Plenary

The next item will be questions to the Cabinet Secretary for Health and Social Care. The first question is from Alun Davies.

Ensuring good access to GP services across Wales, including all areas of Blaenau Gwent, is a priority for this Government.

Cabinet Secretary, I am delighted to hear that it is a priority for this Government, because there's a crisis in Blaenau Gwent and other parts of the Aneurin Bevan health board area. There is a crisis of access to basic GP services, created by eHarleyStreet, a private company that has been brought in and has failed my constituents, and has failed to deliver services for the people that I and others here represent. But not only are they failing their patients, they're failing their staff. They're not paying the pension contributions they should be paying. I've spoken to suppliers in the last few days who also have bills unpaid. This is an outfit that can't pay its bills and can't deliver services. Do you agree with me, Cabinet Secretary, that people have a right to expect excellence in the services they receive, that suppliers have a right to have their bills paid, that staff have a right to work in an environment where they don't feel bullied, and staff have a right to ensure that their pension contributions are made and that the inland revenue is paid? This is a company that can neither deliver services nor pay its bills. Surely it's time to call time on this failed experiment.

Can I associate myself with the comments that the First Minister made in First Minister's questions last week in relation to the important question that Alun Davies raises? I have made my views clear to the health board, most recently in a meeting last week. Contractors for GP services should comply with the obligations that they take on. It is unacceptable for staff not be paid. It is unacceptable for suppliers not to be paid, not least given the obvious risks that come with that. And clinical cover should be provided at all surgeries. I expect the board to put in place arrangements to ensure that these requirements are complied with, and the board has acknowledged that in the discussions I have had with it. I will be seeking an account from the board of the results of the arrangements it has in place, and a reassurance that there is a plan for GP services to be provided at the locations the Member refers to in his constituency, and elsewhere, in a way that is stable, sustainable and, as he says, meets the needs of patients.

Cabinet Secretary, Labour's recent botched budget has caused major damage to many aspects of society, including our GP surgeries. The Chancellor's decision to increase employers national insurance and reduce the threshold at which employers pay towards it will indeed have a devastating impact on the sector, including surgeries in Blaenau Gwent and the remaining region of south-east Wales. Current estimates predict the cost to GP practices in Wales to cover these changes stands at around £7 million. This is massive, Cabinet Secretary, particularly when you take into account that we already have lost more than 100 GP practices in Wales since 2012, and it will, of course, have a serious knock-on effect when it comes to offering patients care and support. So, Cabinet Secretary, what discussions have you had with the UK Government about making GP practices in Wales exempt from these tax hikes, and what direct action will the Welsh Government be taking to limit the damage inflicted upon GP surgeries here in Wales? Thank you.

Given the damage her party in Government has done to GP services across the border over the last 14 years, I think it's rather rich for the Member to put it in quite those terms. As she knows, the decision—[Interruption.] As she knows—[Interruption.] As she knows, the decision to levy national insurance is a decision of the UK Government. We have, of course, outlined our view in terms of the impact of that on GP practices, but in other parts of the health and social care service and economy as well. The UK Government's position as of today, at the moment, is that the provision that they will make will relate to public sector employees specifically, but we continue to make the case that the implications beyond that group of people will be significant, and we are in discussions, of course, with general practitioners in relation to the pressures that they necessarily will face as a consequence.

I'd go further than Alun Davies, I'd say this is a scandal, what's happening with eHarleyStreet in Blaenau Gwent and across the Aneurin Bevan health board. Representing the area, I've been in touch with some of the GPs—the 40-plus GPs—that are now being affected by this. It needs addressing at Government level and not leaving the health board to its own devices in remedying this, so it needs intervention by you now, Cabinet Secretary. I spoke to one GP who's owed £20,000 in locum wages. Him and his former partner, again, are owed in excess of £300,000 from contracts that haven't been fulfilled by eHarleyStreet. It shows a worrying pattern of behaviour. I spoke to another GP who is now travelling from Monmouthshire to Pembrokeshire to work as a locum rather than working in our communities. So, at a time when we're crying out for doctors, this situation can't go on any longer. I therefore ask you, what are you going to do to get to grips with this matter and to ensure that the trust in GPs is not being eroded? This is public money that's being spent. It has been spent in good faith by the health board, going to eHarleyStreet but then not paying people. It's something that needs to be addressed, and needs to be addressed very, very quickly. So, what are you going to do to make sure that these GPs are getting paid? Diolch.

