for therapeutic intervention. This is just, frankly, unacceptable. So, do you believe that your Government is failing children's mental health in Wales?

Had the Member been here yesterday and joined us for my statement on our 'Together for Mental Health' strategy, he would have heard me talk in detail about these. Keir Starmer is entitled to set out his policies for the forthcoming Labour Government in England, but it may surprise you to learn that health is devolved in Wales. I absolutely do not accept that we are failing the children of Wales. As you are well aware, the pandemic has had an impact on waiting times. We've seen a significant rise in referrals and a rise in the acuity of children who are coming forward.

We have instituted the delivery unit review of specialist CAMHS. That's due to report this month. In addition to that, we are working, along with the delivery unit, with every health board in Wales to make sure that they recover their CAMHS position. I am awaiting that report from the delivery unit, and the implementation of its recommendations will be key. Again, had you been here yesterday, you would have also heard me describe the whole range of support we are providing at an early intervention and school level, which is designed to prevent problems escalating to specialist CAMHS.

It's interesting that it also shows that the Labour leader in the UK doesn't believe that the Welsh Government have got any ambition when it comes to health services. That's probably why he's setting his own targets, because he doesn't want to base himself on the failings here. The figures are quite clear that there is a mental health crisis with our children, which is made worse by the Government here not getting on top of it. And no matter how much you stand and say things are difficult, you should be getting on top of this problem.

I also find it unacceptable that nearly 50 children and young people under the age of 18, most of whom were female, were detained under sections 151 and 136 of the Mental Health Act 1983 in the last quarter. Do you think that it's acceptable to detain young children? What are this Government's plans to fix this problem, and if you don't think that that is a failure of this Government, what exactly do you think a failure is?

Well, I think you'll find, James, that there is no section 151 of the Mental Health Act. Obviously, there are protections in place under the law to detain people who are in mental health crisis. We want to see the numbers of young people who are being detained reduced. That's why we're investing all this money in early intervention, prevention, in sanctuary services and in crisis care. But there will always be some people who will need to be detained for their own protection under the Mental Health Act. And we monitor those cases very carefully, and you can see when someone is being detained—by the action that is taken following the detention, with lots of them being referred into secondary services—that those decisions are taken to keep people safe.

Plaid Cymru spokesperson next, Rhun ap Iorwerth.

On 20 September, the First Minister said that the figures and data of the Wales Air Ambulance Charity are behind the plans to close its two sites in Welshpool and Caernarfon and to move the helicopters to one site. I and other Members have written to him to state that it's the Government figures that are behind the emergency medical retrieval and transfer service figures in the health service, and we've asked him to correct the Record. I'd appreciate it if the Minister could confirm that that has happened today. If it helps, I'll quote the words of the charity itself, stating that the analysis,

'has been conducted by our medical partners, the Emergency Medical Retrieval and Transfer Service (EMRTS)'.

Now, because of uncertainty regarding the exact basis for these data, nor, indeed, what exactly the data are telling us, is the Minister willing to commission an independent review of those data and, specifically, to have the review consider the likely impact of the change on those areas that are hardest to reach by road and that are further from the emergency care centers—places such as the furthest points in Llŷn, north Anglesey and Powys?

Diolch yn fawr. Look, at the moment, we're all working on the basis of a leaked report. So, the important thing is that we let the system and the process work its way through. Now, I know that the chief ambulance service commissioner is acting independently of the air ambulance service and the key thing for us to do, first of all, is to find out, once the report has been published properly, whether this does constitute a change in service, and if it does, then obviously the community health councils will be engaged. And at that point, they will determine whether the proposed changes represent that service change, and if they do, then that will trigger a formal consultation. And it's at that point, of course, that we will then have to look at the data. But let me tell you about the data, because I've looked into this and asked what data has been used: we were assured about the rigour of the comprehensive data modelling. What I am told is that it is difficult for us to publish—

It's your data.

I know. I'm going to come to that, Rhun. It's difficult for us to publish that data, because it could identify patients, and that's what I've been told. That's what I've been told, and I'm very happy to put that in writing to you.

That is absolute nonsense.

My concern is that the most rural areas are going to lose out because the ambulance will go after the patient number targets that can be reached by the helicopter without properly considering the likelihood that those could be reached quite quickly by road anyway in populated areas.

I'd like to draw the Minister's attention to the report, 'Service Evaluation of the Emergency Medical Retrieval & Transfer Service (EMRTS) Cymru', which was published less than a year ago. It notes that,

'Despite the service substantially improving equity overall, there remained residual inequity in provision in the North West, and expansion into this area was to be considered.'

In a written statement in April this year, responding to that report, the Minister was full of praise about—and I quote—'the positive findings' of the report.

Now, I'm sure that the same arguments could be made for Powys, but on this particular issue, how can moving the helicopter further away, moving the road vehicles further away, be an expansion of the EMRTS services in the north-west in particular? It can't be about the expansion of flying hours—that helps everybody; we'd all welcome that. How would closing Caernarfon constitute an expansion of provision in the north-west as a means to tackle residual inequity in provision, or what's changed since your statement in April?

Look, the air ambulance is an independent charity. They're the ones who make these decisions, and they have looked at the efficiency of their services. And you would be the first to say to me, 'Why aren't we getting to people quicker?' [Interruption.] You've asked in the past, 'Why aren't we getting to people quicker?' And they are saying, 'We can get more efficiencies—'[Interruption.] Well, other people have asked, Rhun. And, let's be clear, we need to get to people quicker—that is a problem that we need to address. And the air ambulance is trying to address that very issue. They've looked at the efficiencies, they've provided some data, and they have made that assessment. Now, we haven't engaged in that process yet, because it's still not a formal process. At that point, we will engage with the process, when it becomes formal.

The RCN’s report outlines the challenges placed on our workforce by the COVID pandemic and a global shortage of nursing staff. I am committed to ensuring that Wales has the right number of nurses and healthcare staff to meet the care needs of our people.

Thank you, Minister, for your initial answer there. And just for the record, just to be clear, my brother and sister are both nurses in the national health service as well.

At the end of last month, Minister, I had the pleasure of attending the Royal College of Nursing's Listen to Nursing event at the Senedd here, sponsored by your party colleague, Buffy Williams. And it was great to meet those nursing staff, who do continue to provide real high-quality care, day after day. During this event, the RCN released their '2022 Nursing in Numbers' report, which showed that, in Wales, there are currently 2,900 nursing vacancies, and in the area that I represent, in north Wales, in Betsi Cadwaladr University Health Board, there are 650 nursing vacancies up in north Wales at the moment. So, I'm sure, Minister, you'd agree with me, and as you initially outlined, that there is a challenge in recruiting and retaining nurses in Wales. So, in light of this, what further and specific action do you think that you and Welsh Government could carry out to, first of all, recruit more nurses, and, also, to make sure that we're retaining those hard-working nurses that we already have?

Thanks very much. Well, you'll be aware that we're investing record levels in terms of training for the NHS—£262 million just in this financial year. The number of training places for nurses has increased over 69 per cent since 2016—that's 2,396 more nurses that have come on to the system. So, part of the problem is that we've got to actually make sure that we retain people—that's the real challenge as far as I'm concerned. I've asked Health Education and Improvement Wales to work with the RCN to look at what we can do in this space to help retention.

I think it's also worth emphasising that we've recruited an additional 400 international nurses this year. And I was very pleased, on Monday, to meet the health Minister for Kerala in India, who we're going to now be making a partnership with, so that we can recruit directly from Kerala, so that we can have a direct route to qualified, high-quality students. And it was good to hear, actually, that—. Because you always feel quite guilty about taking nurses from a developing country, although India's pretty developed now in many parts, but I think what's important is that we understand what is their motivation. And they were very clear to me that they are happy to train them up, they're happy to send them over. And what happens is that the remittances are sent back to Kerala, and that's why it's in their interest also for us to take on these nurses. So, there are some plans in place, we know that we've got a lot further to go, but this is a global pressure that everybody's really facing.

The health board is in targeted intervention for communications and engagement. This means that there is direct and focused action by Welsh Government to improve communication within the health board.

Thank you, Minister. I just felt compelled to raise this with you, given that, of late, I'm being approached by many constituents who feel that, either when they or their loved ones are in hospital, they get told very little. More worryingly, of the cases that I've raised recently with the health board, only 68 per cent have been responded to within their target of 21 working days. Now, officials have explained to me that delays occur due to clinicians being unable to answer questions immediately, or it can be that medical notes have got lost or have been difficult to find. In one case, I sent a letter last November, and it was only responded to in September this year because, in the end, it went to the ombudsman. An oncologist has apologised, stating that there were some issues in locating clinical notes for that particular patient. This is not the first time that this has been raised with me; it's happening too frequently. This is wholly unacceptable, Minister.

So, what can you do to ensure that, however busy a ward is, notes are written up at the appropriate time, so that the patients themselves know exactly, or their families, but also, that when complaints go in, we're not left waiting—when we're representing these constituents—months on end because the notes haven't been written up with due diligence, and so, it just holds the complaints process up? Thank you.

Thanks. Well, first of all, clinicians should be writing notes; they should be writing notes at the time of treatment. So, there's no excuse for that; that's a requirement. But, in terms of lost notes, I think part of the answer to this is to digitise, which is why I've spent quite a lot of my time trying to make sure that we make sure that we have a far more modern NHS, that we invest in the NHS. And we are investing more per head than England is. So, we're investing about £18 per head compared to £11.50. And that digital transformation programme will make sure that we are in a situation where we can know exactly what's going on, that the systems will speak to each other, and then, we won't have the situation where notes are lost.

Betsi Cadwaladr University Health Board is responsible for the provision of safe, sustainable, high-quality healthcare services for its local population, based on the best and most up-to-date clinical evidence and advice. We've also provided additional investment to support them.

We know, of course, that one in eight nursing posts is vacant in north Wales. We also know from the chair of the health board that of the 642 GPs that we have in north Wales, a quarter of them are over 65, and a third of that 642 are expected to retire in the next five years. And we also know that there aren't adequate numbers coming through to fill those posts. Twenty per cent of posts are filled by locum doctors at the moment, before those I mentioned will retire.

Do you therefore accept that one of the historical failings of this Government, and previous Governments, is the failure to sufficiently plan for the future workforce in this sector, and the upshot of that failure, then, is that we have shrinking staffing levels, that it costs more to the public purse to fill those vacant posts, and it puts more pressure and burden on the shoulders of those left behind?

Well, we have been training people, and we have seen 54 per cent more people working in the NHS over the past 20 years. In Betsi now, we see that almost 20,000 people work for the health board, and there are plans to recruit 380 more during the next two years. And the idea there is that the board wants to get local people to take those posts, so they have a plan for that. And what is important therefore is that that planning is done. I had a meeting with the General Medical Council last week. They demonstrated exactly how many people are going to leave because they're going to retire—'retirement', that's the word.

So, what is important now is that we take all of those figures on board. You know that the Labour Party nationally have said that they are eager to see far more doctors being trained. And certainly, in terms of nurse training, as you heard from the previous question, we are already training far more nurses than we were in the past; more than 69 per cent more than we have in the past. The difficulty is is that we have to retain people in the system; that's where the tension is. And we understand that there has been great deal of pressure on these people over the past two years.

Minister, you'll know I've raised in the past my concerns about the length of delays at our hospitals—Ysbyty Gwynedd, Ysbyty Glan Clwyd and, of course, Maelor. Now, you'll also know that I believe that community hospitals, and in particular Llandudno district general hospital, have a key role to play in addressing some of these issues. I know that you've been listening, because a bridging service trial has now been undertaken at the Aberconwy ward, an operating theatre has been reintroduced, and a new stroke unit is going to be based there. I'd love a timescale on that, please. But there's more that can be done. Only 43.7 per cent of patients spent less than the four-hour target time at A&E Glan Clwyd, yet at MIU Llandudno the figure is a stomping 97.6 per cent. So there we have it: the MIU is performing exceptionally well. So, Minister, will you look at—? It hasn't got an overnight doctor and things like that, and there are ways where, I think, you could enhance provision in these community hospitals, and, without doubt, that will take the pressure of these larger hospitals, which are really struggling to cope. Thank you.

Thanks very much. I'm really pleased to hear that things are going from strength to strength in Llandudno, and, certainly, when I visited there, one of the things I really focused on was what are these people doing there, how long have they been here, what's the plan for these people, and it was clear. I met one man there, I remember, who'd had his leg amputated, but he was in a second floor flat. So, it was clear that he was never going to be able to go home, but they hadn't started working that out until he was coming to the end of his treatment. Well, you could have been working that out weeks before, so it's trying to get people to understand the need to work through those things. As soon as they come in through the door, what is the plan to exit these people? I'm really pleased to hear that that bridging service is working really well. And you're quite right—part of what we need to do now across the whole of Wales is to make sure that people understand that there are alternatives to A&E: that they can go to urgent primary care centres, that they can go to same-day emergency care centres, that they can phone 111, they can go their local pharmacy. All of these things are options that weren't there a few years ago, but we have got a plan, obviously, and we have been trying a campaign, Help Us to Help You, to make sure that people know where they should go to get the right help at the right place at the right time.

We're working to improve bowel cancer outcomes by improving diagnostic pathways, lowering the screening age in line with UK National Screening Committee recommendations, and improving the quality of bowel cancer treatment.

Thank you, Minister. I'm really pleased to see the recent lowering of the bowel cancer screening age to 55, as we know that screening people earlier means cancer can be identified earlier. However, it is also important that treatment can be accessed as speedily as possible. So, I was concerned to note that, in July, just 36 per cent of lower gastrointestinal patients in Cwm Taf Morgannwg started their first treatment within 62 days of being suspected of having cancer. As you will know, that is significantly below the suspected cancer pathway performance target. So, what action is the Welsh Government taking to ensure rapid access to treatment?

Thanks very much, Vikki. Those figures are clearly too low and unacceptable. That's one of the reasons why today I called a cancer summit meeting—a calling together all of the health boards and the leads for cancer in each of the health boards. One of the issues in particular in relation to lower gastrointestinal cancers is that we've seen, partly as a result of that increased screening, a 38 per cent increase in demand for the service—38 per cent. That's a huge increase, and clearly we didn't have the capacity to cope with that, and that explains why those levels are so low. But we've got to do something about that, and that's why it was heartening to hear this morning that Cwm Taf Morgannwg are going to increase the number of rooms in the mobile units at the treatment centres to carry out these operations, and that they've also confirmed a single optimal pathway, which makes sure that patients are sent directly to tests so that they don't have a long time waiting before they start on their journey to really try and get the support that they need.

Minister, we all know that early diagnosis of bowel cancer is vital. It is a fact that nearly everyone who is diagnosed at the earliest stage will survive. Yet, for years, we have failed to detect this illness quickly enough in Wales. We were ranked twenty-fifth out of 29 European countries for our five-year survival rate. With half of bowel cancer patients being diagnosed at a late stage, four years ago, the United Kingdom National Screening Committee recommended that people aged 50 to 74 should be tested. In Wales, people aged between 50 and 55 are not yet being tested and will have to wait years before this age group is treated the same as elsewhere in the UK. This reprehensible performance by Welsh Ministers has put the lives of many people at risk. So, what action are you taking to ensure those between the age of 50 and 55 are supported now, before the screening age is lowered in two years' time? Thank you.

Thank you. I'm glad to see that we've reduced the age at which we're now sending out faecal immunochemical tests to the over-55s, but you're right, we've got to go further, but we've got to do it at the same time as increasing capacity. We are now looking at training more clinicians, so that when that demand—and you've heard that demand, a 38 per cent increase—. That is a huge increase, so you've got to prepare for that. We've got new equipment and new facilities, and I'm sure you will have heard also, at the beginning of the week, about our rapid diagnostic centres that are the first to be rolled out in the United Kingdom, and that should also help as well. So, all of those things will come in, but there's no point expanding until we're ready to support the people when they get the diagnosis. So, we're at that point—we're building the capacity. Certainly, I was heartened to hear this morning that those measures and those steps are being put in place across Wales.

Whilst we recognise that e-cigarettes are being used by some of those wanting to quit smoking, the evidence around their long-term impact is still emerging. We intend to look closely at our policy on e-cigarettes in Wales, including for smoking cessation, as part of our new tobacco control delivery plan.

Thank you, Deputy Minister. On Tuesday of last week, in First Minister's questions, the First Minister said that the evidence is that, for most people who use an e-cigarette, it is as well as and not instead of a conventional cigarette—85 per cent in recent studies show a dual use. That is what he said. My office spoke to ASH Wales soon after, and they are not sure where this figure has come from. They also asked their sister organisation, ASH UK, and they also don't seem to know where this figure has come from. The stat seems to contradict the GP survey marks that vaping is most prevalent within the ex-smoker group. Minister, in Wales, the average percentage of smokers is 18 per cent and just 7 per cent for e-cigarettes. Of those using e-cigarettes, 76 per cent use them to quit smoking. So, Minister, don't you think it's time you started recognising e-cigarettes for their benefits and their role in weaning smokers off cigarettes so that we can finally reduce our smoking numbers in Wales?

Thank you to Laura Anne Jones for that. Smoking is, of course, extremely damaging to health, and stopping smoking is the single most important step someone can take to improve their health. We recognise that, for some people, e-cigarettes and other nicotine products are being used to help them to stop smoking, and current evidence suggests they are substantially less harmful than smoking tobacco. We know that around seven in 10 smokers want to quit, and our free NHS service, Help Me Quit, is available to support smokers and, since 2017, has helped over 75,000 smokers. We know that getting NHS support increases smokers' chances of success by up to 300 per cent compared to going it alone. As with other unlicensed nicotine-containing products, Help Me Quit service providers cannot provide access to e-cigarettes until such a time that there are licensed options available for us to consider. In July, we published our new tobacco strategy, 'A smoke-free Wales', where we set out our ambition for Wales to become smoke free by 2030. We have historically had a cautious approach to e-cigarette products in Wales given the evidence on their long-term effects is still developing and their potential appeal to children and young people. We are very clear that e-cigarettes should never be used by children, young people and non-smokers. As part of our tobacco delivery plan, we intend to look closely at our policy position on e-cigarettes in Wales, including their role in tobacco-smoking cessation. Reports of the increase in use of e-cigarettes by children is very concerning. We will also be looking at what more could be done to prevent their use by children and young people.

As of 11 October, a total of 363,000 COVID-19 vaccination boosters have been administered in Wales. The programme is on track for all eligible people to receive an invitation for their booster by 30 November, in line with the commitment given in our winter respiratory vaccination strategy, which was published on 15 July.

Thank you, Minister. That's excellent news. The vaccine, of course, is the most effective way to defend ourselves against COVID, and, in order to live with the virus, it's incumbent on us all to accept the jab when it's available to us. It's also vital that the roll-out of the programme continues in the most efficient and equitable way. Are you confident that people are able to have the vaccine in a consistent time frame across all communities and for each age group in Wales?

Thanks very much. Well, we are talking about trying to get this booster to 1.6 million eligible people in Wales. That's being delivered through 400 vaccination sites, so I think that does give you the coverage that should allow people to take up that opportunity. As I say, our target is to get to a 75 per cent uptake of that cohort, and so far we're on track. So, we're getting to it. I'm slightly concerned that we're not getting the response from health and care workers that I had hoped we'd get, so I would encourage people to try and encourage those health and care workers in particular to take up that opportunity, in addition, of course, to vulnerable people, and to come forward if it's offered. I know that, in Clwyd South, for example, 34 per cent of the people eligible have already had their vaccinations.

Question 9, Cefin Campbell.

Thank you very much. Last week, Minister—

The question on the order paper, please, again.

Sorry, I skipped ahead.

It's a catching habit.

Thank you very much. The Hywel Dda University Health Board workforce is now at record levels, but we recognise the workforce challenges in mid and west Wales alongside significant demand pressures on services.

Thank you very much. Last week, as I said, I had the pleasure of meeting with the RCN here in the Senedd to discuss their latest report, and in the evening I had the pleasure of meeting a number of nurses from the mid and west Wales region. I heard about the huge work pressures that they're facing: a lack of staff; insufficient pay; morale being low; and they said that they were exhausted, that they were disheartened because they couldn't do their work as they wished to. There are also strategic problems, such as insufficient planning to retain nurses, insufficient recruitment and planning of support for the workforce, and so on. So, alongside the low wages and challenging working environment, I'm not surprised that so many nurses are leaving the sector. The problem is that, across the Hywel Dda area, there are around 540 registered nurse vacancies. This is amongst the highest in Wales. This health board also has one of the highest levels of nurses employed via agencies. This has increased 46 per cent over the past year and costs close to £29 million. So, bearing all of this in mind, Minister, what steps will you be taking to put together a strategy for retaining more nurses in the profession?

Thank you very much. This is an area that I have asked my officials to focus on. It's difficult to do it, because, as you can imagine, in terms of retention, if you have 1,000 people off sick with COVID, what are you going to do to fill those vacancies? How are you going to take the pressure off those people who have to make up for that sick leave? And if we don't use agency nurses, then the pressures are going to be even greater. Now, I'm very unhappy in terms of how much we spend on agency staff at the moment, and that's why I've asked HEIW to focus on this work and to ensure that we work with the unions, quickly, to ensure that we're in a better position. But, at the end of the day, what's needed is to convince more nurses to remain and to continue with training provision. But I have to say that the staffing levels in Hywel Dda are now at unprecedented levels. Eleven thousand people work for the health board, and, in terms of nurses, there are 136 more than there were three years ago. So, there are more staff. But the demand is increasing constantly, and that's the problem. We have an ageing population and so the pressures are greater. So, it is important that we do that strategic planning for the future workforce.

Finally, Russell George.

Thank you, Llywydd. Minister, during the recent Petitions Committee debate, you said,

'it's simply inaccurate to suggest that extending section 25B to all of those areas would result in giving Wales "the full team of nurses", as the petition puts it, and that's simply because, at the moment, those nurses don't exist.'

What I'm just trying to rectify, myself, and give you an opportunity to expand and clarify, is that the Welsh Government—yourself—claim there are various recruitment strategies, including international recruitment as well, and you talk about record investment in education and training programmes. So, surely, if that is the case, those two don’t really sit with each other. I wonder if you can, perhaps, give some further context to your comments during the Petitions Committee debate.

Okay, so, when you write a law, you've got to comply with the law, and if the law says, 'You've got have x many nurses in a particular ward', you've got to comply with that law. If you can't do that because you don’t have the nurses, you're in breach of the law. So, what's the point of writing a law that you know you can't comply with? And at the moment, it's really difficult for us to comply because we don't have enough nurses.

So, what we need, and I accept that—. We're already doing a lot in terms of workforce recruitment. We're training more than we’ve ever trained before. We're doing international recruitment. But I do think that what we need to do now is to focus on retention, because we're losing people as fast as we’re training them. So, that's the area that I think that we need to focus on. And if we can do that we'll be in a much, much better position. These people are exhausted. They've been working their socks off for two years. So, we do need to give them the support—so, working with the unions and with HEIW to really understand what is the pressure and what more can we do to take the pressure off them—and then we'll be in a position to starting writing laws that we can comply with.

I thank the Minister.

No topical questions are accepted under item 3.

Item 4 is the 90-second statements. The only statement today is from Heledd Fychan.

Thank you, Llywydd. Bearing in mind that it was World Mental Health Day on 10 October, I would like to take the opportunity today to celebrate one particular group in my region, namely the Metalidads.

The Metalidads, also known as the Fathers of Metal, bring together that holy trinity of fatherhood, mental health and heavy metal and meet twice weekly in the town of Barry to encourage local dads to get out of the house and away from the children and partners in order to form new friendships and get involved in fun activities and initiatives such as beach litter picks, fundraising for local causes, family film clubs, grub and games night, going to gigs and even learning how to French plait their children's hair, ready for when they go to school.

Using their social media platform, they discuss taboo topics such as depression, trouble conceiving children, child bereavement, autism diagnosis, tackling awkward toddler sleeping patterns and struggles within a marriage as a way of destigmatising serious talking points and to support each other through different lived experiences.

This year, Metalidads have reached out and engaged with and interviewed multiple globally recognized bands and musicians in heavy metal royalty to normalise the question of 'Are you okay?'

Such groups are so important to support parents, and I'm sure that my fellow Members will agree that we need to support local organisations and initiatives in our communities that offer this kind of support that saves lives. Indeed, I received a very warm welcome by the Metalidads and derived great benefit from meeting them.

To end with a frequently used quote by the Fathers of Metal,

'whether it's whammy bars or weaning, Napalm Death or nappies...it's always good to talk.'

Rock on.

Item 5 is the next item, the debate on the Economy, Trade, and Rural Affairs Committee report on the review of the Water Resources (Control of Agricultural Pollution) (Wales) Regulations 2021. I call on the Chair of the committee to move the motion. Paul Davies.

Diolch, Llywydd, and I move the motion tabled in my name. Llywydd, it feels like a long time ago that the Senedd unanimously passed a motion for a committee to urgently review the Welsh Government's Water Resources (Control of Agricultural Pollution) (Wales) Regulations 2021. And that's because it was.

The Economy, Trade, and Rural Affairs Committee took this task extremely seriously, agreeing to embark on this review at our first meeting. However, as Members will be aware, the committee's report was delayed because of a judicial review into the legality of the regulations, which was out of the committee's hands. That judicial review was important to this debate, not just to explain why the committee's report took so long to produce, but also to highlight just how significant these regulations are.

Whilst all regulations we vote on are important, these agricultural pollution regulations affect things that are core to sustaining life in Wales—food production, our water quality and the wider environment. The Welsh Government believe that the regulations will ultimately reduce pollution in our rivers, avoid pollution swapping and prevent or minimise increased losses of nutrients in the environment. The Minister made it very clear that by taking this approach the regulations deliver against a wide range of Wales's responsibilities and provide a holistic response to environmental challenges related to agricultural production.

Nevertheless, in order to implement these regulations, many farmers will be required to undertake compliance work, which will include significant construction work at a significant cost, and that could threaten their viability. Therefore, it's crucial that these regulations set the right balance between protecting our natural environment and maintaining a workable regulatory system for Welsh farmers.

Now, before I run through the report and its recommendations, I just want to highlight the Welsh Government's response to our report and its relevance to this debate. The Welsh Government's response was due on 14 September, and yet it was eventually laid on 5 October, which was the absolute deadline for inclusion on today's Plenary agenda. This delay severely hampered Members' ability to scrutinise the Government's response, and as such it has an impact on this debate. Therefore, I sincerely hope that in the future all Ministers will reflect on the importance of responding to Senedd committee reports in a timely manner, so that we can have fully informed debates on Senedd committee reports.

Now, the Economy, Trade, and Rural Affairs Committee launched a consultation on the regulations, which ran over the summer of 2021, and a wide range of stakeholders—including anglers, farmers and environmental organisations—responded to the consultation. Members will not be surprised to know that the regulations have proved controversial. In response to our consultation, farmers have referred to them as 'draconian' and 'punitive', and they raised concerns that they will be prohibitively expensive to implement and may push farms out of business.

On the other hand, we received evidence from environmental organisations and anglers who welcomed the regulations, arguing that they are long overdue. They told us that the current system does not deter the worst agricultural polluters, and that action in the form of these regulations went some way to curb the pollution in our rivers. So, as a committee, we were acutely aware that these regulations needed to strike the right balance and were as effective as possible. Once the judicial review had concluded, the committee was able to continue with our inquiry and lay our report.

Llywydd, it contains 10 recommendations, and, as time is limited this afternoon, I'd like to concentrate on three specific areas: support for implementation, derogations, and concerns around farming by calendar. Firstly, one of the pressing issues raised was the cost to farmers of implementing these regulations, and it was made pretty clear to the committee that farms could be put out of business. Therefore, I was pleased to see a commitment from the Welsh Government of an additional £20 million to help farmers implement these regulations, as was made clear in the written statement that accompanied the Welsh Government's response to the committee's report. I'm also pleased to see a commitment from the Welsh Government to provide the committee with a detailed breakdown of the provisions being made, including direct financial support and additional funding to advisory services. And perhaps in responding to this debate, the Minister will confirm when the committee can expect that information.

Similarly, there needs to be support for public bodies. Natural Resources Wales have estimated that they will require 60 additional staff to deliver the bare minimum, with possibly over 200 staff members needed to deliver the full product of enforcement around these regulations. Of course, a patchy, under-resourced enforcement regime will give us the worst of both worlds, and I was a little concerned to read in the Government's response that the service level agreement for the regulations has not yet been agreed by Natural Resources Wales and the Welsh Government. Surely Natural Resources Wales will need time to recruit and train additional staff, and so it's vital that a service level agreement is put in place as soon as possible. So, I do hope the Minister will give us an update on its development and any further information she has on how long it may take Natural Resources Wales to be in a position to enforce these regulations.

Llywydd, the committee also received some concerns regarding derogations. We were concerned that the withdrawal of the derogation for qualifying grassland farms would put Welsh farmers at a competitive disadvantage, and so we recommended that the Welsh Government reintroduces the derogation that allowed qualifying grassland farms to spread up to 250 kg per hectare of nitrogen. Farming unions warned that the decision not to include the derogation could require destocking on many Welsh farms, with impacts on farm viability, critical mass within the supply chain and employment, and that the lower rate of 170 kg per hectare could lead to the offshoring of production to countries with lower standards. Therefore, I'm pleased to see, in the written statement accompanying the Government's response, that Welsh farms will now be able to apply for a licence to spread a higher amount of nitrogen. And I do hope the Minister will today provide assurances to Welsh farmers that this measure will not result in further bureaucracy for them.

Finally, I want to mention farming by calendar. Part 5 of the Welsh Government's regulations stipulates closed periods, when spreading is prohibited. And whilst there are exceptions for some holding and soil types, the closed period runs from October to January, with some further restrictions running until the end of February. The committee heard strong arguments about the importance of flexibility for farmers in when they spread slurry, and that was really reinforced to us during our committee trip to the Agriculture Research Centre at Gelli Aur in Carmarthenshire. We had already heard great things about their work on slurry processing and the use of technology to determine the best time to spread. During the visit, we were shown equipment that supports an app the centre has been developing. It was an impressive combination of a weather station and sensors that monitor the conditions, where the information gathered is fed into an app that processes the data and gives farmers a red, amber or green status for spreading slurry. We were told that the system was tested during the 2021-22 closed period, and the findings were that the app was showing a green status for spreading through February and March, meaning that the weather and ground conditions meant it was fine to spread slurry. However, almost as soon as the closed period ended, the app flagged the conditions as red, indicating it was not suitable for spreading slurry. Of course, we are all very aware of how unpredictable the weather can be, so it's vital that farmers are allowed to move over to a technology-backed system based on real world, live conditions, not a calendar system based on seasonal averages, as soon as possible.

The committee recommended that the Welsh Government should prioritise any suitable alternative proposals that utilise technology rather than closed periods for spreading, and, whilst I very much welcome the Welsh Government’s openness to new suggestions, I am disappointed their response puts the onus on the farming community rather than the Government proactively pursuing technological alternatives to farming by calendar. Therefore, I hope the Minister will reflect on this and give it further consideration.

Llywydd, the committee's report covers everything from water quality data to enforcement and incorporating the regulations into national minimum standards, and I urge every Member in this Chamber to read our report. We have asked the Welsh Government to review the effectiveness of alternative technological measures, to be fully transparent about the funding support available to farmers, and to provide assurances that there is adequate resourcing and guidance for Natural Resources Wales to monitor and enforce these regulations. As a committee, we intend to keep reviewing these regulations in the months and years ahead to ensure their effectiveness, and so, on that note, Llywydd, I look forward to Members' contributions to this debate. Diolch.

I welcome the opportunity to speak in this afternoon's debate. The Welsh Government's NVZ policy, the topic of this report, has been a flagship yet controversial policy of this and former Welsh Governments. Therefore, it was only right that this Senedd tasked the Economy, Trade and Rural Affairs Committee to urgently review these regulations. I know that the Minister has been keen to stress that these aren't NVZs, but with Parts 2, 3, 4, 5 and 7 of the water resources regulations word for word the same as that of an NVZ policy, then I'm afraid to say that if it looks like a duck and quacks like a duck, then it is indeed a duck.

Focusing on the report itself, I was disappointed to see the Welsh Government reject recommendation 1 of this paper, that

'The Welsh Government should re-introduce the derogation which allowed qualifying grassland farms to spread up to 250 kg/ha of nitrogen.'

Now, I appreciate that this was rejected on the basis that last week's joint statement with Plaid Cymru, as your co-operation partner, superseded recommendation 1, however, the content of that statement does leave the industry and me with several concerns. Despite the narrative that was pushed out, the statement did not offer our agricultural community any change in policy, unlike what recommendation 1 would have delivered. And, once again, the consultation announced on a possible licensing scheme will see the same evidence submitted and the same arguments discussed, so I really hope we don't see the same old outcome delivered. Because nothing, in terms of derogation, has been guaranteed, and let's not forget that a lower derogation limit puts Welsh farmers at a competitive disadvantage against other farmers across the UK, as committee Chair, Paul Davies, outlined earlier.

I also note with interest that the Welsh Government accepted recommendation 3 of the report, that

'The Minister should set out to the Committee her considerations of the impact these Regulations may have on the planning system'.

Despite accepting the proposal, the Welsh Government's response failed to recognise the fact that large numbers of planning applications will have to be submitted and processed in order for farms to meet the Welsh Government's regulations. Indeed, whilst it's the Welsh Government's view that the infrastructure requirements of the regulations do not significantly differ from pre-existing regulatory baselines, your response, Minister, fails to acknowledge that small-scale family farms do not have the existing infrastructure in place to adhere to these regulations. In return, this will mean that new planning applications will have to be submitted for infrastructure, with the potential for these applications to swamp local authorities, many of which already have planning departments under immense stress. Having read your response, I am not confident that you are fully aware of the impact and the way in which these applications will impede local authorities.

Thank you to the committee, the Chair and all of the staff, as Sam Kurtz said, for their very thorough work on this inquiry. We must begin by acknowledging that we see far too many cases of water pollution in our waterways, and everyone must take responsibility and play their part—the farmers, yes, but also the water companies, construction companies, and everyone else. But, we must also recognise the role of the agricultural industry in our rural communities, in terms of its valuable contribution to our local economy, its invaluable contribution to culture and community, not to mention its central role, namely producing high-quality, nutritious food.

The first recommendation regarding the derogation goes to the heart of the problem. As the agricultural unions state in their response, the new regulations would have led to the majority of cattle farmers in Wales having to stock fewer cattle, impacting their viability, as well as the viability of related businesses, such as dairy factories and so on.

In the report, we see Aled Jones of the NFU as well as the FUW warning that the new regulations, as they stood, would be hugely damaging, particularly to the small upland farms of Wales. No word of a lie, I saw farmers in my constituency who were telling me that they would be getting rid of all of their cattle from the uplands. For some, this would mean that they would have to give up farming entirely, and for others, it meant stocking more sheep on the hills. Now, the irony with that, of course, is that removing cattle from the uplands and replacing them with sheep would lead to more damage in terms of biodiversity. The RSPB and other bodies argue that cattle are needed to graze our uplands, and this is noted in the report.