I refer the Member to the answer I gave a moment ago to Alun Davies. And in terms of what I'm doing, I outlined the actions that I'm taking in that response, and I'll be very happy to update Members when I have the further information I'm seeking from the board.

Since these queries were first raised in the Senedd about eHarleyStreet, about how this private company is managing GP surgeries in Blaenau Gwent and throughout the Rhymney valley, I think a number of us have been contacted by constituents who can't get appointments. One person described ringing the telephone line of a surgery affected and hearing a recorded message saying that they were number 85 in the queue. Now we've heard about the distress caused to doctors who haven't been paid, who are owed thousands of pounds. But I'm also concerned about the lack of clinical governance in some of these practices. The company eHarleyStreet seems to be working to a model that relies on nurses and nurse practitioners leading care rather than GPs. Now, I've been sent information that on one day, in one of the surgeries affected, only one GP was present for a practice of over 11,000 patients. Usually a practice like that would have five or six GPs, and because so many GPs are, perhaps understandably now, refusing to work in these practices because they haven't been paid, that could surely get worse.

Patients deserve better. So, with that in mind, in terms of the clinical governance issue, what could the Government do, please? What do you expect that the health board could do to ensure that these surgeries, and those people who rely on these surgeries, aren't left in this limbo any longer?

Well, look, clearly there are requirements in the contracts that GPs take on from the health board that stipulate outcomes of the sort the Member is referring to. And I made it clear in my response to Alun Davies that clinical cover at all the locations to which he and I think you were referring is absolutely essential, and I'd be happy to report back to Members my further discussions with the board in relation to that.

The Welsh Government has recently allocated just over £7 million in additional funding in recognition of financial pressures in the current year, which will support Powys Teaching Health Board to deliver safe and timely access to its residents.

Okay, well, thank you for your answer, Cabinet Secretary. Acute stroke services currently take place, of course, in Bronglais hospital in Aberystwyth, which serves large parts of my own constituency, and you will be aware that Hywel Dda Health Board are considering proposals that include the downgrading of stroke services at Bronglais Hospital, which would mean mid Wales patients suffering from a stroke would have to be transferred to Withybush or Llanelli. Now, as you know, Cabinet Secretary every hour is critical following a stroke, and all options proposed would mean my constituents would not have access to time-critical care, and time critical is something you mentioned in your earlier answer to me, Cabinet Secretary.

Apart from not receiving access to treatment quickly, of course recovery is also important, and it is entirely unreasonable, I would suggest, and often impractical, for someone living in Llanidloes or Machynlleth, and relatives, to have to travel to Withybush in order to visit a relative. So, how are you supporting Powys patients and Powys health board to ensure that there are sufficient and timely acute stroke services for Powys patients?

Well, my understanding is that no decision has yet been taken by Hywel Dda in relation to reconfiguration of stroke services, and there will be a consultation on that in May. He makes an important point about the implications for residents living outside the footprint of the health board in relation to that kind of reconfiguration, and I do expect health boards to undertake a rigorous options appraisal with that in mind, and a collaborative approach not just with delivery partners, obviously, which is critical, and the Stroke Association and others, but with neighbouring health boards where there are implications for residents in those health board areas as well. My understanding from the health board is that they’ve said that the initial care and treatment for stroke patients will not change and that all four main hospitals, including Bronglais, will still be able to provide life-saving thrombolysis. The rehabilitation provision as well also won’t be affected. But I would expect both health boards to be in discussion in relation to the implications for those residents outside the footprint of Hywel Dda itself.

Questions now from the party spokespeople. Welsh Conservatives spokesperson, James Evans.

Diolch, Llywydd. Cabinet Secretary, the recent Audit Wales report has laid bare alarming shortcomings in Wales’s cancer services, particularly the lack of clarity and accountability in leadership roles. This failure has caused widespread confusion and inefficiencies in patient care. Despite a staggering 54 per cent real-terms increase in spending in cancer services over the past 13 years, the NHS in Wales continues to miss the target for starting cancer treatment. Leadership failures have resulted in shocking delays for patients, with some waiting over 100 days to begin treatment. These delays exacerbate anxiety and lead to poorer survival rates, which are already worse in Wales than in any other nation across the UK. Given the lack of clarity, accountability and duplication of leadership roles, and, as someone said, ‘We don’t know who’s in charge’, how do you and the Welsh Government justify this chronic mismanagement? What actions will you take to fix the leadership vacuum, dismantle bureaucratic silos, and ensure that patients no longer have to face appalling delays, which cost lives?