But in addition to this, forcing such a change so quickly would do the same to our agricultural communities as Margaret Thatcher did to our mining communities, which is to cause lasting damage almost overnight. That is why the recent joint statement between Plaid Cymru and the Government with regard to pausing the introduction of the next phase and considering the introduction of a licensing system for farmers, to enable them to spread up to 250 kg of nitrogen on their land, is to be warmly welcomed. Not only will this ensure the continuity of the backbone of our rural communities and everything associated with that, economically and culturally, but it will be of significant benefit to biodiversity in Wales, and that is very much to be welcomed too.

The report makes clear that the costs of building the necessary infrastructure are huge, and increasing, and the second recommendation makes it clear that transparency is needed regarding what support is available to farmers. It is clear that the amount initially allocated was nowhere near sufficient, as the evidence given by Gareth Hughes from the FUW noted. It is, therefore, good to see that the Government, in its agreement with Plaid Cymru, has secured an additional £20 million to try to ensure that farmers have the necessary infrastructure and resources. Will this be enough? Perhaps not, but it is much better than what was previously on offer in the previous situation.

I live in my constituency, in Caerphilly, and we have a concentrated area of farms, and around those farms are many houses, and you can imagine that constituents are very concerned about how slurry is dealt with and how these issues are regulated—perhaps more so in farms that are more isolated and less close to communities. Therefore, I think the regulations have been broadly welcomed by residents in Caerphilly, if not by all farms, and I think that's reflected in some of the comments that have been made by Mabon ap Gwynfor and by Sam Kurtz. And of course, it's reasonable to say that one size doesn't fit all, which was the direction of the report that's been produced.

I've got to disagree with the Chair on one point: he said that he was concerned that the Government took time to respond to the committee report. Well, actually, given the importance of these regulations and the importance of the issue to the Senedd as a whole, I think getting these right, getting the response right, and carrying two thirds of the Senedd with us when it comes to the implementation of the regulations is important, and I think that was what was managed in the days leading up to the Government's response. I think, therefore, you can see now that the Government's response should have—I would be surprised if it didn't have—a two-thirds majority of support in the Senedd, despite some of the concerns still expressed by the Conservatives who have spoken so far.

And I'd also say with regard to the regulations, these regulations have been subject to a quadruple set of scrutiny, more than many other regulations we see, so they've seen a Senedd debate, they've seen the committee inquiry, they've seen a judicial review, and the debate today. Those four things have scrutinised these regulations, plus many questions that I and many others have raised in the Chamber throughout the course of the last few years. So, there is certainly a case to be made that the Government have allowed a great deal of scrutiny of these regulations. I would say they've listened. I would say they've listened particularly with regard to recommendation 1, and as Sam Kurtz recognised, recommendation 1 is subject to the agreement now between Plaid Cymru and the Government, and I think that effectively addresses some of those concerns. I think what we're seeing today is a listening Government that is listening to the residents in my constituency who are concerned about agricultural pollution, but also to those farmers who have concerns about the impacts. The money that is now being put towards that, plus the additional consultation, demonstrate that this Government have effectively listened without reducing their commitment to controlling nitrogen pollution.

So, I'd welcome the Government's response on the whole, and I'm glad I was able to take part in the inquiry, because it certainly showed all aspects of this process to me. I would say to the Minister now that she has done a good job in ensuring that we can make progress and protect our environments, our rural environments, from nitrogen pollution.

May I thank the committee and the committee Chair?

A huge amount of work has been done by the committee, for which we're very grateful, to make the case for a more proportionate response to what is a really serious issue. I haven't spoken to any farmer who doesn't recognise that the water quality needs to be better. Everybody wants to work together on this, a team Wales approach.

I have written to the First Minister to ask for an economic impact assessment. I did this in August, recognising that increased costs form part of farmers' concerns around the future. I'm concerned that the unintended consequences of these regulations will be felt far beyond the individual farm gate, because not enough attention has been paid to the wider impact on our rural communities, or implications for pre- and post-farm-gate supply chains. I was reminded only today that the proposed 170 kg derogation limit would result in a destocking of dairy cattle at 17 per cent—a loss to us of some 330 million litres of milk production. We really do need to work together to ensure that the four-year review period, included in the regulations, looks not just at the impact of the regulations on reducing agricultural pollution, but at the impact of the regulations on the industry itself.

My first question, if I may, Minister, is to understand a little bit more about the proposed licensing scheme and how that sits in relation to recommendation 1 of the report. I have questions, for example, as to how many farm businesses can expect to benefit. Will there be any learning to inform potential changes to the regulations? What are the parameters of that consultation to ensure it's fair, balanced and evidence led, and what are the successful criteria for that consultation? Farmers have repeatedly said that a delay alone is just a sticking plaster, so we do need clarity for farmers around what this licensing scheme actually entails in the long term.

I'd like to also focus on recommendation 2, and the costs of introducing these regulations. The funding package to date falls far below what the Government's own figures are for the upfront cost of around £360 million. The FUW have estimated that the cost could actually be in the region of £450 million, which is a huge difference. The additional £20 million last week can't be put into context without being provided with full detail of financial support to date, and, in the face of ever-growing cost pressures on our farmers, it does sound like a drop in the ocean.

The new technology, as highlighted by Paul Davies, is really interesting, and I am concerned that the new technology coming forward could actually negate the need for new slurry stores to be built. Some farmers will have forked out huge sums only to find that the expenditure wasn't needed, putting huge additional cost pressures on farms. So, there needs to be some alignment between the proposed licensing scheme, the four-year review period and the introduction of alternative measures. To be provocative, my question would be: why can't we wait until the new technology comes into play and see the effect that that has?

Can I start by commending the committee for a fabulous report? But it is a shame that we ever got to having to have this report. I've just listened to Jane Dodds from the Liberal Democrats preach how bad this is for farmers, but if her party had stepped up in the last term of the Senedd and supported farmers, like Plaid Cymru and us on the Conservative benches did, we would never, ever be in this situation. So, I find some of her comments quite hypocritical.

What I do want to talk about to the Minister—and we do welcome some of the announcements that you have made—is around the additional £20 million, and on recommendation 3 about the pressure this is going to put on our planning authorities. I do not believe, and nor do the industry, that this additional £20 million is going to help farmers to cope with these regulations when they come in, with the infrastructure costs, and everything associated with that. I've got a number of friends who are farmers, who say that some of the money that you're making available won't even put the concrete in the ground to allow this to happen.

What I'd like to hear from the Minister—. Yes, additional money is welcomed, but we're going to have to see more investment, because if you're asking farmers yet again to fork out more and more money, it's going to make farm businesses unviable and unsustainable, going forward. I'm sure we don't want to see these regulations driving our farmers from the land, from producing food to keep our public fed and watered. Because if we see our farmers leaving, our rural communities right across our country are going to die. I know that's not something that I want to see, and my colleagues don't want to see here. So, additional funding is welcomed, and I do hope that you put more money available to support the recommendations that you've put forward. Thank you.

I'm going to start by acknowledging and welcoming what was announced by Plaid Cymru and the Government last week—not quite as cynical as some, perhaps. It's not the end of the process, of course, but it does keep the debate alive, and it does mean that there has been a change of attitude. The other choice was that we just let it go and carry on. So, I think we need to acknowledge that great work has been done on these benches to get to this point and to at least provide an opportunity that at least some Welsh farmers will be licensed and that everything will fall into place to ensure that they can spread 250 kg per hectare of nitrates on the land.

The £20 million, of course, is in addition to what's already been committed, but nobody's saying that that's going to pay for everything. But surely, it's better than what was there previously, so don't be so negative and don't be so cynical. But we're not blinded by the fact that there's a lot of work still to be done, and one of the things that I want to refer to also is that there is going to be another look at the regulatory impact assessment. Because we're in a different context—there's the cost-of-living crisis, we know that the costs of inputs in the industry have gone through the roof. The cost of construction, and the inflation in construction, to meet the infrastructure requirement is entirely transformed. And I think it's quite right therefore that that assessment should be looked at again so that it does reflect the new context—Ukraine, food security, and all of those things—that we need to bear in mind.

But there are still serious questions and real concerns that remain, and the Chair, of course, has referred to one of them, namely this adherence to the closed periods. I've raised this with you in the past, Minister; two years and more ago, I referred to the fact that some of the UK's greatest environmentalists said that farming by calendar was counterproductive. And you agreed that you were struggling with that approach, and with justifying that approach, and you acknowledged at the time that it doesn't, as we heard, take account of the fact that there could be days in the open period that could be totally inappropriate for spreading slurry, and days in the closed periods that would be appropriate. But, of course, that's what you've chosen to incorporate in the regulations.

So, in responding to the debate, perhaps you could tell us what persuaded you that that was acceptable. What changed your mind against the views of some of the great UK environmentalists, that looking at a calendar to see whether the circumstances are favourable was better than looking through the window? That's essentially what the regulations say. And your response to that recommendation—it's recommendation 8 if memory serves me—does refer to technology, and that technology is being developed, and that we're approaching a time where we'll be able to adopt a system that is far more real time in nature, and will provide precision. So, the technology is there, and it's almost ready to be rolled out across the country.

Two more points just before I close. I think that contractors seem to have been forgotten by the Welsh Government in this. They're one of the biggest employers in our rural communities, with most of their work, of course, based on small, family-run farms. The three-month closed period is going to be pretty catastrophic for many of them. When 31 January arrives, they may well have no labour, no equipment to empty all these new big slurry stores, because, of course, they'd have little or no income coming in over the previous months. Some will go out of business. Some will vote with their feet and leave the industry. And if there are fewer contractors, then who on earth is going to be there to empty the bulging slurry stores when the closed period comes to an end on what many of us are now describing as national slurry spreading week? And if there's no-one there to move the slurry, then what happens? Maybe you could tell us how you think farmers can resolve that. I hope the regulatory impact assessment will take full account of the key role that contractors play.

Finally, we've heard a lot about planning; whilst I acknowledge there is a capacity issue, what I would ask you is: what is your message to those farmers who have actually already applied for planning permission to meet the new requirements with bigger slurry stores, but who've had their planning applications refused, not once, not twice, many times, and now find themselves not able to meet your new requirements and not being allowed to adapt in order to meet your new requirements? What's your message to them? Because what I'm hearing is that you are effectively forcing them to shut down the family farm.

Can I thank the committee for their report, and the Minister for the recent statement as well related to this? I better declare at the outset my role as the salmon champion. But also, I have to say, for the decade that I've been an elected representative, I've also championed the needs and aspirations of small and medium-scale farmers, particularly those who are strongly sustainable in their farming and are strongly pro-environment and environmental gains as well. And many of them, including award-winning farmers, are within my own constituency, which is often described as a former coalfield constituency. It's far more than that; it's a very rural constituency, and has always had farming embedded deep within it long before industry came there.

We are facing really challenging times for farming, but we're also facing real challenges in terms of nature. We're in a nature crisis and a biodiversity crisis. We've seen recent announcements by the Welsh Government, who recognise that. We're running up to COP15 with the biodiversity announcements. We're looking for the targets to come back, to be bolted down by Julie James, the Minister, and to be translated into action here in Wales. So, that forms the backdrop of where we are.

It's interesting, the response to this report—the polar response to it. Environmental groups have lined up to say this is really disappointing, this is really sad, this is a delay, and a delay means, once again, we're going to see polluted rivers. Farming Unions—the Farmers Union of Wales, the National Farmers Union, and others—have lined up to say that this is a breathing space. That's an actual quote from one of them—a breathing space, a chance to rethink perhaps, not just with the licensing and so on, but, actually, more fundamentally. That's what they're putting out to their members. So, it leaves me in some confusion, Llywydd, as to actually what we are discussing here, not just on the back of the report, but what the Government has announced. Is this a fundamental rethink? Is it just a temporary pause? Is it some tweaking? Or is it, actually, that in three, four months, five months, we proceed as normal and we do the review, and we're actually going to proceed as has originally been laid out? I don't know. Perhaps the Minister can answer me today, but the challenge and the diversity in those responses has been quite telling.

There's clearly been a role for this committee report. There has been a challenge within the courts that was unsuccessful. The committee actually had to wait to see what that was before it brought forward its own consideration and have the Minister in front of them. I see that. There's also been the co-operation agreement as well, and I have no doubt, personally, that the co-operation agreement has played into what we're seeing playing out in front of us right at this moment. But my message is as simple as this: we can't carry on, given the uncertainty out there. The points that Llyr just made about investment decisions by farmers are well made, as is the point that Jayne made about exactly the same: are we going to say to ones who've already invested, 'Well, that was a waste of money' because we're now going to have some super-duper technology solution that means that was wasted money?

I have read the report with interest. I've made my views very clear on agricultural pollution many times over many years here in this Chamber. I contrasted the tough, but necessary, action that we've taken in Wales with the regime of negligence in England only last week. That has enabled a proliferation of agricultural pollution in our waterways with devastating environmental consequences. So, while I'm cautious, and I mean extremely cautious, to welcome any watering down of the regulations—because that's what it is—that were introduced last April, I appreciate that politics is the art of the possible, and, in the end, whatever works to protect the environment is the way forward. So, I support the Minister's resolve to find a sustainable solution that works for our farming industry, but achieves those vital ecological ends. And you won't be surprised that I'll be watching that extremely closely and speaking out, if I feel the need. I am frustrated that some farming businesses failed to take necessary steps to comply with the regulations pending that unsuccessful judicial review. The Minister's recent statement implied as much.

Will the Member give way?

In a minute.

It's not acceptable, and it does really set a poor precedent. We've heard from Huw Irranca quite clearly that it is the case that most farmers want to comply with and see the advantage of a favourable environmental condition, not only on their farms but in the rivers as well. It is not the intention, we all know that it isn't the intention, of most farmers to pollute. Unfortunately, it has been the case that there have been instances where deliberate pollution has happened and there's been plenty of evidence to that end.

Thank you. I'm grateful to the Member for giving way, and I'd just like to declare an interest as well; it was remiss of me not to do that at the beginning.

I did notice.

But, at the same time, the reason that these businesses have failed to comply in the sense that you're saying is that they're trying to; they're trying their very best to go to local authorities to ask for that planning application, to ask for that planning to be approved so that they can install the infrastructure, the slurry lagoons that are necessary, but they're being turned down by local authorities.

That is probably the case in some instances. I don't accept it's the case in all instances, though, I have to say. And I don't think that businesses should be rewarded for failure to prepare or to comply with legal obligations. However, I do appreciate that the rising costs and global circumstances that were mentioned have added additional pressures. Although, actually, these regulations were well known well ahead of that.

So, I'd like to know about the £20 million—and I welcome it—to help achieve compliance, but to be reassured that people aren't being double paid—that people who've already been paid to comply aren't getting more money or the same money twice.

The committee recommends this derogation that we've heard about—the 250 kg per hectare of nitrogen. While that was not accepted, the implementation date for the 170 kg per hectare limit has been put back. I find that extremely disappointing. The Minister has announced a consultation on the 250 kg per hectare licensing scheme until 2050. We should, of course, assess the economic and the environmental impact of the reduced limit, but in my view, 170 should remain the default limit. I support Wales Environment Link's view that alternative ways of managing animal waste should be found, as opposed to reintroducing that higher limit. So, there are other ways. If we don't look at other ways, we're back to exactly where we started again, and agricultural pollution is the most frequent cause of contamination in our waterways. If we fail to deal with that, we fail our farming community and the wider environment. With that in mind, we should all support whatever is available and whatever works for the protection of our environment, which, ultimately, is protecting the future sustainability of all our land and our waterways.

The Minister for rural affairs now to contribute to the debate—Lesley Griffiths.

Diolch, Llywydd. I would like to thank the Chair and members of the committee for their work in carrying out this review and drawing up the report and recommendations. And I thank those who've participated in today's debate and I will try to respond to as many points as possible.

The report from the committee raises a series of constructive points with respect to the implementation of the regulations. The report provides recommendations that seek to help us ensure that the regulations and support available to help farmers comply are both well understood and adequate to the scale of the challenge we all face. I've agreed to provide further detail and assurances on funding and in relation to NRW's enforcement role and the arrangements for regulatory review. I've provided further clarification in relation to how we guard against unintended consequences and how they can be applied in a way that safeguards the interest of tenant farmers and those facing TB restrictions.

The committee has also made recommendations in relation to the work of the Wales land management forum, and I fully support the spirit of those recommendations. I am not able to direct the work of that forum, but with the agreement of its members, I am happy to continue to work with the group in exactly the way that the committee has recommended. The first recommendation of the committee report seeks the introduction of a process to allow farmers to spread higher levels of slurry, providing certain conditions are met. I've been working throughout the summer on ensuring that we find a way of responding positively to this recommendation and, as part of the co-operation agreement, Plaid Cymru has also been closely and actively engaged in this work.

Last week, I published a written statement arising from those discussions with Plaid Cymru, which sets out our intention to make provision for a consultation to take place to examine this proposal, and to bring forward changes to the regulations should it be established that such a scheme is both practical for farmers and protective of the environment on which they, as do all of us, rely. So, just to reassure Jane Dodds, I want to say that I can't pre-empt the consultation. It's a meaningful consultation, so no design has been worked up in the way that you are asking for some assurance, because it would be wrong to have a consultation that wasn't meaningful. Huw Irranca-Davies asked if there was going to be a fundamental rethink—absolutely not. This is just delaying one regulation whilst we look at a licensing scheme, and we will be working with Plaid Cymru to design that scheme and we will be going out to a full consultation. Paul Davies, again talking about the licensing scheme, you mentioned the need to ensure no further bureaucracy, and I go back to what I was saying to Jane Dodds, the consultation will be out there; it will be a 12-week consultation. Please, everybody, put your views forward, because, then, as we make the design of the scheme, obviously, we can ensure that there's less bureaucracy.

It is not possible to accept the committee's recommendation in relation to recommendation 1 in the way it was formulated—a point I think I have explained in detail in my response to the committee's report. However, I do hope that committee will see that this does provide a way of responding positively in the spirit in which I know that the recommendation was intended.

The Water Resources (Control of Agricultural Pollution) (Wales) Regulations—not nitrate vulnerable zones, Sam, you might want to continue discussing NVZs; clearly, you know the difference, I don't—are absolutely critical to delivering on our domestic and international legal obligations. And whilst the regulations focus on nitrates, the actions that they require are also a necessary means of addressing a range of other matters, all of which I know are extremely important to Members right across this Senedd.

Dealing with agricultural pollution is an urgent and necessary priority to mitigate the impact of the climate emergency, because of the greenhouse gasses it contains, as well as the release of emissions as a result of the environmental damage that it causes, and it needs, as Jane Dodds referred to, a team Wales approach. Agricultural pollution is the predominant source of harmful ammonia pollution, which threatens the development of children's lungs and levels of cardiac disease, as well as the conservation of ancient woodlands.

Quite a few Members raised the £20 million. James Evans mentioned it and clearly doesn't think that it's enough. And, as Llyr said, I don't think anybody would say that that would be the first amount of money that we've brought forward; we've brought significant funding forward. But let me just tell you: I don't have a pot of money where I can just find another £20 million, and it's just a pity that the UK Government put the bankers first, rather than our hard-working farmers. Joyce Watson looked for some assurance around farmers not being paid double, and I've always said that we could not give public money to ensure that farmers complied with the regulations that were already there, so I can assure you around that.

I'm giving the Minister the opportunity to reflect on the comments made this week by the former long-serving agricultural Minister in DEFRA, George Eustice, who himself has laid into—has lain waste to—the proposals that are now coming out of the UK Government, on the back of the work that has been put in, and the work that has been put in with farmers, to actually drive greater levels of environmental stewardship. He now says that that is being thrown out of the window—thrown under the bus—by the UK Government.

I think that we can see why George Eustice is no longer the Secretary of State in DEFRA.

However, this Welsh Labour Government remains committed to upholding and keeping pace with EU environmental standards. I will resist and, where possible, prevent any changes made by the Conservatives in Westminster from undermining those standards, and that includes as they are reflected in the agricultural pollution regulations. While the committee report was published before the UK Government’s policy was announced, I am sure that the committee would agree that no undermining of EU environmental standards should be allowed in Wales.

A couple of Members raised issues around actions that farmers had already taken in relation to the new regulations. I think that it’s fair to say that some farmers have taken action already, and I think that they will have delivered benefits both for their businesses and for the environment. I think that many farmers did make efforts to do so in advance of the prospect of the 2021 regulations, because of the benefits that they could see for their business.

I very much welcome the fact that the committee and other Senedd Members will continue to take an interest in this area. I continue to believe that the best future for Welsh farming is a future in which we keep farmers on the land, supporting them to produce food in a way that is sustainable for the environment and for their business. And in the week that, for the very first time for generations, Welsh lamb is being exported to North America, we can be sure that maintaining high standards will continue to be critical to our success. Am I able to take an intervention?

Yes.

Sorry, I just suspected that you were winding up. You haven't addressed the closed periods, which have been raised by about three or four different speakers.

I wasn't winding up, actually. I was just seeing the time. Just in relation to closed periods, if I can answer Llyr: you are quite right, it was something that I really did grapple with for a long time. One of the things that persuaded me was around the crop need and the nutrient applications that need to be made. It's really interesting that not one member, in any of their responses, mentioned crop requirements or crop needs.

So, just to make it shorter: I know that applying slurry—. The crop growth and the nutrient requirements in winter may increase due to soil temperature increases, but one of the factors for me was that sunlight hours don't change very much. So, that was the reason why I was persuaded in the end. That was one of the main reasons, but there were quite a few reasons. But it was something—you are absolutely right—that I did sort of grapple with.

In conclusion, I do remain committed to working with Members of the Senedd, and with all of our Welsh stakeholders, as we continue to bear down on the levels of agricultural pollution that present such a clear threat to the natural environment. Diolch.

Paul Davies, Chair of the committee, to reply to the debate.

Diolch, Llywydd. Can I thank Members for contributing to this debate this afternoon? There is no mistaking just how important these regulations are, and how important it is that we set the correct balance between protecting the environment and supporting our farmers to produce the food that our nation needs.

We've heard very insightful and, indeed, passionate contributions this afternoon, and I'm sure that Members will understand that I won't be able to respond to each and every one. But I am grateful to the Member for Caerphilly for raising the timescales that the Welsh has had to respond to our report, and I very much agree with him: it was important that the Government took time to consider our report in detail. The only point that I would make regarding the timescales is that the reporting deadline was breached, because the deadline was on 14 September, and the report was actually laid on 8 June. It would have been, perhaps, helpful if the Government had just kept the committee updated on when it intended to respond to the report, but I am grateful to the Minister that she has also written to me again today on that point.

Now, Members such as the Member for Carmarthen West and South Pembrokeshire and the Member for Dwyfor Meirionnydd have raised the impact of implementing these regulations on farmers, in particular the financial costs. The committee understands that these regulations will have a huge impact on Welsh farming and that they could seriously threaten the sustainability of many farms. For that reason, we recommended that the Welsh Government set out exactly what support will be made available to farmers to meet the water quality and other various requirements of the regulations. This should, of course, include the amounts, the funding delivery mechanisms and indeed the timescales.

Members such as Jane Dodds and Llyr Gruffydd have also raised the use of technology this afternoon, and, as I said earlier, the committee received strong evidence about the use of technology to facilitate greater flexibility in when farmers could spread slurry. Now, the Minister made it very clear to the committee that the Welsh Government is open to considering alternative measures and technology, and I welcome that commitment. But I hope that, as Llyr Gruffydd said, the Government will look at technological alternatives in the near future, not just in the next few years.

More generally as a committee we look forward to receiving further information on the implementation of these regulations. We are particularly keen to learn more about the preparations for Natural Resources Wales to be in a position to adequately and fairly enforce these regulations. We’re also keen to see a detailed breakdown of support for farmers to comply with these regulations, and we’d also like to receive more information about the Welsh Government’s proposed licensing system for farms that need to use higher nitrogen. I know that the Minister said that this consultation will now take place, and I look forward to that consultation.

As I said in opening this debate, I believe stepping away from farming by calendar and introducing a technology-based approach to spreading is vital for Welsh farming. I’ve heard what the Minister has said this afternoon, but I do hope that this is a core feature of the planned review of these regulations, a review that I expect committee members will also be keen to be involved in.

Dirprwy Lywydd, I’d like to finish this debate by thanking everyone who gave evidence to the committee. The only way of ensuring these regulations strike the right balance is by rooting them in evidence, and that’s the same for the committee’s report. I believe our report and the recommendations in it are based on a high level of good quality evidence. Therefore, in closing, can I thank Members and the Minister for their contributions today, and say that the committee looks forward to being updated on the progress of the implementation of our recommendations in due course? Diolch yn fawr iawn.

The proposal is to note the committee’s report. Does any Member object? I don’t see any objections. Therefore, the motion is agreed in accordance with Standing Order 12.36.

Item 6 this afternoon is the debate on the Health and Social Care Committee’s report, ‘Hospital discharge and its impact on patient flow through hospitals’. I call on the Chair of the committee to move the motion. Russell George.

Diolch, Deputy Presiding Officer. I’m pleased to open this second committee report debate this afternoon, this debate on the Health and Social Care Committee’s report on ‘Hospital discharge and its impact on patient flow through hospitals’. I’m happy to move the motion tabled in my name.

Our report made 25 recommendations and I was very pleased that the Welsh Government accepted 20 in full. Of the five that were accepted in principle, it is disappointing that a number of those recommendations were aimed at improving dementia care. Our recommendation 19 called on the Government to mandate further dementia training for NHS staff who may come into contact with people living with dementia. We made this recommendation because witnesses told us that there was a lack of understanding of the needs of people with dementia in hospitals and how best to support them in their situation in a less frightening way for themselves.

So, our recommendation 20 asked the Welsh Government to work with health boards to set up pilot schemes to trial set discharge slots for people with dementia. This would ensure that vulnerable people are not being discharged from hospital late at night when there is limited access to transport, and when they may be going home, perhaps, to a cold house, or at a time, of course, that causes distress by disrupting family routines.

It is clear from the evidence that we received that issues raised around delayed transfers of care were, of course, no doubt exacerbated by the pandemic—that's, of course, accepted—but also recognising that there are long-standing problems that existed well before COVID-19. It is, however, totally unacceptable that there are more than 1,000 people in hospital beds when they could have been discharged.

And let's just remember as well that delayed transfers of care are not just statistics. Behind every delayed transfer, there is a person who has not received the care and support they need to be able to return home or to move into appropriate accommodation. It also affects family members and unpaid carers, who find themselves in the impossible position of leaving their loved ones in hospital longer than is necessary or taking on further caring responsibilities that they may not be able to cope with, often at a cost to their own health or well-being. And the financial implications, of course, with that as well also can be significant, especially in the context of rising costs of living.

We’ve all seen pictures of ambulances queuing outside A&E departments unable to hand over patients. This inevitably affects the number of ambulances available to respond to emergency calls, leading to the unacceptable long waits for people who are ill or injured and in pain, and in some cases, sadly, with life-threatening consequences. But at the heart of this issue is the severe lack of capacity in our social care system. Patients who may be ready to leave hospital are unable to do so because there isn’t enough capacity in the care services to put in place homecare packages that would enable safe discharge. This lack of capacity, coupled with the social care workforce crisis that we have, continues to be one of the main causes of delayed hospital discharge and restricted patient flow through hospitals.

Now, unlike the NHS, which I'm sure everyone will have accessed at some point in their lives, the social care sector is largely invisible except to those who need its support; to them it's invaluable. Unless radical steps are taken to reform the way in which social care is provided, rewarded and paid for, we are unlikely to see any real change. Social care providers told us that these are unprecedented times in terms of staffing shortages. People are leaving the sector because they can earn similar amounts elsewhere for doing less pressured jobs. Until there is true parity in pay and terms and conditions for social care staff with their NHS counterparts, I think the sector will continue to struggle to recruit and retain staff.

So, it was disappointing that the Welsh Government’s response to our request for information on how it will increase recruitment to the social care sector was less than robust. While it repeated what has been done to date, it provided no real clarity or assurance on plans for the future, so I do hope perhaps the Minister could provide that detail this afternoon. It would also be helpful if the Minister could provide an update on the work of the social care fair work forum in developing a pay and progression framework for social care workers, and assurances that this work is being taken forward with the urgency it needs.

Thank you very much, Dirprwy Lywydd. Thank you to my fellow members of the committee, and thank you to the researchers and the clerking team. This is a very important report. We're getting to the heart of issues that are holding our health service back at the moment.

We're talking about patient flow through the health service. If there isn't that easy flow through the system, you have a problem. We'll start at the back door of the hospital, when a patient is ready to leave the general hospital after receiving treatment. I've sat in huddles in Ysbyty Gwynedd twice—the morning meetings where staff come together to assess where they are at the beginning of another busy day—one of the statistics discussed is how many patients are ready to leave on a medical basis, medically fit for discharge. It's striking to find that 80 or more beds in the hospital are being used by patients who don't need to be there. The same is true in general hospitals across Wales. That means a problem at the front door: cancelling treatments because there aren't beds available, perhaps, and longer waiting lists then; it means that patients arriving through the emergency department can't move from the emergency department to the ward if needed, because the ward is full. The emergency department is full, which means that an ambulance can't unload a patient; they're queuing outside the hospital; they can't respond to calls. It's a vicious cycle, isn't it, and through our work as a committee, of course, we tried to understand why this block is happening at the back door, this delay in discharging patients—why that is happening.

Now, the focus in recent years has turned to care services. There are robust recommendations in this report to this end: how to ensure that the NHS and social services departments in local authorities work better together to integrate health and care; how to ensure that integration funding is spent effectively; and how to support care staff, to pay them properly, and to support them so that we can recruit. I won't go into the details of that; they are comprehensive recommendations in the report. The Welsh Government, as we've heard from the Chair, agrees to the vast majority of the recommendations. It's a matter for us to hold the Government to account and to scrutinise progress.

There are five of the recommendations that are only being accepted in principle, and I want to turn to one of those, namely recommendation 8:

'The Welsh Government should set out how it will work with health boards and other partners to increase the availability of more appropriate step-up/step-down facilities across Wales'.

The lack of that step-down provision is a huge problem. The capacity isn't there. It has become increasingly clear to me that we can't depend on the care sector to provide that capacity and that, indeed, it's not fair for us to ask them to provide that capacity. And I'm afraid that what we're seeing here is the result of decades of poor policy. I've seen figures that suggest we had around 20,000 hospital beds in Wales at the end of the 1980s. There are very specific statistics by 1997, where there were just under 16,000. Just over 10,000 beds, that's how many we have now. What we've seen is a purposeful deliberate programme of closing community hospitals, closing beds, decreasing capacity. And now, are we genuinely meant to be surprised that there is a capacity problem, that there's a poor flow of patients through the system? The Government is turning to the care services, and says that that sector needs to be accepting patients more quickly. I'm afraid, as I've said, that we are asking them to do something that is impossible to do. Does that take away from the recommendations of the committee? No, it doesn't, not at all. We need to strengthen the care sector, we do need to fund it properly and we need to support care workers.

I thank the Chair for chairing the committee in a collegiate manner and for the report that has come out of that. We can't, of course, look at every aspect in this short time of what is creating the problems, but one of the problems in discharging patients at the appropriate time, quite clearly, is staffing. It isn't of any value at all, whatsoever—quite the opposite, really—for patients to be staying in a hospital unnecessarily. So, it isn't conducive to the patient's physical or mental well-being, and neither is it fair on the hospital staff who, despite their very best efforts, won't be able to give the necessary attention that is required in an overly busy ward to somebody, for example, who might be suffering from a condition like dementia. The report does highlight staffing in the social care sector. It's been mentioned already. It does need urgent addressing. And I do know and understand that the Welsh Government is in that space and that they are trying to come to terms with what they're able to do, like the living wage, like extra training, but nonetheless, we cannot move away from the fact that there is a huge shortage of staff within social care, but also within hospitals as well.

And I did mention, just last week, that we need to address why it is that people—and it's mostly women—are moving out of the profession at a certain age, and it's around the age of 40. What is underneath that? Why are they leaving and leaving us with these shortages? Is it because they themselves have become carers, or is it because they've been in a system for 20 years and they completely want out? We don't know the answers, and the Minister said she would seek that, because that will help us, if we know the answers to those questions, in looking at and forward thinking about managing that turnover of staff, and also what we will need to do in terms of the numbers being trained to fill that gap, if we know that that's the age where most people might consider leaving, or alternatively offering them different contracts, more flexible working, part-time working. We talk often here about agency staff, but very often, if you ask somebody why they've gone to an agency, they will tell you it's a lifestyle choice because they can work the hours they want to work, in the places they want to work. So, we need to examine that, because all of this actually plays a part in what we're talking about here. If you haven't got the staff, wherever those staff are missing from, you cannot and will never solve the problems.

I do want to briefly talk about unpaid carers and the need for respite. We know, and there was evidence again about this, that lots of the facilities they relied on are no longer available to them, either, again, due to staffing shortages, lack of funding from the austerity that we've all endured, or whether other facilities are available but not immediately accessible to them. We've heard an awful lot about step-down community beds, and whilst I support the need for those, ultimately people want to go home. If people don't go home, they deteriorate really quickly, and whether they're in a hospital bed or a community bed, that person is still in a bed. They become very confused very quickly. They become dependent very quickly, even though they go in from an independent state of living. So, it is essential that people go home.

It's a pleasure to take part in this debate this afternoon, and of course as a member of the Health and Social Care Committee, I've seen first-hand evidence from witnesses who are placed in the best position to commentate on the current state of hospital discharges across Wales.

After hearing cases by multiple people across Wales, it's clear that this is an issue that the Government must take immediate action on. However, because the Government has suspended the collection of figures since February 2020, there is no real indication of how big a problem it actually is, and if the cases that we see on a daily basis are our evidence, I expect it could be a lot worse than thought. The last figures showed that many people were prevented from leaving hospital because of delayed transfers of care, which left an additional burden on the availability of beds. This issue leads to greater implications for the NHS, as daily available beds are shockingly low and showing little sign of improving.

Since Labour took responsibility for the running of the Welsh NHS in 1999, we have seen a 29 per cent drop in daily available beds. Although these statistics are appalling, the suffering many face due to this issue is all too real. It's emerged that a patient was forced to wait for 41 hours before ambulance crews transferred care over to A&E, and considering the target time is 15 minutes, this shows that calling it a failure is too soft a verdict on this problem. And in social care, what we need to be aspiring to achieve is a system that is fit for purpose, so that safe discharges can be conducted. Currently, low staffing levels and resources are the main contributors to discharges not occurring, which in turn leads to the whole system blocking, resulting in overcrowded A&E departments and long waits for ambulances, which we see all too often.