I welcome the report that the auditor general published yesterday. It is an important report. I accept the thrust of the challenges and the concerns that the auditor general outlines in the report. So, the overall picture is that too many people are waiting too long for treatments that they should be getting faster. I obviously want to see faster diagnosis, faster treatment. It is true to say, for a number of cancers in a number of parts of Wales, those targets are being met and sometimes being exceeded quite significantly, but the overall picture, I accept, is that the targets are not being met.

The auditor general makes a number of recommendations. I think it is fair to say he acknowledges the priority that the Government gives to cancer services in Wales and the investment that the Government has made into cancer services. I think there is absolutely a case for better co-ordination, better alignment, of the range of interventions we have in the system to support patients with cancer in Wales, whether that’s in prevention, in the performance of services themselves, or in the wide range of research that we make into cancer. I think there’s a case for aligning that better, giving it a clearer sense of direction at a national level, and that’s what we will be doing. That actually accords with work that’s already under way. Much of what’s in the report echoes our own analysis over recent months in relation to cancer provision, and I will also be looking at the cancer quality statement to make sure that is current and that the roles and responsibilities and our expectations as a Government are clear for all of those participating in the system.

Thank you, Cabinet Secretary. It’s good you accept the report. It would be good to see you come forward with actually what you’re going to do around those recommendations, because another part that the report highlighted was the severe workforce challenges that we have here in Wales. After 26 years of the Welsh Labour Government’s stewardship of the Welsh NHS, particularly in cancer services, workforce numbers have increased by 27 per cent, but the chronic recruitment and retention issues persist across the system. The growing reliance on expensive agency staff—now representing 5.5 per cent of the NHS workforce, and, in cost, that’s £325 million in 2022-23—is a clear sign of workforce planning failures. These staff shortages are directly delaying cancer diagnosis and treatment, worsening outcomes for patients. Despite repeated warnings from organisations like the Wales Cancer Alliance, the Welsh Government has failed to deliver a comprehensive workforce strategy. You said about the cancer statement, but what we do need here is a comprehensive workforce strategy around this issue. I’d like to know why has this Welsh Labour Government allowed this crisis to deepen year after year and what steps are you going to take to address the disastrous recruitment and retention problems and end the wasteful overreliance on agency staff in the NHS in Wales, because it’s about time we sorted that out to ensure that our patients get the timely and high quality of cancer care that they deserve.

Well, the Member starts by telling us how much more recruitment there has been into cancer services—

It's not doing anything.

—so I think it's important to acknowledge the scale of recruitment into cancer services. That is important. The Member is not right to say it isn't doing anything. There's a sharp increase in the number of referrals into cancer pathways. And it is true to say that Wales is not the only country that is finding it challenging to recruit into some aspects of cancer services. Radiology is challenging, but so are many other disciplines. He makes an important point about the reliance on agency staff, and I couldn't agree more with him—that is an unsustainable position for the NHS to be in. He will, I'm sure, have seen the guidance that I gave to the NHS before Christmas in the most recent planning framework, which was explicit about actions that I expect the service to take on an 'adopt or justify' basis. And several of those go to the heart of the point he's just made about reducing agency spend and putting retention and recruitment on a more stable footing.

Reliance on agency staff is a problem. A lot of these agency staff are on the front line, and, quite rightly so, the public and I, and I'm sure every Member across this Chamber, hold our NHS front-line staff in the highest regard. But there is becoming an outrage in the public about the ballooning number of managers across the NHS compared to front-line healthcare providers. While the overall NHS staff numbers have risen between 2014 and 2023 from 72,000 to 91,000, that does not address the clinical shortages of people on the front line. Shockingly, administrative and estate staff have increased by 51.1 per cent during that time, from 15,000 to over 22,000 full-time staff now. And I'd like to know, Cabinet Secretary, after 26 years, how can the Welsh Labour Government justify the bloated expansion of administrative roles while patients face unacceptable delays for treatment due to a lack of front-line staff? What is the Welsh Government doing to prioritise our front-line healthcare professionals and stop the unchecked growth of directors and managerial roles, and finally deliver an NHS that the patients in Wales deserve and pay for?

The Member makes an easy point, and a populist point, but the truth is that a complex healthcare system requires people who are competent to run the healthcare system, and that is a skill—[Interruption.]—and that is a skill in itself. The level of recruitment into the NHS over recent years has been—[Interruption.] Is the Member happy for me to answer his question?

I am—

Thank you.

—but I think, honestly, there are too many managers in the NHS.

Thank you.

The questions have been asked; allow the Cabinet Secretary to respond, and listen to the response, please.

There has been an increase in recruitment to the NHS across all disciplines and all important roles that enable the NHS to be effectively run. He has acknowledged several times in his question so far the sharp increase in recruitment of front-line staff. The Welsh NHS, like the NHS in other parts of the UK, and, indeed, internationally, does struggle to fill certain disciplines in certain parts of the service, and we must do better, collectively, in relation to that. But I think a worldview that suggests that managers and those running the NHS simply should be taken out of the system is a very naive perspective.

Plaid Cymru spokesperson, Mabon ap Gwynfor.

Diolch yn fawr iawn, Llywydd. I'd like to develop a little bit on James Evans's questioning on the Audit Wales report into cancer services in Wales. The report makes a number of findings, as we've heard: a lack of clarity over the status of national strategies; the need to better define and delineate the roles of the Welsh Government and the NHS executive in delivering strategic leadership; and the quality and reliability of data being below standard. They all had a familiar ring, because they match almost word for word the issues explored in Plaid Cymru's report into NHS governance, which was published back in November. The Cabinet Secretary kindly mentioned a few weeks ago that he had read our report, so, presumably, he's aware of our recommendations to reform the governance architecture of the NHS. Therefore, in the spirit of showing in deeds as well as words that no one party has a monopoly on good ideas, will he commit to implementing the recommendations of our report?

The report, I remember, followed a statement that I had made in the Chamber and a speech that I gave to the NHS Confederation, which found many echoes in the report that Plaid Cymru published two weeks later. And I was very pleased to see that the kind of fresh thinking I was seeking to bring to the challenges that we face was agreed—[Interruption.]—was agreed to by Plaid Cymru. I see the same thing in the plan that Plaid Cymru have published yesterday in relation to tackling waiting lists: establish regional elective care hubs, tick; triage services, tick; embedding collaboration between health boards, tick; waiting list planning, tick; technology, tick. I mean, I’m very grateful to the Member for echoing the interventions that we’re already making on the NHS.

The substantive point he’s making, though, is that there is a need to rebalance that relationship across the NHS. Planning guidance, which I gave before Christmas, starts us on the path of doing that. It sets out clearly a smaller number of top priorities that I expect the NHS to deliver and then interventions that will support them to do that. I recognise that, beyond that, there is a level of flexibility and a level of discretion and judgment that health boards are absolutely best placed to be able to undertake to reflect the needs of their local population. But that approach, which is a set of clear expectations, flexibilities to deliver, and a centre able to support and intervene when those aren't met, I think is the right way forward.

With respect, that’s a disappointing response, because you seem to be in complete denial about the problems within the health service. The suggestions that we have put forward in a series of reports are ones that have come up from clinicians, saying that these are problems on the ground and these need to be implemented, so, you’re clearly not implementing them if you’re saying that you have done them already.

Now, of course, long waits have become emblematic of Labour’s quarter century of management of the health service. The fact that Wales has amongst the worst survival rates in the Organisation for Economic Co-operation and Development for cancer comes as little surprise when we consider that almost half of cancer patients don’t receive the treatment they need in time, with even longer waits for conditions such as gynaecological cancers.

The targets of the Welsh Government’s planned care recovery plan, which were set by the First Minister in her previous role, of course, included an ambition to ensure that 80 per cent of all cancer patients receive treatment within the clinically recommended 62-day period by 2026. Can the Cabinet Secretary guarantee, contrary to the other targets contained within the plan, that this one at least will actually be met?

The Member makes, in this question, an important point about the importance of setting targets for the system to enable the system to deliver the outcomes that we expect and that the people of Wales expect. So, he will have seen, I’m sure, in the planning framework that I issued before Christmas, the target for 80 per cent by March of next year that I’ve set in relation to cancer performance. There is, as we’ve discussed previously, a reasonable level of variability across Wales in relation to meeting cancer targets. So, for example, breast cancer in Cwm Taf Morgannwg University Health Board, lung cancer in Cardiff and Vale University Health Board—these are well performing services that are meeting their targets. And there are some cancer sites—so, skin cancer, blood cancer—where the performance across the system is very good. But the overall performance isn’t sufficient.