Part of the reason for that is that social care staff levels are low and the pay and conditions the staff receive are low. Where the Welsh Government bathe in their minimum-real-living-wage glory at £9.50 an hour, it simply isn't enough. So, what I'm calling for is the alignment of social care staff pay with NHS pay scales, which it is estimated would cost the Government within the region of £9 million. I think this is achievable and I'd be very grateful if the Minister could cover this in responding to the debate this afternoon. Because let's not forget that social care don't just work nine to five, Monday to Friday; they work 24 hours, seven days a week, and work weekends, nights, unsociable hours and sleep-ins. So, I think it's high time that they were rewarded for their commitment to helping our most vulnerable and that we make a career in social care more attractive.

Turning to winter, if I may, and, as I mentioned in health committee last Thursday, I get very anxious at this time of year as the temperatures fall and the nights draw in, and it's simply due to the fact that, year in, year out, we see the horror stories on a daily basis, as pressures are exacerbated during the colder months. It's all well and good talking about winter plans when we're in the full throes of it, but what we'd be best doing is planning for the winter when the sun shines and making sure we have the correct resources in place in a proactive way, so that we can best protect our people from the health conditions that the elements of winter can cause.

As a new member of the Health and Social Care Committee, I want to start by thanking my colleagues and the clerks and everybody who contributed to this report, and I am glad that the Welsh Government has accepted, or accepted in principle, all 25 recommendations.

As a Member with a hospital in my constituency, the Princess of Wales, hospital discharge continues to be one of the key issues, whether that's from healthcare workers on the front line or patients, or their families. I am pleased that the Welsh Government has accepted, as a matter of urgency, to act on step-down care provisions, as set out in recommendation 11. My own health board, Cwm Taf Morgannwg, have told me that hospitals have become a little too much like care homes at this point. Over 25 per cent of patients in hospitals need a step-down bed; there are simply none available. So, they are waiting on wards, some for really long periods of time, where it is not the best place for them, as we've heard from my colleague Joyce Watson. We know that evidence shows that patients start to decline if they are not discharged when they need to be, and I've also been told that the cost-of-living crisis is resulting in some of the care homes in my constituency considering having to close, which would then, of course, reduce bed capacity even further. In Cwm Taf Morgannwg, Prince Charles has access to 100 step-down beds, the Royal Glamorgan Hospital has access to 100 step-down beds, and the Princess of Wales Hospital in Bridgend has access to just six step-down beds, so I am told that step-down beds are critical for my community. So I know, and I do acknowledge, that the Welsh Government has accepted these escalating pressures, laid out in their response to recommendation 1, and have prioritised a system reset to improve the transition of patients to the most appropriate place for their care, but I would ask that when this money and these discussions are going on with the health boards, that it does make sure that it goes to all of the hospitals across that whole health board.

I'd also like to highlight recommendation 5 on the discharge to recover then assess, and the need to reduce the risk of readmission. Again, in Bridgend, we have some amazing community organisations, such as Age Connects Morgannwg, Care and Repair Cymru, who have been helping with patients post discharge, and I know, from speaking with many community nurses, how much they rely on Care and Repair to assist with recovery time at home and to ensure that patients are safe during and after leaving hospital. Bridgend has also relied on the Age Connects service for discharge for over 20 years. Not only do they provide transportation for patients from hospital, but they also get them settled back into their home, as opposed to just dropping them off at their front door, and they also follow up then over six weeks and offer signposting to other organisations. That helps with aids, adaptations, housing, meal planning and maybe introducing them to a hobby. However, due to financial constraints, these services have now been cut by the health board, so that's no longer happening. I heard from an employee of Age Connects that they were in the hospital the other week, because they were just passing out information about their services, and one of the nurses came up to them and said, 'Would you mind taking this patient home?' They said, 'Well, we don't provide that service anymore.' So, then, the patient had to wait for an ambulance to be able to take them home. So, like I said, I do understand the financial constraints, but it does demonstrate that when these services are disinvested, it impacts patients, but also puts pressure on the ambulance service.

I recall about 10 years ago the then chief executive of the Cardiff and Vale health board telling me that in the Heath hospital—our tertiary hospital—the average age of patients was 84 years old, and I very much doubt that that age profile has changed. So, I don't think we should be blaming hospitals for the situation we're in. Everything tips up in the hospital because the other services aren't there. We are never going to arrive unless we are redirecting resources from those hospitals where we have these emergency responses. We have to therefore strengthen community nursing.

Nobody wants to spend more time in a hospital than is medically necessary for them to be there, unless, of course, they haven't got a home to go to that is suitably equipped to meet their needs for convalescence or ongoing needs. I recall one of my constituents, who was a former headteacher, who, aged 93, went into hospital because he had a urinary infection. He played absolute merry hell with me, the MP, the police commissioner, to get him out of there, as well as his family, because he just did not want to be there any longer. Obviously, being a former headteacher, he was somebody who was used to being obeyed, even though he was in his nineties. But you can imagine how somebody else, who didn't have that skill set, would just be left there to die. We cannot go on like this. Nobody wants to die in hospital at all. I certainly don't.

District nursing is not a new idea. It was pioneered in Liverpool in the 1860s and it was an important forerunner of the NHS. It used to consist of a nurse with a bag of kit strapped to the back of a bicycle. But modern district nursing needs to use electronic case load scheduling to optimise safety and cost-effectiveness. I recall visiting the Cwm Taf neighbourhood nursing team in 2020 just before lockdown and heard how the e-scheduling system saved the senior management absolute hours of scheduling to take account of people either going into hospital or people coming out of hospital who needed to be added to the number of people they needed to deal with.

I know that this is something that the Minister is working on, and I'm very glad to hear the progress that is being made, because it really is one of the keys to changing the dial on this system. Because what it does is enable us to understand the demand for district nursing services where there is capacity or need to support the system to prevent admissions and to facilitate discharges. The team leader has got to be able to understand what demand the neighbourhood requires and what skill and volume of staff they're going to need to meet it. This has also enabled teams to safely incorporate the skills of healthcare support workers into their teams and release more highly qualified registered nurses to deliver more complex care. Understanding capacity and demand on an hour-by-hour basis can enable district nursing services to flex the workforce to meet the demand and to respond to any short-term financing issues. So, I'm really pleased to understand—[Interruption.] Altaf, did you want to make an intervention?

Thanks, Jenny. I have worked in the hospital, and apart from nursing care and apart from social services, it is the discharge summary that is never prepared on time. And that discharge summary comes from the most junior doctor in the department when it should be coming from the consultant when he is taking the ward round and discharging the patient. That should be done as early as possible.

Thank you for pointing that out, because that was something that was picked up by Audit Wales as well, in their report. They said that less than half were recording whether the discharge was complex or simple, and less than a third of hospitals were recording when the patient was actually fit for discharge, as opposed to when they actually got out.

I'm glad to say that, today, at the Queen's Nursing Institute annual conference, the Betsi Cadwaladr nurses are presenting the work that they're doing up in Betsi Cadwaladr on how the visibility of their community services data is transforming care delivery. So, well done to the Betsi Cadwaladr team. And tomorrow, Paul Labourne, who I pay a lot of attention to because he's our integration and innovation nursing officer for primary and community care in the Welsh Government, is speaking. It's really important that we understand that the way in which we're rolling out these electronic case load systems is also being used to test whether we can capture the levels of care for every single patient visited on this system. This apparently has never been undertaken before, and so this could seriously improve our genuine understanding of what people need in the community. So, well done, Minister.

What is also good news is that up to three local authorities that have now started using the same system with their domiciliary care services are reducing duplication, enabling better joined-up visits with neighbourhood district nursing—hooray—

Jenny, you need to conclude now, please.

—as well as giving those services the workforce, the productivity and efficiency savings that such systems can and should deliver. This will make for a much more interesting and less stressful job and therefore will impact positively on our retention systems. So, I look forward to hearing exactly when we're going to have it out across the whole of Wales.

Can I thank the committee for the report and for the debate today? I have to say that there are a lot of good recommendations and analysis within this, focusing particularly on the issues of discharge and how we deal with this. I think it's also recognition that this is exceptionally challenging, extremely complex and that there isn't a simple switch to solve this. There is a range of things that we need to do.

Minister, I just want to reflect in my opening remarks on the fact that the NHS, the staff within the NHS, from the clinicians and the nurses to the people who clean the operating theatres and prepare them and the porters, are performing miracles every day, and I get told that by my constituents as well. So, whilst there is immense pressure, probably unprecedented pressure, on the system and it isn't, as you were saying, simply in winter any more, it's every single day through every single year, the demands are rising on what we expect of the NHS as well as the challenges that it's facing post pandemic and the cost pressures on it, it is performing miracles, and I know that. Both my parents passed away in the last few years, and the treatment they had and the care they had over the years, in acute settings and actually when they finally went into hospital and didn't come back out, was simply incredible, and I challenge anywhere in the world to give them the care that they had and the compassion and the treatment that they had.

What this report focuses on is something that I reflected on after I recently visited the hospital that Sarah and I share, the Princess of Wales Hospital. I met and spoke in detail and at great length with the emergency services staff in A&E and wider. I reflected with them that I've always known that that A&E unit has been from time to time commended for the best-practice approach that it has in the way that it deals with patients, identifies the problem coming off the ambulance and gets them into the hospital, and so on. It's been an innovator over many years. And they're still doing what they believe to be best practice, but the simple fact is—. Their analysis was interesting, because they feel that they are now caught in a situation where they cannot provide the standard of care that they need to, and it's not to do with what you see at the front end of the hospital, it's what you see at the back end; it is discharge.

They saw as symptoms the fact that you have ambulances queueing; they saw as symptoms the fact that you have people stuck too long in emergency services, sitting in chairs when they should be in beds, lying in beds when they should be in a ward, and so on, and when they get to that ward, being stuck in that ward too long and not being able to actually leave the hospital because of problems with discharge. They're seeing people, as has been remarked in this debate already, who are turning up—these are not people who are turning up for futile, silly reasons within emergency services; they are typically much older, they're typically much iller by the time they present. So, it's not people you can turn away.

I call on the Minister for Health and Social Services, Eluned Morgan.

Diolch yn fawr. I welcome the report, and I'd like to commend the committee on its really thorough approach to the review. The report explores a wide spectrum of areas that can impact patient flow through our hospitals, and ultimately on to discharge and recovery. What we've heard today is how complex the situation is. It has got to be a whole-system approach, because unless we do it as a whole system, some part will bung up the other part. The recommendations that you've made will be valuable in helping to provide further steer and focus as we tackle improvements in this area. We've provided our formal response to the report. I welcome the comments provided today by Members, and I wanted to use this opportunity to highlight a number of key measures that we're taking forward in support of addressing patient flow and safe and timely discharge.

Now, in order to make improvements to our systems, we must look not only at patient flow and discharge, but also at community responses and admission avoidance services. So, it's not just at the end of the system, as you suggested there, it's actually, 'How do we stop them from coming in in the first place?' as well. It's the preventative, so, again, that's an extra complication, but we're putting a huge amount of resource and work into those prevention measures as well. We have work under way focused on anticipating care and to support people closer to home, wherever that may be, and we seek the best clinical response for them.

Part of that prevention strategy is within our six goals for urgent and emergency care, and that's a strategic primary care programme, so it brings in primary, secondary and ambulance and all of those. This is all being developed by clinicians and they've told us, 'This is what will work'. So, we've got six goals. A lot of it is about prevention, a lot of it is about, 'How quickly can you get people out? Where is the flow coming from?' I expect all services to use that home-first principle and to adhere to the discharge to recover then assess pathway. So, we know that it's better to make an assessment in someone's home, rather than in a hospital bed. That's something I'm really pushing on, so the reablement, for me, has got to be done in the home, so getting those occupational therapists back out into the community is really important.

It's important also that we provide same-day emergency care and support people to return home without admission into hospital. Estimated dates of discharge should be set early and communicated so that all the teams, both within the hospital and community know what's being planned, and then allocating the correct discharge to release is really important, and to ensure that we have fewer days when someone is in hospital.

Will the Minister take an intervention from Altaf Hussain?

Of course.

Thanks, health Minister. Does it include an observation ward of 30 or 50 beds attached to each A&E department and district general hospital? It will be that ward that you could be using for these extra patients who are fit for discharge, but not going home.

Altaf, you'll understand that the real challenge is not actually infrastructure, it's staffing. So, that's the issue, and we know that the staffing issue is something that is challenging everywhere, but particularly social care. So, we want people to go home, we want that support in the community, and we're having difficulty with recruitment. Part of that difficulty in recruitment, I think we all accept, is that carers need to be paid more.

Gareth, I'm going to say this gently today, but I'm going to warn you that this noise is going to increase in volume every time you tell us to spend some money, because, actually, we would love to pay more to carers. But, actually, your Government has just made this a hell of a lot more difficult—a hell of a lot more difficult. That is going to be really problematic for us, and that's on top—

Will the Minister take an intervention?

I'll take an intervention.

Thank you for that. It's not just carers I was talking about, it's social care staff pay, which are completely different things. And I do understand the complexities in social care compared to healthcare, because 99.9 per cent of healthcare services fall within the NHS, whereas in social care, it's fragmented and it's public sector, local authority and private sector. And I do understand those challenges, but I think if we can really work to achieve some parity of esteem between health and social care staff pay, I think we can really be a shining example to the rest of Europe and, indeed, the world.

Gareth, I would absolutely love to do that, that is absolutely our ambition as a Government, it's in our manifesto, that's what we want to see, it's just that your Government has just made that a hell of a lot more difficult. We've just had a £207 million bill for energy that we weren't expecting, and we've got a bit of a rebate from the UK Government—maybe £100 million—but that leaves me with £100 million gap that I've got to find from somewhere. So, that is a problem, and that's going to be a problem next year. We decide as a Government where that money's going to go. And we actually spend about 33 per cent more on social care in Wales than they do in England already, so I'd hate to imagine what state the care system is in England if they're spending 33 per cent less than us. Huw, you were mentioning that we've got to put this funding together—we have. We are putting £144 million where we expect local authorities and health boards to determine together how they're going to spend that money, and it's all in this space, it's all in this space, which is about how we address this delayed transfer of care bill. There are a couple of other issues in there as well—mental health and whatever—but a huge amount of it is about this delayed transfer of care.

The community care capacity initiative that we have embarked on now is aiming to deliver additional system capacity from October this year until April 2023. This is something, again, that we've been working on over the whole summer, and the objective is to create extra step-down-to-recover beds and community equivalent provision, alongside taking additional measures to boost the community care workforce. And the focused effort for this winter is consistent with and complimentary to that urgent and emergency care programme of work, and I look forward to giving you a bit more detail on that, because we have been working really, really hard to prepare for building that additional community capacity over the winter. So, capacity within social care is an area that we absolutely are focused on. We are aware that the lack of sufficient numbers of social care staff is having an impact on patient discharge, and we've got a number of actions to deal with this. Additionally, each region has developed a plan to increase its community social care capacity and is co-ordinating recruitment drives at local and regional levels.

Now, a couple of people talked about the need for systems—digital systems—to work together, and what we have now is the Wales community care information system. We've already spent £30 million on this, and we intend to spend £12 million additional in the next three years. And what this is going to do is to integrate social services and community health data, so that they can have shared electronic records for health and care, so we get the systems talking to each other. We've got to get modern here; this is going to help us to get modern, and this is going to do some of issues that many of you were talking about, and getting data—why are people stuck and what is stopping them? I think that's really important. We've done a huge amount of work with local government to identify exactly why people are not moving in the system. Is it because their medicines haven't arrived? Is it because they haven't got transport home? Is it because there's nobody to look after them when they get home? So, all of those things, we've broken it all down and we're coding it and we're making sure that we know why people are stuck there.

Minister, you need to conclude now.

Thank you. Rhun, you asked about hospital beds. Well, we've got considerably more hospital beds in Wales, according to the Nuffield Trust, than they do in England. There are 270 beds per 100,000 in Wales; 170 beds per 100,000 in England. But what we're keen to do is to make sure that we get into that reablement space that you talked about. It's not just about hospital beds, it's about actually how do we get them out of hospital beds into the community.

Now, we have a report from the expert group on care, and that's going to be published soon. I think it's probably worth saying that whatever the ambitions were, we could be restricted in terms of our financial restrictions in future. So, we've just got to understand that, whatever the situation was before the summer, it has changed significantly. Julie Morgan, my colleague, has been working very hard on this as well. I think that that is enough from me, Chair.

I have been very generous, Minister.

Thank you very much.

I call on Russell George, Chair of the committee, to reply to the debate.

Thank you, Deputy Presiding Officer. Can I thank all Members for taking part in this debate this afternoon, and I particularly thank—I think Gareth Davies made a point in his contribution of thanking the clerking team and the wider research team that support our committee’s work, so I’d like to put that on the record from myself as well.

I think that it was Rhun and Sarah who talked about the need for step-down beds, and the need to allocate funds for step-down beds fairly across health boards was a point that I think Sarah made. The Minister, in her contribution, referred to that, and I welcome some of the contribution that the Minister made in terms of building more community capacity. Also, I think that Rhun, in his opening remarks, talked about the importance of considering patient flow. I think that we do need to look in the round, and examine where the barriers lie, and of course remove and address some of those barriers.

Joyce mentioned, in her contribution perhaps why the committee has focused on hospital discharge. We had quite a discussion about this in committee: long-standing issues, social care capacity, health and social care integration, the workforce crisis that we are in. And Joyce highlighted, of course, the plight of unpaid carers as well, and some of the challenges that they have now. Joyce also put the question as well that we need to know more about why people are leaving the social care profession. I think that we know that to a certain extent, but I think that there is more that we can do to understand why that is.