The lesson I took from the auditor general’s report, which I thought was constructive, was the need to look again at the range of interventions that we have—the quality statement, the cancer improvement plan, the support programme—to make sure that they are all aligned, managed with purpose, and that is able to give the system the direction that it needs. But it does require as well innovation in the delivery of services on the ground. So, he will know that we’ve increased the ability to send patients straight to test without having to seek an out-patient appointment first. Those sorts of initiatives, we know, will be able to help us speed the journey of patients through their pathway to get the care that they need in a timely fashion. Most cancer patients in Wales are being seen within the 62-day target, but we are not hitting the target and we must.

Far below—far below the target. Now, as I mentioned in my first question, it is self-evident that timely collection and publication of data is essential to a well-functioning health service, particularly for the purposes of efficient workforce planning and resource allocation. But, time and time again, we hear the same issue being raised by healthcare professionals: the quality and accessibility of health data in Wales is simply not up to scratch. I was talking to people who work in the field of lesser survivable cancers over lunch time, and this issue came up once again.

The Wales cancer registry is meant to provide timely data on cancer incidence to allow Wales to contribute to national and international cancer studies, but it hasn’t published validated cancer data since 2021. Shamefully, this means Wales can’t fully take part in essential national cancer audits, such as the national lung cancer audit, or in global studies, such as the international cancer benchmarking partnership. It also means that Public Health Wales is fundamentally hamstrung in its ability to project future demand on cancer services. When will you correct this glaring data gap by publishing cancer incidence data right up to the end of 2024?

Well, I think he makes an important point about the importance of data and reliable data in all parts of the health service, actually. I would go further: I would say the availability of data is critical. My own view about data across the system is that the availability of data itself isn’t our main challenge. The main challenge is being able to use that data in a way that is as purposeful as it possibly can be. I think that’s a challenge for health services everywhere, by the way, but it’s certainly one that I would recognise here.

So, in terms of cancer data specifically, which is what his question was about, we have, actually, improved the publicly available data, and we publish on a monthly basis about 18 pages of cancer treatment statistics so that they can be scrutinised. We do want to improve transparency further by looking to add data at sub-type level, so more granular data than we are currently able to provide, and there is work under way to get us to that point, and that’s part of a much wider set of actions on improving cancer data generally.

The Welsh Government is committed to ensuring accessible services and effective support for autistic people and their families. Through the neurodivergence improvement programme and the national neurodivergence team, we continue to provide support and drive improvements to enhance outcomes, empowering autistic individuals to thrive in all aspects of their lives.

I’ve just had Llyr Gruffydd’s statement of opinion this, which I urge Members to sign, and I’ve recently assisted a constituent who received an autism diagnosis before Christmas. She feels that her autism spectrum condition referral system in school delayed her assessment with the local health board, which resulted in her becoming very ill, and she’s concerned that this might be happening elsewhere, and I’ve seen evidence in my casework. The additional learning needs review needs to take account of the fact that schools have to go through local authorities in order to contact health boards, and that is a circular system that delays very much the ability of schools to contact the health board. Therefore, does the Cabinet Secretary agree that local health boards need to be involved in any review of how autistic spectrum condition referrals happen within schools? And will he work with his colleague the Cabinet Secretary for Education to ensure this happens within the context of the wider review of ALN?

I thank Hefin David for that supplementary. The ALN legislative review, which my Cabinet colleague the Cabinet Secretary for Education is taking forward, as I understand it, is focused mainly on the clarity and accessibility of the legislative framework itself and gathering evidence on some of the practical challenges for that. He does make an important point about the relationship between schools, local authorities and health boards. I will say that, as part of the neurodivergence improvement programme, we held an event in November last year, which was aimed at improving ND services for children, creating an integrated approach, involving all partners and including education partners. And it was clear, I think, from the discussions there, just how important it is, as we redesign the system, to ensure that all parts of the system, all parts of public services, are engaged and working together in the way they can support families. An important part of that work and the work that we’re already doing to improve services is making sure that staff in schools have the necessary training and the skill set they need to be able to support children who may be neurodiverse, and then making timely referrals to assessment when that’s needed.

I’m grateful to you, Hefin David, for raising this important and timely question in the Chamber here today. Cabinet Secretary, you will be aware that recent reports have shown that, by 2027, the number of children who will be seeking autism and attention deficit hyperactivity disorder assessments could triple to around 61,000. Now, we already know, as Hefin David outlined, the pressures that those assessment services are under, and in my region of north Wales I'm aware that children are now having to wait up to five years for that assessment to take place. In a child's lifetime, five years is a huge length of time. That's clearly having an impact on their educational attainment and the appropriate services to support them through their childhood. I wonder if you could just briefly outline why you think that, in a place like north Wales, children are having to wait that length of time, and why you think that the pressure on assessments is not being met currently. I know that there's a £3 million additional fund that the Welsh Government made available to support this, and do you think that's enough to deal with this additional pressure that the service is seeing?

I thank Sam Rowlands for that question. I think the source of the information that he refers to was the evidence that my colleague Sarah Murphy gave in committee last week. The point that she was making, I thought very transparently and very openly in that discussion, was that unless we take steps to reconfigure services, that is where we are likely to be heading. So, it isn't an inevitability and we don't want to see it happening.

The direct answer to his question is that I do not think that the £3 million intervention to tackle the longest waits is sufficient on its own, but we've never said that it will be. We think that the need to put the service on a different footing in the longer term is the solution to being able to see people more quickly. So, as well as the additional funding for the longest waits between now and the end of March—and all parts of Wales have benefited from that, including north Wales—the reconfiguration of the service through the improvement programme is the longer term solution. So, the point that I was making earlier to Hefin David about the redesign event that we had in November is exactly part of that. It brought stakeholders in—more than 100 stakeholders, I believe—to look at how we can reconfigure services so that we don't find ourselves in the position that Sarah Murphy was saying we otherwise would be in.

I'd like to highlight the wonderful work of a charity in Llay, Your Space, that help numerous neurodivergent families. They provide support for 165 young people and outreach to 140 parents. There is some crossover as well, but there's a waiting list of 70 young people and also 45 outreach families. Their rent has been trebled by the local authority this year and they're at risk of closure, despite referrals from the local authority and the health board to this amazing charity. So, I'd like to ask—. These are also people that aren't even on the waiting list, maybe, but they're self-diagnosed as needing support. So, how does the Welsh Government help support third sector organisations such as Your Space so that they continue the important work that they do?

I thank Carolyn Thomas for that, and she makes an important point about the range of providers making a real contribution to the lives of young people and others from the perspective of ND services more generally. And I absolutely recognise that a number are facing pressures for a range of different reasons. I know that, through the sustainable social services grant scheme, which my colleague Dawn Bowden has responsibility for, we do provide support for a range of organisations. I'm not sure that I can tell her that the organisation that she's mentioned is one of them—I just don't know that information—but there are a range of organisations that do benefit from that grant, and it's designed specifically to enable them to be sustainable, given the kind of service they provide and the extent to which we and young people depend on them.

We recently consulted on our draft all-age mental health and well-being strategy, which sets out our priorities for the next 10 years. This includes a focus on the early years and the mental health of young people through prevention and early intervention. We will publish the strategy in the spring.

Diolch yn fawr. There are young people in Wales at this moment considering taking their own life and, for young people in the LGBTQ+ community, the statistics are alarming. Figures from the Trevor Project suggest that almost 60 per cent of LGBTQ+ people are seriously considering or have seriously considered attempting suicide. Recently, I visited Progress Cymru Counselling, based in Swansea, that's provided support to young people within the LGBTQ+ community and their families for 20 years, and the founder, Debbie Lane, was recognised for her services to the mental health of young people in the new year honours list. This is an organisation that makes a real difference. Not only have they never lost anyone they've supported, but of the referrals made to them, none have ever had to be re-referred back to the NHS, and they're, of course, a preventative service. Calculations from the Mental Health Foundation show that, for the last two financial years, their social return on investment amounted to over £1.5 million each year, and, of this, the direct cost avoidance benefits to Government were over £1 million each year. But all this good work could soon come to an end because, because of a lack of funding, this organisation will have to close in April. The LGBTQ+ action plan commits to ensuring the mental health needs of this community are supported. So, Cabinet Secretary, will you meet with Progress Cymru Counselling to hear about the challenges they're facing, and is there anything that can be done to ensure a really vital service like this isn't lost?

I'm really grateful to Sioned Williams for raising this in the Chamber. I absolutely recognise the point that she makes about mental health challenges, but suicide is a particular challenge for young LGBTQ+ individuals. And, as she has acknowledged in her question, it is a critical part of our action plan to support the mental health and well-being of young people in particular in that community. Preventing suicide is a priority for us as a Government, as I think she acknowledged in her question, and the funding that we've made available, on a preventative basis, has increased quite substantially. That has helped us, I think, to strengthen the infrastructure in Wales, notwithstanding the very important point the Member was making. I think that has enabled us to strengthen the infrastructure around prevention of suicide and self-harm, either through the regional co-ordinators, coupled with the national action through the national suicide and self-harm prevention team. I would be very happy to meet with the organisation that she refers to, to hear from them about the challenges that they're facing and the contribution that, from her question, they are clearly making to young people.