Many Members mentioned those beds that—. I mentioned in my opening comments the ambulances queuing outside hospitals. I think that it was Huw who mentioned—and it was a good phrase—the queuing of ambulances as a symptom of patient flow. So, while I mentioned that, and we are all aware of those ambulances waiting outside hospitals, so patients and people who need those beds can’t get in there, there is the other side to this as well, which Joyce and Jenny referred to, about people’s health deteriorating when they are in hospital beds, and when they themselves need to go home for their own health as well, but in terms of the frustrations of people in those beds who can’t get home. Jenny gave an example of one of her constituents, but perhaps not all of those have got the skills to advocate for themselves to get home, which I think was the point that Jenny was making.

Many made the point as well about the need for people to get home as quickly as possible, but again, of course, we know that this then links to some of the issues that we have within care staffing levels. Gareth, importantly, mentioned the issues around data. This is part of the report, and some of the issues that we made some recommendations around. But he was also mentioning around the pay and working conditions as well. But, importantly, we need to make the profession more attractive, don’t we? And pointing out as well the exacerbated pressures that we will have this winter.

The proposal is to note the committee’s report. Does any Member object? I don’t see any objections. Therefore, the motion is agreed in accordance with Standing Order 12.36.

Item 7 is next, and that’s the Plaid Cymru debate on the private rented sector. I call on Mabon ap Gwynfor to move the motion.

Thank you very much, Dirprwy Lywydd. At the outset, I want to declare an interest that is on the public register.

So, back in January, I put forward a motion on rent controls in the Siambr. The Conservatives, as expected, voted against it, while the Labour Party abstained, largely because of a promise that the Government had commissioned a paper to look into the idea that would feed into the White Paper on housing. But the White Paper continues to be some time off, while this motion looks to respond to an immediate crisis.

So, this Senedd has already accepted the principle that we need to see intervention in the rental market in order to defend tenants, many of whom are the most vulnerable people in our society. Contrary to noises from the Tories opposite, who believe in hoarding wealth and who claim that this proposal is anti-landlord, this proposal in front of us today, if it’s anti-anything, is anti-homelessness and is pro ensuring that everybody has a roof above their heads. Because here today we have a proposal to at least do something to help many of those threatened with homelessness this winter, as opposed to doing nothing. A rent freeze, as the name suggests, is merely a temporary action to tackle an immediate crisis. The same applies to a ban on evictions similar to the actions taken by this Government during the height of the COVID pandemic. Now, I understand the concerns about unintended consequences of taking these actions. There are concerns that rents will increase significantly at the end of the period, and that people will be made homeless. I get those concerns. But there are consequences to doing nothing, which are that many people will be made homeless this winter because of their inability to pay their rents. It stands to reason, therefore, that knowing that people will become homeless is an entirely intentional consequence of doing nothing.

Only this Monday we marked World Homelessness Day, and the Minister was cutting ribbons to open the Crisis Skylight building in Swansea, which will help people at risk of homelessness. Well, I’m sorry to say that there’s a very real prospect that that centre will be inundated over the coming months with tenants that have been turned out because they can’t afford the rents on their homes. We’re in the midst of both a housing crisis and one of the worst cost-of-living crises in living memory. Like every financial crisis in the modern era, this crisis also has its roots in housing. In the case of private renters, all they do is work hard—sometimes more than one job—in order to transfer their hard-earned money to a private landlord.

Now, the Tories will argue that the housing crisis is the result of a dearth of supply. That’s correct, to a point. There is a chronic lack of social housing, which is the result of decades of underinvestment. But the irony of this argument seems to be lost on the Tories, because it completely undermines the most fundamental tenet of the open market dogma that they so fervently believe in, that of supply and demand. There’s plenty of demand but the supply side is falling woefully short. Supply and demand, just like trickle-down economics, just doesn’t work, and it’s a free market myth. This scarcity of available housing means that there’s a fierce competition for houses, with landlords able to increase rents knowing that people are desperate.

'speaker Adam Jones advised landlords to issue “smaller, regular rent increases” instead of large, more sporadic hikes'.

It's tactics like this that have led to Wales having the largest increase in rents anywhere in the UK, except for London. In some cases, we're hearing of rents doubling and families left bereft.

Now, we hear that private landlords are leaving the sector with claims that the added burden of regulations are making things difficult for them. Ignore those claims. Firstly, regulations are there to protect the well-being of tenants. What we're seeing is property owners cashing in on inflated property prices, and, in some cases, cashing in after taking advantage of Government funds to make their properties more habitable and suitable for tenants, and then selling them for a profit or placing them on Airbnb. So, once again, what we're seeing is public funds being transferred directly into private bank accounts. Surely, you can see that there's something rotten in this system. So, we have a scarcity of available properties, which is adding to the problem and leading to massive increases in rents in some cases.

In Wales, average rents have increased by over 15 per cent year on year. This is far more than inflation, and can't be justified. Two years ago, many private renters were spending over a third of their incomes on rents, and here in Cardiff tenants were spending closer to 40 per cent of their take-home pay on rents. This was two years ago, and, since then, we've seen double-digit rent rises.

Our local authorities are already inundated with people presenting themselves as homeless and requiring temporary accommodation. They don't have the capacity to take on any more, but that's the situation they face this winter. Many millions of pounds are spent on assisting people who find themselves in this position, requiring temporary accommodation or homeless, and council budgets are completely blown. By doing nothing and letting people find themselves homeless, this Government will have to find more money to give councils to cope with the increase in homeless numbers.

Yesterday, the First Minister challenged my colleague Adam Price to find the money to pay for nurse pay increases. Well, the challenge is thrown right back at you. Can you tell us where the money will come from to fund the massive increases in homelessness costs that will come as a consequence of inaction? A rent freeze is a temporary measure. It could be enacted immediately and last for the period of this cost-of-living crisis, which economists expect to be around two years. It could be reviewed on a six-monthly basis. You could then introduce a rent cap immediately afterwards in order to avoid that fear of some landlords massively hiking up their rents.

I have selected the three amendments to the motion. If amendment 1 is agreed, amendment 2 will be deselected. I call on the Minister for Climate Change to move formally amendment 1, tabled in the name of Lesley Griffiths.

Formally. Formally.

It's okay—I heard.

I call on Janet Finch-Saunders to move amendments 2 and 3, tabled in the name of Darren Millar.

Diolch, Dirprwy Lywydd. I refer Members to my declaration of interest form in terms of property ownership.

I rise once again to contribute to another debate that references and tries to do down the private rental sector. Now, let me say from the start and without any doubt that it is a matter of fact that private landlords are a very large, significant contributor to providing good quality and safe homes across Wales. The majority of these landlords are signed up with Rent Smart Wales, and they take their role as home owners and landlords very seriously and professionally. Speak to any one of them and they will tell you, 'All we want is to find a good tenant who will look after my asset—the property—and pay their rent so that it does make it worth while.'

Now, this debate today I believe is coming as a consequence of continued failure of the Welsh Labour Government since the start of devolution, and you in Plaid Cymru are not free from this; you have been in Government here in the last 23 years. House building has collapsed over the past 23 years—the number of dwellings completed between 2021-22 9.3 per cent lower than before the pandemic. You're not even halfway yet to achieving the target of 12,000 new homes a year. The Welsh Labour Government has also failed to build social housing in Wales, and it's a fact that because of what you're calling for now there's nervousness growing in the registered landlord agencies. Only around 9,000 housing association and local authority homes were built between 2010 and 2019. Your failure so far has resulted in 67,000 households stuck on housing waiting lists in Wales. So, don't say people are going to become homeless—it's already happening.

Temporary accommodation spend has rocketed from £5 million in Wales in 2018-19 to over £20 million in 2021; 25,200 people placed in temporary accommodation. Let me tell you, these are not nice, cosy little homes—these are rooms in golf clubs, bed and breakfasts and hotels. Whole hotels have been taken over in Llandudno, in a tourist destination, to provide a roof over the heads of our vulnerable families.

The private rental sector market is voting with its feet. These valuable home providers are leaving the market. In the National Residential Landlords Association's latest landlord confidence index, landlords in Wales have the lowest levels of confidence when compared to landlords in all English regions. NRLA's member survey data shows that 26 per cent of landlords in Wales have sold over the last 12 months; 49 per cent are planning to sell a property in the next 12 months. Landlord repossessions have been steadily increasing in Wales in the past year, up to 150 in the second quarter of 2022, compared to only 78 at the end of 2021.

Will you take an intervention?

Yes, go on.

I've heard you refer to houses as 'assets' twice already. Isn't this the crux of the problem with this issue, that houses are being viewed as assets? Houses are homes for families. Will you not accept that?

Yes, but bear in mind that a lot of these homes have been bought, you know, and are subject to mortgages.

To make money, so they're not for families.

No. I'm sorry, no. The policies alone—

Can we not have a dialogue? There's not a dialogue between Members.

No, thank you. These two policies alone will turbocharge the tsunami of landlords leaving the sector and a section 21 notice is issued. Already, between 2018-19 and 2021-22, there have been 20,070 landlords deactivating from Rent Smart Wales. It is policies such as yours that are actually now spooking the market. Evidence shows that an eviction ban delays the threat of homelessness rather than seeking to prevent it. Following the lifting of the previous ban, landlord possessions in England and Wales increased by 207 per cent. These are not my figures; these are documented stats. A study by Assist Inventories of 10,000 landlords found that 45 per cent planned to move away from long-term tenancies, with a further 41 per cent saying they're going to consider it.

Then we have this nightmare of rent controls. Prior to the Scottish Parliament passing their legislation, the Scottish Association of Landlords warned that landlords were just selling their properties in light of the proposals. If we look further afield, in San Francisco, where the housing supply then fell by 15 per cent, while in Berlin rent shot up by almost 10 per cent between 2015 and 2017. So, there we have it.

I'm not going to say Welsh Labour, because it's not their debate this, but I was very pleased with Hefin David on Sharp End on Monday evening, when he spoke common sense and said that he's been approached by councils—

Janet, you need to conclude now, please.

—who were saying, 'Please do not freeze rents.'

I'm outlining the truth, and have repeated several times that you and your policies will push people into temporary accommodation. I genuinely invite fellow Members of this Parliament to accept reality, let us all work together, cross party, to tackle the housing crisis in its entirety. So, there, we can a make start today by backing the amendments tabled in the name of Darren Millar MS. Diolch.

Our motion today is one that seeks to ensure social justice and protection from the worst economic storm in decades. It's about taking action now, saving people from misery and destitution now. It's about insisting that it is protecting the most vulnerable in society that must be the focus of a just Government, not protecting the assets and incomes of those who won't have to face the anguish of trying to keep food on the table or losing their homes.

People who rent their homes are more likely to live in poverty or be on low incomes. They are less likely to have savings or assets that they can use to cushion economic shocks or short-term financial difficulties. These are the groups of people that will be most anxious about being able to afford their rent as everyday costs rise. And I'm sure all Members would agree that no-one should have to be worried about losing their shelter—not their assets; their shelter—during the coldest time of the year.

So, remember, 35 per cent of social renters and 21 per cent of private renters report they struggle to afford the basics, compared to people who own their own home or have a mortgage. Nearly 10,000 households in Wales were threatened with homelessness last year, and more than one in 10 people in Wales are worried about losing their home in the coming months. That has to be our focus these coming months. Mainly those in the private rental sector—

Will you take an intervention?

No, I think you've spoken enough, Janet. Those in the private rental sector face increasing rent inflation. On top of this, remember, 45 per cent of households in Wales are now trapped in fuel poverty, and 98 per cent of low-income households are living in fuel poverty, having to spend more than 20 per cent of their income on energy. And these figures were published before inflation hit record levels, pushing up costs of everyday items. Dirprwy Lywydd, there is simply nowhere for these families to turn. There's no slack in the budget.

The Welsh Government has tried to offer different programmes of support where possible, which, of course, is to be commended, but the truth is that the payments on offer are not going to touch the sides and they are not going to help everybody in need. It may be mild out there today, but be in no doubt that winter is already here, a winter that will have a terrible impact on the health and well-being of too many Welsh families. And the worst affected will be those who already suffer socioeconomic disadvantage. The worst affected will be people with disabilities; women; single parents; people from black, Asian and minority ethnic backgrounds; people who have physical and mental health problems; families with children; younger people; LGBTQ+ people—groups of people who already face barriers as regards housing, employment opportunities, income gaps, health inequalities, higher costs.

The cost-of-living crisis has to be seen in the same terms of the COVID crisis, the lessons of which were hard learnt by this Government. But the phrase I remember being used by Ministers, when they understood, although too late for some families, that radical and bold action needed to be taken to save lives in the face of Westminster inaction was, 'Go hard, go early.' We need to see the same approach again with this crisis. We need to go hard and go early. The Government have the powers to protect the people of Wales from the brunt of the harm of Tory ideological indifference in respect of protecting those who are at an increased risk of economic hardship, debt and homelessness this winter, because there are circumstances in emergencies and crises where it is necessary to bring in temporary emergency measures, and this is especially needed by those groups who are most disadvantaged by the combined housing and cost-of-living crises. The director of public health at Cwm Taf Morgannwg health board, Dr Kelechi Nnoaham, said today:

'The cost of living crisis is going to do exactly what the Covid crisis did'.

The impact of the crisis was deeper on the most deprived areas of Wales, the death rate twice as high. It's that same inequality, those same vulnerabilities, that the cost-of-living crisis is deepening. The suffering of people in those groups and communities will again be greater.

Will you give way? Just building on this point, during the COVID crisis, what did we do? We shielded the most vulnerable. Isn't that what these proposals for a rent freeze and a temporary emergency ban on evictions are designed to do? They are to shield the most vulnerable in the context of this cost-of-living crisis.

Exactly, and the health aspect of this has been pointed out today by the Royal College of Physicians, who have said, of course, that poverty causes illness and poor health. The cost-of-living crisis is likely to have a significant impact on the NHS, just as the COVID crisis did. Tenant associations such as ACORN, Living Rent, and Generation Rent agree that the measures brought in by the Scottish Government are a good way to help protect those most at risk from the crisis. As we heard, London mayor Sadiq Khan's response to what's happened in Scotland is that a rent freeze is exactly what Londoners need. Plaid Cymru believe it's what the people of Wales need.

If we wait too long, if we don't act now, then it will be too late to prevent those who are most disadvantaged in our society from the crippling and devastating effect of unaffordable rent and the terror of homelessness. The Welsh Government does not have the power—

Sioned, you need to conclude now, please.

Yes. The Welsh Government does not have the power to stop bills soaring. It can't ensure that the Tory Westminster Government increases benefits in line with inflation. But it can take action to give people security that they can stay in their homes, that budgets already stretched to breaking point don't snap due to rent increases, while the cold winds of this terrible economic storm chill the people of Wales to the bone.

I thank Plaid Cymru for bringing this debate forward today. I think we need to talk about housing much more often than we do. I believe housing is important, and until we deal with housing effectively to create a balance between supply and demand, there will continue to be a problem. A lot of the problems we have in education and health stem from inadequate housing. There are two answers to the housing crisis, using actions that have previously worked. The one I prefer is to build council houses at the scale required to meet demand. This worked between the 1950s and the 1970s. If we were representative as a Senedd, at least 15 and probably 20 of us would have been brought up in council housing. We would have Members who understood its importance.

Obviously, the Conservatives have a different view. That is to abandon planning controls. This worked in the 1930s—I'm not saying it wouldn't work—but there are substantial environmental costs. I mean, do the Conservatives really want to see large-scale uncontrolled development in areas of outstanding natural beauty, national parks, rural and seaside areas? Because that's what abandoning planning regulations actually means. Look at the areas that you cherish as green and pleasant. Do the Conservatives want to develop on these? Of course, there is no problem that the Westminster Conservatives—

Will you take an intervention?

Please.

You're talking about supply and demand. We know for a fact that we need about 12,000 houses completed every year in the Welsh property market. At the moment, at best, the Government is completing about 6,000, maybe as low as 5,000 in a bad year. We're not even getting close to what the demand is. Surely you recognise that as a problem, and calling for considered planning control permissions is something that's to be welcomed, so long as the infrastructure's put in place, such as doctors' surgeries, schools and transport infrastructures. So, it's not about going over beautiful places; it's about having a sensible planning policy that meets the demand.

I think you've just made a number of builders very happy, knowing you would welcome large-scale building in Cowbridge and the Vale of Glamorgan.

The UK Government's freeze on local housing allowances means that most people and families receiving local housing allowance rates face a gap between rates paid and their rent. This increases the risk of homelessness, as it becomes more and more difficult for people to keep up with paying rent, on top of covering essentials, such as food and energy bills.

Over the last 50 years, the housing mix has changed. There's been a decline in council housing and a large increase in the number of privately rented properties. The privately rented sector is now the second most common tenure after owner occupation. There's been a growth in the number of private landlords. Yes, I realise that all private landlords are not modern-day Rachmans. In fact, most private landlords are good landlords and treat their tenants well. A lot of these only own one property, and many of these were bought via a mortgage. Social tenants in Wales are already protected over the winter from rent increases, as social rents are set annually, with the next change in social rents not due until April 2023. Registered social landlords are facing huge pressures, especially where they have to refinance loans.

Superficially, freezing rents in the private rental sector is attractive, but it freezes rents as they are now, and some rents are too high and others too low, relative to properties of the same type. With interest rates rising, it could lead to properties having to be sold. If what happens is that the properties are sold and then bought by first-time buyers, that would be a great thing. Reducing the number of privately rented properties, increasing the number of owner occupiers: good. But, unfortunately, we have the wild west of housing, Airbnb, and that is what worries me, that people will take these houses from renting to families and put them into Airbnb. This removes the property from the housing market. When properties being sold are used as Airbnb in east Swansea, then this has to be a problem all around Wales.