Neurodiverse conditions, including autism, are not mental health conditions; they're lifelong neurodevelopmental conditions that shape how people see the world and how they connect with others. Many autistic people have meltdowns when completely overwhelmed, and their condition means it's difficult to express that in another way. It's not the same as a temper tantrum, and not bad or naughty behaviour. In these circumstances, however, autistic young people continue to be illegally excluded from Welsh schools, and their parents continue to be blamed and subjected to child protection procedures. The Association of Directors of Social Services in England have now published a report on autism and parental blame, which states that 90 per cent of parents said their child did not get the right support as a result of parent blame, and over 70 per cent of parents said their child's mental health worsened, with one in four parents reporting a high suicide risk for their child. So, instead of continuing to throw money and responsibility at those public sector perpetrators who continue to be responsible for this in Wales, when, if ever, will you finally take action to end these long-standing human rights abuses?

Well, I would associate myself with the first part of the Member's question in identifying the concerns. I haven't yet had an opportunity to read the report to which he refers, and I would be very happy to do that and to discuss its contents with my Cabinet colleague the Cabinet Secretary for Education, who will have an interest as well in that area.

I wouldn't accept the characterisation that the Member makes in the second half of his question. It is a challenging area and, actually, in my experience, professionals working in the public sector are looking to do their best for young people, whatever their needs. There is obviously more room for training, obviously more room for awareness raising and other support, and perhaps, having had the benefit of reading that report, we'll be able to reflect further on what more we can do.

Regional partnership boards and the £0.25 billion pound investment in them are supporting collaboration and integration between health and social care partners. The work of the care action committee, supported by an additional £19 million this winter, has further supported collaborative approaches to system improvement and, crucially, delivering better outcomes for people.

Thank you for the answer. The integrated care fund has been really important in providing step-up, step-down care, improving flow with enhanced care facilities, which show good partnership working. I believe that Denbighshire County Council have allocated some funding for that to help with, hopefully, the building of the Royal Alexandra, the improvements, with capital funding from the Welsh Government.

We heard at the Local Government and Housing Committee that the exercise referral scheme hasn't had additional funding for three years from the health boards, and there are other schemes that are delivered by local authorities. But I was just wondering, because there's always a fight over these budgets from the health boards, between health boards and the local authorities, how we can improve collaboration between the two and improve the flow, and make sure that the money follows the person.

Well, the Member makes an important point. One of the important roles that regional partnership boards are tasked with delivering is to ensure that deeper collaboration and to use the funding in a variety of ways—we provide a range of different streams of funding—and are used in a way that breaks down the barriers between the provision of care and the provision of healthcare.

I will say—and I think it has been the experience that I've had and that of the Minister for social care in recent weeks—as we have been planning for winter pressures, and as we've been focusing the system on the most effective things that both health boards and local authorities can do to ensure the safe and speedy discharge of people from hospital into care settings or to be supported at home, I actually think that the ways of working and the collaboration have improved, and I would say that's been true in all parts of Wales. Obviously, different regions have things to learn from one another, so some have strengths in areas where others don't, but I think every part of Wales has seen, I think, a deepening of that collaboration.

I'm planning to make a statement shortly in relation to the outcome of the 50-day challenge, as we were calling it, and I think you'll be able to see then the positive benefits of that. I just want to be clear, it's not a job and finish: 50 days is the time frame to put those things in place. Actually, the benefits of that collaborative way of working will be seen, I hope, very much into the future as well.

Well, isn't it a bit rich and ironic that the Labour Party, after 26 years in Government in Wales, are suddenly posing themselves as solution makers for their own problems? The fact of the matter is that you failed to deliver on such ambitions in the ensuing years: you failed to deliver the north Denbighshire community hospital in Rhyl over a decade after promising it and you conveniently took Betsi Cadwaladr health board out of special measures ahead of the last Senedd elections in 2021 to save your political skin. The public and my constituents will be well within their rights to ask what is the next trick up your sleeve in the next 12 months as a desperate attempt to save your bacon.