Can I just quote from Crisis, which is something Mabon spoke about earlier, who are the major housing charity? An immediate flood of notices to quit and letters notifying of rent increases are what they fear would happen with what Plaid Cymru are putting forward today. Crisis would advise learning from the recent announcements of similar legislation in Scotland. During the delay between announcement and enactment, colleagues across the housing sector in Scotland reported tenants being issued with notices to quit and letters notifying them of rent increases.

I thought rent controls. I want rent officers to be brought back. Because landlords can evict tenants with a section 21 notice once the fixed term expires, Welsh tenants lack any real rent controls. The landlord can ask them to pay a higher rent and evict them, or find new tenants if they refuse. This demonstrates the ease with which tenants can be evicted and is intimately linked to the lack of rent controls.

We've heard already today how the cost-of-living crisis and the housing crisis have a greater impact on certain sections of society or communities than others. As Plaid Cymru's spokesperson for older people and communities, I'm aware just how difficult winter can be at the best of times for older people, and this certainly isn't the best of times. Older people in Wales are amongst those most likely to be affected by the cost-of-living crisis. Given we have a higher proportion of older people living here in Wales, compared to other nations in the UK, this is a particular worry.

For many older people, turning the heating down or off is not an option, and they will be feeling the higher energy costs more than most in the coming months. I hope we can all agree here that no older person in our communities should be at risk of homelessness this winter. Older people should also be able to retire with dignity, with enough income to live comfortably and happily. It is an enduring disgrace that this has been denied to many women in Wales due to the Tory Government's ill-advised and ill-mannered pension equalisation policy, which has pushed many into poverty. This policy was rushed through, and it left the retirement plans of so many women in Wales in absolute tatters.

The rent freeze and eviction ban we are calling for today would not only protect older people from homelessness, but it will ensure that, in the face of rent inflation, older people can remain connected to their communities and live around the people who support them. This will be essential during winter months to prevent issues such as falls and cold home-related illnesses. If older people have to downgrade to less appropriate housing due to rising prices, they may experience social isolation, illnesses, fuel poverty and even winter deaths. A lot of these consequences can be avoided if the measures in our motion today were to be implemented.

Moving on, the cost of living and housing crisis will negatively impact on the wider community without emergency measures. Rent inflation threatens to push lower-income tenants out of the neighbourhoods they live in and potentially contribute to the gentrification that we have already seen elsewhere. Another consequence would be increasing commuting times, as well as having potentially psychological and social consequences on the individuals and communities affected.

Finally, research from the United States has found that rent controls can be particularly effective at preventing the displacement of racial minorities and can help foster diversity in affected areas. If we are to do right by the most vulnerable people in Wales, we need to go further than what we are currently doing. Please support this motion. Diolch yn fawr.

Can I thank Plaid Cymru for bringing forward today's really important debate on the private rented sector? I was really pleased that, on these benches, we were able to support the vast majority of the proposals that you've put forward today. But, of course, we aren't able to support point 6. In our proposal, we propose to delete that, which is obviously in relation to the freeze on rents in the private sector. But, I am really pleased that we also have been able to provide some alternative solutions to some of the challenges that are out there at the moment, and I will be exploring those a little bit further in my contribution today.

First of all, I would just like to come onto the point that Mabon ap Gwynfor mentioned in his opening, which is about some of the unintended consequences around a rent freeze. As we've seen in Scotland, where those rent freezes have already been introduced, this has already provided some unintended and negative consequences for tenants and for those seeking to rent property, because the supply of rental housing is reducing whilst demand is growing. Indeed, Scotland's largest house builder has now announced that they are going to halt investment in the private rental sector, partly because of these measures. Also on unintended consequences, in Ireland, where, as mentioned, there are already forms of rent control in place, we've seen recently chaotic photographs on social media of hundreds of people queuing up to try to get hold of rental properties in places like Dublin at the moment. So, clearly, it's not the panacea to solve everything, certainly, at the moment.

The other point that Mabon ap Gwynfor highlighted in opening, which others have mentioned as we've gone through this evening, is the mismatch between supply and demand on privately rented houses. It's quite clear that a rent freeze would do nothing at all to address supply and demand challenges. So, it's really important and, whilst it might be easier to try to dismiss some of the unintended consequences, they are very real if a rent freeze is something that Government wanted to support and progress with.

As is outlined in amendment 2 today of our proposals, local authorities are being faced with some spiralling costs of temporary accommodation, and there are some significant challenges there that need to be addressed. It struck me that the Welsh Government actually provided local authorities with around £10 million of the COVID tenancy hardship grant scheme, but only 2.3 per cent of that money was actually ever used. So, I wonder, as a quick fix to help in the immediate term, if the Welsh Government could consider using the significant underspend on supporting those who are struggling fairly immediately. There is a key role that our councils can play in helping to tackle some of these challenges. We know that empty homes in Wales are a significant issue; we know that there are more empty homes than there are second homes in Wales. So, we propose that there should be more work done to promote the empty home loan scheme, to make sure more empty homes are being returned into occupied homes. There's a real opportunity there to make a quick difference.

Will you take an intervention, please?

Certainly, Jane. Yes.

Thank you so much. It was really great to hear you saying 'more homes, less people homeless', but I'm just really concerned about the Conservative position in relation to selling off our social housing. It's something I believe your party still supports. I just wondered if you could comment on that. Is that something you believe in—taking the social housing stock from local authorities and selling it on? Thank you very much. Thanks for allowing me to intervene.

Not at all. I think it's a real aspiration for people to own their own homes, and I wouldn't want to be seen at all as holding people back from actually owning their own property, having that destiny in their own hands. I think that's a really important principle we should be looking to agree on.

I'll go back to the point around building more private homes, because nearly 85 per cent of homes in Wales are either owned or in the private rental sector. It's a real significant proportion of homes here in Wales. We also know that—and I appreciate time is running, Deputy Presiding Officer; I'll be as fast as I can here—in Wales, data from Propertymark shows that twice as many landlords are leaving the sector compared to other parts of the UK. So, it's clearly an issue here in Wales that is different to other parts of the UK, causing landlords not to want to be here as much as other areas of the UK.

I appreciate time has gone; I would urge Members to support our amendments as outlined in the paper. Thank you.

What we're discussing today are urgent actions to support a crisis that we are all seeing. People are being made homeless now. More people will become homeless this winter—

Would you take an intervention?

I've only just started, Janet. If I can carry on, and if you still want to intervene on something I've said—.

But just to respond to Sam Rowlands: of course we need to be building more homes, but that's not going to solve things for people who are homeless now, where there are inadequate solutions now. And we know already that families have been struggling to make ends meet in recent years due to deliberate austerity measures, with single parents, children and young people being some of the most disproportionately affected groups.

The Bevan Foundation found that over the summer of 2022, the number of households with one or two children that were having to cut back on food for children had nearly doubled since November 2021. That's one in 10 families with one child, and one in five families with two children, cutting back on food.

As we know, there is a significant body of evidence that demonstrates the impact of poor nutrition in childhood on a child's long-term health prospects. So, these figures are especially concerning, and they will only worsen as we reach the winter months and as the cost-of-living crisis worsens. We have to ensure that we are not only providing support to ensure that households aren't having to choose between feeding their children and heating their homes, but aren't also placed at risk of losing their home through evictions through the coldest months of the year, or being priced out because of rent inflation.

We know, also, that there's been an increase in the number of young people and care leavers being placed in temporary accommodation. In 2021-22, 95 16 and 17-year-olds were placed in temporary B&B accommodation under the current homelessness legislation and 114 care leavers were place in temporary accommodation under the same legislation. Both figures have risen since the start of the COVID-19 pandemic.

We also know that students have been raising significant financial concerns as the cost-of-living crisis has worsened, with 92 per cent of students surveyed by NUS concerned about their ability to manage financially. Student loans and grants are not increasing in line with inflation, yet they’re facing rising costs. Students have been spending more and more of their money on rent. Three years ago, the average student rent in Wales took up about 53 per cent of their financial support package, but now this figure is almost 60 per cent, with student rent rising astronomically in Wales during the past three years.

In that survey undertaken, it also stated that almost one in three students had just £50 left per month after paying their rent and bills in order to purchase food and other essential items needed for study. Eleven per cent were using foodbanks. Over two thirds of students, 69 per cent, had seen their housing costs go up since January of this year, with almost half of students saying this had gone up by over £20 per week. Eighty-nine per cent of students cited that the cost-of-living crisis has had an impact on their mental health, with a key theme in this category surrounding ‘worry over paying bills’ and ‘constant worry and stress’, as well as ‘struggling to eat’.

In many European countries, the majority of people rent their houses, but in the UK, properties are classed as an investment. The idea that a home is a human right and that everybody is entitled to a roof over their head is subordinated to the whims of market forces, privatisation and the pursuit of profit.

When Margaret Thatcher came to power, the Government withdrew funding for councils to build housing. The disastrous right-to-buy policy further entrenched neoliberal dogma into UK housing policy and saw a 45 per cent reduction in social housing available between 1981 and 2014. Most homes sold under this policy were never replaced. It represented a mass sell-off of state assets into the private sector, which as a result cost local people more to rent and, in some cases, the public purse more in housing benefit. It wasn't until 2016 that local authorities could keep the rent from properties and reinvest in bringing them up to the Welsh housing quality standard and new council house building. Unfortunately, by this time, Tory cuts under austerity were biting.

The Welsh Government spends over 90 per cent of its budget on public sector funding and does not have the fiscal levers to borrow. The UK Government does and should provide funding to build housing. Under Clement Attlee's Labour Government, the state directly provided funding to councils to be invested in increasing social housing. The results were that hundreds of thousands of social rented homes were built. From an economic point of view, the justification was obvious: with the state building large numbers of homes, house prices and rents remained affordable because of high supply.

The current Tory policy of cutting public service funding as well as limiting social house building has created a loss of local planning, drainage, highway and transport experts, and will create mass unemployment in Wales, and poverty, as one third of people are employed in the public sector here in Wales. I am told that people in the public sector are now presenting as needing a roof over their heads, as wages have not risen with the Tory cost-of-living crisis. And the Prime Minister needs to be educated that you cannot grow the private sector while cutting the public sector under austerity too. The private sector cannot step in, as there is a huge workforce and skills shortage there too following the pandemic and leaving the EU.

Social landlords are already subject to a rents freeze until the end of March next year; caps are reviewed annually and are set by Welsh Government. The private sector needs also to have rent controls, the right to secure tenancies with the right to keep a pet included in the tenancy, and ban the use of no-fault evictions. And we need to ensure that banks and building societies take historic rent payments into account when assessing mortgage applications. Many people are paying rent prices that are higher than mortgage applications.

Carolyn, will you give way?

Sorry, I just want to carry on. I'm mid flow and I've only got a minute left.

I just wanted to ask a quick question.

No. She's not giving way.

I've just—sorry, I don't know where I'm up to you, now. I have just read that the Scottish Government's rent freeze has lots of exceptions for private landlords, where a landlord faces increased property costs, mortgage interest payments and some insurance costs, so they do have exceptions, and they're not included in that rent freeze. We need to ensure that there is targeted help for those struggling tenants who are earning enough to cover rent but are entitled to benefits.

I welcome the funding to allow councils and housing associations to purchase private rental properties as they come on the market to help secure tenancies, save evictions and move properties into the social housing market, which is what we need. There are approximately 25,000 empty properties in Wales. Often, one of the reasons given by owners of empty properties for keeping them is that they are waiting for the property markets to improve before selling. Because of the lack of supply of housing, owners know that, if they hold on to a property long enough, it's likely to increase in value. People now will probably realise that their asset will depreciate because of what's happening with the economic status and put them on the market, hopefully.

I call on the Minister for Climate Change now—Julie James.

Diolch, Dirprwy Lywydd. People across Wales are facing an unprecedented cost-of-living crisis, fuelled by soaring energy, fuel and food costs. But, Dirprwy Lywydd, let's be clear: this is entirely a Tory-made crisis, from a decade of austerity to cruel cuts to benefits and broken promises on taxes. Mortgage bills are rising as a result of the fallout from the mini budget, or fiscal event, or whatever it is that we're supposed to call it, and the UK is forecast to have the slowest growth of any major advanced economy next year, and the lowest of any G20 economy, bar Russia. The Tories have created the conditions for this unprecedented crisis and are adding to the pressures on household budgets. The Welsh Government entirely recognises the pressure that the rising cost of living is placing on already struggling households budgets. This, of course, includes rental costs for tenants.

We know that rents sought for new lets and rent in particular areas of Wales are increasing at a much faster rate than the average 2.5 per cent reported by the Office for National Statistics. Mabon talked of doing nothing, but this Government is committed to helping tenants, including supporting them to remain in their homes. That is why we have provided an additional £6 million this financial year to local authorities for discretionary homelessness prevention and relief measures. This funding can be used for both private rented and social tenants, and can include a payment of rent arrears, providing a rent guarantee or assistance with household bills. Preventing homelessness remains an absolute key priority in Wales and is reflected in our programme for government and in the co-operation agreement. Underpinning this, of course, is our ambitious target to deliver 20,000 new low-carbon homes for rent in the social sector in this Senedd term.

Our commitment is absolutely demonstrated in the investments that we are making: over £197 million of housing support and homeless prevention services, and a record £310 million in social housing this year alone. We do not underestimate, however, the scale of the challenge facing households across Wales, who are, understandably, extremely worried about the impact of the cost-of-living crisis on them and their families. That is why we are working across the Government to offer and deliver immediate support for those most in need.

As the Minister for Social Justice set out in a recent cost-of-living debate, in this financial year alone, we will be spending £1.6 billion on targeted cost-of-living support and universal programmes to put money back in people’s pockets and help alleviate this crisis. Only a few weeks ago, the First Minister announced an additional three measures that we will implement, on a third ‘Claim what’s yours’ campaign, on warm spaces and on foodbanks.

Turning specifically to the private rented sector, in January this year, I launched leasing scheme Wales, committing £30 million over five years to improve access to longer term affordable housing in the private rented sector. It will deliver security for tenants and confidence for landlords. The scheme is designed to support the most disadvantaged people and households who are experiencing, or who are at risk of, homelessness. Tenants on the scheme will benefit from longer term security of tenure between five and 20 years and rents restricted to local housing allowance rates. There will be additional funding to ensure that they receive the level of support that they would expect in social housing. We have also provided £300,000 of funding for Citizens Advice Cymru, to establish the private rented sector or PRS debt helpline. During the first year of the scheme, more than 900 tenants have been supported.

But it is clear, looking at the legislation laid in Scotland, that neither rent freezes nor an eviction moratorium offers a panacea or absolute certainty for tenants. I’m sure that Members have seen the paper from Crisis on this very topic. Crisis points out that a blanket rent freeze policy benefits all tenants in the rented sector, but not all tenants in the rented sector are experiencing problems with affordability. The private rented sector in particular—and these are Crisis’s words, not mine—is a very diverse sector in terms of the households it serves, from students and young professionals, to families with children and older households. There is a group of middle-income households for whom affordability is not such a problem. There’s a sizable group who are really struggling to meet their housing costs, who these proposals might benefit. There’s also a group who are already having to make up shortfalls between their rent and their housing benefit. Now, a rent freeze and an eviction ban would serve to delay evictions of this group, but would not eliminate the risk of accruing rent arrears. They go on to say that they support exactly what this Government is doing, which is to target the support at the people who are most vulnerable in this sector and make sure that they stay in their homes. We do not want to drive landlords away from the sector; we want to make sure that people take advantage of the PRS and stay in their homes.

Mabon ap Gwynfor now to respond to the debate.

Thank you very much, Llywydd, and thank you to everyone who has contributed to the debate, which has been very interesting.

I must say, listening to Janet Finch-Saunders's first contribution, and also Andrew R.T. Davies's, the irony that they recognised that the free market is absolutely failing our communities, and therefore they are calling for and demanding a state intervention on building houses, only then to see those social houses be sold back to the private sector—there's a certain irony there that is obviously missed. You want to see more social housing being built, which is state intervention—[Interruption.] Yes, I will take an intervention.

The point I interjected on with Mike Hedges was the ability to build more houses. We're only building about 6,000 a year when we know that we need 12,000. I didn't mention anything about state intervention whatsoever.

Janet has just said 'more social housing', which is state intervention, which is coupled with what you said. [Interruption.] Okay. So, do you want to make an intervention, Janet?

Can I take an intervention?

No. You can make an intervention.

Yes, can I make an intervention? [Laughter.] I beg your pardon. Would you withdraw the comments that you've just made about landlords doing their properties up out of the public purse and then selling them on? That is not allowed. If you have one of the lease agreements with any local authority where they give you money—I think at the moment it's about £25,000—you have to pay that money back before you can sell your property. So, that does need to be taken back, because that's making out that private landlords are actually making money out of the public purse, and that is not correct.

No, what we have seen once again is examples from this Government and from your own Government of public money being transferred to private pockets, and making sure that people who are already relatively wealthy are making more money off the back of working people—[Interruption.] That's the policy—

Okay, okay. Allow Mabon ap Gwynfor to carry on with his closing.

That's the policy that you're perpetuating. Now, what we did hear as well, thanks to Luke's intervention and Sioned, was that they did mention the fact that what we need to do is protect people, not assets. Houses are homes. They are where people need to live; they are not the way for people to make profit, which is what the Tories have been propagating here.

We heard from Sam Rowlands about empty homes—absolutely, we agree. We need to bring empty homes back into use again. And we heard a lot of ideas around empty homes, around developing social housing, and others. These are all long-term ideas. They don't deal with the crisis that we are facing today and they won't help those people that are facing evictions over the coming months over this winter period.

Heledd referred to students and the fact that 60 per cent of their income goes on rent. I'm glad to say that NUS Wales/UCMC support this call today. Also, it's worth noting that the TUC are also supporting action on rent controls and rent freezes. In fact, two years ago, a TUC survey showed that 66 per cent of their members supported this motion, and only 8 per cent oppose it.

Carolyn mentioned the post-war Clement Attlee Government. The thing with that post-war Government was that housing was then under the public health department. It shows the importance and ties in exactly with what Mike Hedges said about that link between poor housing and poor health. Mike also referenced Airbnb, and what we're finding at the moment is that landlords—different from what Sam said earlier that landlords are leaving the sector—yes, they're leaving the sector and they're going and transferring their property over to Airbnbs, or, in some cases, they're profiting from the high price value of houses.

So, that's the situation we have, but the fact remains that everyone should be guaranteed high-quality, affordable housing, but this isn't the case here in Wales at the moment, and it's been exacerbated by the cost of living and housing crisis that's occurring at the moment. We're told that the first responsibility of a Government in a democratic society is to protect and safeguard the lives of its citizens. This is said at a time of conflict when we're at war—every time we hear of conflict, millions and billions of pounds are pumped into supporting and ensuring the safety of our citizens. Well, this is the case today. We need to make sure that we defend and protect our citizens and make sure that they don't suffer because of homelessness, because they can't afford to have a roof above their heads.

Would you give way on that point?

Yes, I will.

I agree with the sentiment entirely, but would you please respond to the points that are made in the Crisis UK report—and I draw, like the Member opposite, attention to my register of interests as well—where they say that the very measures being proposed carry a significant risk, in their words, of an immediate flood of notices to quit and increases in rent, a wave of rent rises and evictions, debt accrual of rent arrears by tenants, and negative impact on the supply of and access to private rented housing for those at the lowest end of the market? You have passion, you have great intentions, but Crisis is showing that the measures you are proposing will have negative consequences.

We accept what Crisis are concerned about, and I believe I referenced that in my original comments. What we're saying is that while we accept that might happen in the future, we know it's going to happen now. We know people are being made homeless now, so we need steps to mitigate that situation. Now, we know also that these steps that we've referenced work in France, they work in Denmark, they have worked in Ireland as well. So, what you're asking is, because of your fear that something might happen—because of Crisis's and the Government's fear that something might happen—let's do nothing. That's what you're asking for.

Now, we can't—

Will you give way?

No, I'm running out of time, I'm afraid, Huw. [Interruption.] Well, I am running out of time, I'm afraid, Huw.

You don't have to accept the intervention.

Well, I'm coming to—. I will accept, given that I have time.

Okay. He's accepting the intervention.

Thank you. Would you then respond to Crisis's observations on better ways to deal with exactly the issue that you are putting forward? I agree with your passion and I agree with the fact that we need to do everything we can. They've suggested other ways. What's your response to their alternative measures?

They have suggested some ideas that will help, and, at the moment, the Government haven't taken those ideas up and they're not delivering on them. Also, what we know is that people will be made homeless over the coming months, so we want to see action now to make sure that those people aren't made homeless, instead of maybe pushing it forward into the future. That's what we are proposing. A rent freeze would help deal with that. That's the truth of this matter. At the moment, there's no other alternative; there's no other suggestion coming from the Government or anybody else to deal with the crisis facing us today, and unless we take action today, then we know we will see more people being homeless. Fear is what's causing this inaction, and right now we can't afford inaction. You could do this; you could take action to save lives. We need to see that same conviction that your Government showed during the COVID crisis and that courage that you showed. We need to see that taken again today. As Sioned said, we need radical action and we can't stand by and do nothing. So, let's support this motion so that we can give the Government the leadership it needs to take action to mitigate the worst of the circumstances today. Thank you.

The proposal is to agree the motion without amendment. Does any Member object? [Objection.] There are objections. We will, therefore, defer voting until voting time.

That brings us to voting time. Unless three Members wish for the bell to be rung, I will move immediately to the vote. So, I call for a vote on item 7. That's our first vote this evening. I call for a vote on the motion, tabled in the name of Siân Gwenllian. Open the vote. Close the vote. In favour 11, no abstentions and 38 against. Therefore, the motion is not agreed.

The next vote is 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. The vote is tied: 25 in favour, 25 against, and no abstentions. Therefore, I exercise my casting vote against amendment 1. The result of the vote, therefore, is that there were 25 in favour, no abstentions, 26 against, and therefore the amendment is not agreed.

I call for a vote on amendment 2, tabled in the name of Darren Millar. Open the vote. Close the vote. In favour 39, no abstentions, 11 against. Therefore, amendment 2 is agreed.

Amendment 3 is next. Amendment 3, again, is in the name of Darren Millar. Open the vote on amendment 3. The vote, once again, is tied with 25 in favour, 25 against. I use my casting vote against the amendment.

[Inaudible.]

I've closed the vote.

My screen said that I had permission to vote and that the vote hadn't been closed when you called the result of the vote. Does that mean that my vote wasn't recorded?

I will pause on that and check, but I think your vote will have been passed. Yes, we can confirm to you, Alun Davies, that your vote was cast and has been recorded. The final vote, then, after my casting vote, was: in favour of amendment 3 25, nobody abstaining, and against 26. So, amendment 3 falls.

We will now take a vote on the motion, as amended by amendment 2.

Open the vote. Close vote. In favour 39, no abstentions, 11 against, and therefore the motion as amended is agreed.

That concludes voting time for today.

But we do have a short debate, and I call on Luke Fletcher to speak to the topic that he has chosen.

And if Members can leave the Chamber quietly if you're leaving the Chamber, so that the short debate can be heard.

Diolch, Llywydd, and I've agreed to give a minute of time to Mike Hedges, Heledd Fychan, Peredur Owen Griffiths and Jenny Rathbone. What is education maintenance allowance other than a lifeline for so many, both today and in the past? In 1999, the UK Government announced a pilot programme in 15 local authority areas. The programme proposed a payment to students aged 16 to 19 from families who were considered low income and who were in full-time education in either school or college. The question was a simple one, but also an ambitious one: could participation and achievement be raised through directly addressing the financial problems faced by kids from low-income families? In 2000, 15 local authority areas turned to 55 and, after the pilot concluded, EMA was rolled out UK wide in 2004. It lasted until October 2010, when the UK Government decided to scrap it.

But it wasn't scrapped here in Wales, and, as I've said before, it's important that we acknowledge that Welsh Government protected it then, and have protected it since. For that, like so many other kids from low-income families, I am grateful. But if it still exists here in Wales, then why are we having this debate? The reality is that EMA is failing to meet the needs and challenges faced by learners today. First and foremost, the value of an EMA payment is nowhere near enough to support a learner. The value has remained at £30 a week since 2004, almost two decades without a rise. Had the payments kept up with inflation, the payment would be today £45 a week. That has resulted in a real-terms cut in the value of EMA by a third over this period. In 2020, Robert, 17 at the time, told the Bevan Foundation,

'You need more EMA. £30 doesn't buy you anything. It's crap. It's gone by the time you cover basic costs.'

Chloe, 16 at the time said, 'It's okay, but hard to divide it into what you need.' And Thomas, 18 at the time, said that books proved to be too expensive to afford.

The biggest concern, however, identified by education providers in relation to the payment as it stands, was that some learners dropped out because they thought that they would be financially better off claiming jobseeker's allowance or to take up a full-time employment post. Many simply couldn't afford to continue with their education even when they were receipt of EMA. This, of course, flies in the face of the main principle that EMA was founded upon, and the pandemic, and no doubt the cost-of-living crisis, will only make the situation worse. So, as a matter of urgency, the weekly payment needs to be addressed.

Secondly, the eligibility criteria must be addressed and expanded. Too many young people are being locked out of support that they desperately need. The thresholds have largely remained unchanged since 2011, meaning that inflation hasn't been taken into account. This has resulted in learners today needing to be poorer than learners back in 2011 in order to be able to claim. Again, the Bevan Foundation calculated that the threshold for eligibility should now be £4,000 higher after accounting for inflation and that, the real-terms reduction in eligibility thresholds, has meant that the number of learners accessing EMA has consistently fallen. Overall, it has fallen from roughly 30,000 learners in receipt in 2013 and 2014 to roughly 20,000 in 2018 and 2019. Previously, the Welsh Government has said that this has been due to demographic changes, but the logic doesn't follow. Although the number of 16 and 18-year-olds has fallen by 8 per cent, the number of EMA recipients has reduced by a third. A common message heard often is how children from low-income households are unable to afford food in the canteen or relevant learning materials, yet they're not eligible for EMA.

Finally, real concerns have been expressed to me by education providers relating to the complexity and lack of awareness of the application process. I have to take a moment to thank the team at Bridgend College, who consistently made this point, in particular Carys Swain, who has been a fantastic advocate for learners within the college. The process of applying itself is locking out students, and this again came across in research conducted by the Bevan Foundation, as well as being recognised by the Welsh Government in its 2014 review of EMA. Colleges and schools are, of course, doing their best to refer, but it's challenging. There are a lot of learners who are unaware that they are entitled to EMA.

So, what am I asking for? What is the purpose of this debate? What I want from the Government in the first instance—. And of course I recognise that the Welsh Government's budget is limited and things will only get tougher, but what I want is an assurance that EMA is a priority for this Government, and that, when the funding is available in the Minister's portfolio, EMA is one of those policy areas that is at the top of the list. What I would also ask is that the Minister reviews EMA, not only relating to the payment but also the eligibility criteria and the application process, and that the Government steps up its entitlement awareness campaign amongst young learners.

Dirprwy Lywydd, every Member in this Chamber right now is here because they know how important EMA is to the success of a learner from a low-income household. Coming back to the original question as to what is the purpose of EMA, 'Could participation, achievement, be raised through directly addressing the financial problems faced by kids from low-income households?' Well, it was; the evidence is there for people to see. But unfortunately it's falling short. I know the Minister takes these concerns seriously. I know the Government does as well. But what we need now, more than ever, is action.

Can I thank Luke Fletcher for giving me a minute in this debate? EMA is very important. From my time as a further education college lecturer in RCT, if EMA had not existed many students who went on to successful careers in ICT would not have been able to continue their studies. EMA provides the finance to allow them to continue studying and then move on to higher education. EMA allows those from less well-off families to continue to study past 16 years of age. It is means tested, and based upon total family income. Does it catch everyone that needs it? No. But it provides a lifeline to many. I agree with Luke Fletcher that it needs to be expanded. More people need to be eligible for it. But it's providing such a tremendous opportunity to so many young people from less well-off backgrounds. As someone who, from both personal experience and seeing my former students succeed, has seen the benefit education has on income—the better educated you are, the better the chance of getting a good job—that should not be restricted to only those who come from affluent families; every child should have the same opportunity. EMA is a necessity for many.

Thank you, Luke, for bringing forward this debate today.

It is a lifeline for many. We cannot underestimate how important it is. One of the things that I'm really pleased that you've emphasised today is in terms of the eligibility criteria, because one of the things that has been brought up with me, from those whose young people within families are completely reliant on the EMA, has been the eligibility criteria when that young person is a carer. At present, they have to have 100 percent attendance in order to receive that EMA. And one of the things also that we see time and time again is in terms of the increase in public transport costs maybe impacting them from being able to get to that college et cetera to have 100 percent attendance. So, I think we do need to look now. We saw, during the pandemic, more colleges using Teams and so on, that people could join remotely, whereas that now is being pulled back again by colleges, and this emphasis on being present physically is actually providing a barrier. I think we need to embrace what happened during the pandemic in terms of people being able to join remotely, because, if the amount of money received via EMA cannot be increased at this point in time, then at least we can make it easier for students to be able to be present and they're not then losing out on these essential payments, which then means that they're dropping out of education, because their families can't afford to not have even that £30 per week. So, I very much hope that the Minister can work with colleges to ensure that the eligibility is there and that people aren't then punished if they can't have that 100 per cent attendance because of a whole array of things that are outside of their own control, including the cost-of-living crisis.

Thank you, Luke, for bringing this issue forward today and allowing me to contribute to this debate, which, I know, is very important to you.

We've heard from Heledd just then about the—. And I want to go on from what Heledd was saying: the charity Barnardo's Cymru go as far as describing the EMA as a lifeline for many young people that they help. They go as far as saying that it can be the difference between a young carer being able to go into education or not. Unfortunately, many of these young carers end up being penalised, as Heledd said, through their EMA payments due to lateness or absence, which are often caused by their caring responsibilities. Minister, I hope you agree with me that a missed payment for these young people, who are only trying to improve their prospects but have extra responsibilities beyond their years, is wholly unfair. And Minister, would you also please explain to us what sort of level of care or protection is given to young people in receipt of EMA, especially young carers, to make sure that they are not exploited by third parties? Diolch yn fawr.

I thank Luke Fletcher for bringing this debate. I think it's really useful to remind us that the EMA hasn't been uprated since 2004; it clearly buys a lot less than it used to that long ago. It is a vital—. Even the reduced amount that it currently buys, is still a really, really vital way of enabling young people to stay in education who otherwise might be pushed into going into a job that leads nowhere. It's absolutely vital that we encourage people to stay on in education post 16, so that we have the workforce we need to do all the new tasks that society requires, particularly with the net-zero plan. We need to train up huge numbers of people in clean, green jobs, as well as enabling people to get those entry-level qualifications, whether it's in social and healthcare, or in other sectors that they may want to spend their life in.

I think it's worrying that a lot of learners are unaware of the EMA, because what are schools, colleges and FE institutions doing if they're not promoting it? I think it'd be good to hear from the Minister about that and what we can do about it. Because it's a similar story with the healthy eating voucher, as some people are not getting that, or large numbers of people are not getting that, and we certainly need to maximise all the benefits that people should be able to get in these very, very difficult times.

I now call on the Minister for Education and Welsh language to reply to the debate. Jeremy Miles.

Thank you. As a Government, we acknowledge the positive impact that the education maintenance allowance can have on young people. That's why we, during the years of austerity forced on Wales by the coalition Government, have tried to safeguard the allowance, as opposed to what happened in England, where it was abolished in 2011. And now we face another extremely difficult financial situation, we are still committed, in accordance with our programme for government, to maintaining the allowance. Alongside our other commitments for young people, and at an annual cost of £17 million, the EMA makes it possible for more than 18,000 young people to continue in post-compulsory education every year. Almost one in three—31 per cent—of full-time students who meet the eligibility criteria in terms of age receive support through the EMA.

The current payment rate in terms of attendance, namely £30 a week, is consistent with what is available in Northern Ireland and Scotland. Of course, I understand that there are concerns, particularly at a time of crisis, that the EMA hasn’t increased for some time. I acknowledge the work of the Bevan Foundation and continue to welcome their views in terms of where we can make further improvement in terms of our commitment to young people. I realise that young people also are feeling financial pressures as a result of the cost-of-living crisis that we are currently facing. But, at a time when we all have to get to grips with this new pressure on spending, it isn’t possible to increase the level of the EMA from £30 to £45. We estimate that doing so would mean £8.5 million in addition annually. Also, even though I understand that the threshold for considering a young person’s household to be eligible hasn't changed, the additional £8.5 million that would be required to increase the rate would increase to more than £15 million a year if we were to introduce these changes as suggested.

Due to the rapid rise in inflation, Dirprwy Lywydd, we know that, overall, our budget will be worth around £4 billion less over this three-year period than previously thought. Effectively, this is a cut to our budget. Without any additional funding from the UK Government or cuts to our existing programme for government and co-operation agreement commitments, maintaining EMA is where our ambition will have to rest for now. Despite our limitations in increasing the rate of EMA we have expanded the eligible cohort to include some of the most vulnerable young people in Wales. This includes those impacted by Brexit, family members of those with protected immigration status, and, more recently, the expansion to include young people fleeing the war in Ukraine.

All young people can apply for EMA at any point in the academic year, and where their family circumstances change, resulting in a drop in income, we encourage young people to apply for EMA with a current-year income assessment. Our schools and colleges work closely with their learners to ensure that they are receiving the support they are entitled to. Young people in receipt of EMA can also access a range of additional support. Schools and colleges can often loan ICT equipment and learning resources, removing the need for their EMA to be spent on essential course items. They may also be able to get free or subsidised transport during their course from their local authority. Over £6 million has been provided to further education institutes, y Ganolfan Dysgu Cymraeg Cenedlaethol and the Open University in Wales for the academic year 2022-23 for the financial contingency fund. The fund aims to ensure that learners across Wales, including those in receipt of EMA, are not inhibited by financial constraints. For example, eligible learners can receive additional money towards course fees, course materials, childcare costs, food and other study-related items. For the academic year 2022-23, access to the FCF has been extended to include asylum seekers and any learner eligible under the post-16 funding eligibility for mainstream funding.

More broadly, all schools and further education institutions in Wales have been provided with funding to ensure learners have access to free period products and free meals during college holidays, a combined package of support worth over £1.5 million. Laying the foundation for post-compulsory education starts at the foundation phase, and we provide a wide range of support for learners as they progress through school. As per the co-operation agreement, £35 million of new capital funding has been provided to local authorities to invest in improvements to school catering facilities and £200 million has been committed for the day-to-day provision over the next three years to roll out free school meals in all Welsh primary schools.

I thank the Minister, and thank you, everyone. That brings today’s proceedings to a close.