I know the Member for North Wales has been silent on this matter of the north Denbighshire community hospital for over three years because of your party's failure, but conveniently, after your success in the last general election, has started to talk about the issue to make your party suddenly start smelling of roses ahead of the next Senedd poll. So, my question is, Cabinet Secretary: do you genuinely want to deliver on such vital projects for my constituents, or do you just see them as political pawns in an attempt to keep you in Government post 2026, despite an ever-growing record of failure, which you'll do anything and everything not to be held accountable for?

The former. The former.

Sorry?

The former.

You caught me out there, Cabinet Secretary, and I suspect you caught quite a few people out there.

Question 6, Cefin Campbell.

A great deal of work is being undertaken across Wales to improve equitable access to stroke services and outcomes for people following a stroke. The expectations set out in our stroke quality statement set this work out.

Cabinet Secretary, you will appreciate, of course, how important it is for people to receive treatment for strokes as close as possible to where they live. This includes live-saving emergency treatment as well as intensive post-stroke rehabilitation. You'll also be aware, I'm sure, that there's a great deal of concern around proposals to downgrade stroke units at Bronglais and Glangwili hospitals, and to turn these into treat and transfer units. You may know that a public meeting has been called for twenty-fourth of this month to discuss the plans for Bronglais in particular.

Bearing in mind what Russell George has already told us this afternoon, there is concern right across Powys and Gwynedd about these plans or these recommendations, certainly, particularly the time of two hours, perhaps, that it will take for people to receive that comprehensive treatment that is needed for stroke. And this follows, of course, the downgrading that has already been seen in Bronglais Hospital with regard to paediatric services. So, campaigners are tired of hearing about the further centralisation of services and the withdrawal of services from rural hospitals. So, can you give us an assurance today that complete stroke services will be retained at Bronglais Hospital and Glangwili?

As I understand the situation, the health board hasn’t taken any decision on this issue, and there will be a consultation before any change is made to stroke services. As the Member knows, the medical consensus, for a very long period of time, has been that we need to ensure that the hyper-acute elements, in terms of supporting people experiencing stroke, happen at a regional level, because that’s how the expertise can be available to ensure the best possible service for individuals. But as he says, it’s also important that stroke services are available in hospitals more generally. As I understand it, what the health board has in mind is that stroke services will be available in all hospitals, but the hyper-acute element is what’s currently being considered. But there will be an opportunity for further consultation on this when the decision comes closer, if you like.

Again, I also want to emphasise the concern and anxiety, I think it's fair to say, about the proposals, particularly for Bronglais. I understand what you say, that no decision has been taken, but that at the moment isn't allaying the anxiety that is existing in that community.

You're right to say that the clinicians are stating quite clearly that the acute needs need to be met in an area where that experience and expertise presides. But there's also a statement reassuring people, and these are only proposals at the moment, that those sites will still be able to provide the life-saving thrombolysis that people need—that 'golden hour' in other words—for clot busting, which isn't, of course, appropriate in every case.

So, moving on and trying to allay that anxiety, I'm keen to know what conversations you've had with the health board, if any, about the post-stroke care that will have to happen. Because a stroke doesn't just happen, then people are treated and then sent home, there are an awful lot of social care needs and community care needs post stroke, which are probably the most required in the long term. And I think that is sort of part of the anxiety that is residing, from all the information that I'm receiving through my e-mails.

Well, I thank Joyce Watson for that. I think she is right to say that people do become understandably anxious in the context of potential changes to stroke services. I think she is right to say there are—. I've always thought, in my mind, there are three dimensions to it. I speak not as a clinician, but one element is the presentation at the hospital setting and the requirement for immediate action, then perhaps an acute period, and then, as she rightly says, the access to ongoing recovery support and rehabilitation.

My understanding, as is hers, is that Bronglais will still be able to provide thrombolysis in the way that she was saying in her question. And my understanding of what is under consideration at least is that ongoing recovery and rehabilitation will still be able to take place closer to home, which is obviously what people want to see. But I just want to repeat the point I made earlier. Obviously, I'll expect health boards to not only consult, as I expect will be the case here, but to take that kind of collaborative approach, working with people like the Stroke Association, and also engaging with the lived experience of those who have experienced stroke, so that decisions, which can be sensitive, are fully informed and have taken full account of the range of voices.

We introduced legislation in 2023 to underpin a new unified contract for GPs, which was the biggest change to GP contracts since 2004. The new contract makes clear what services every GP in Wales must provide, supporting improved care. Embedding this new contract takes time, but a robust national assurance process is in place to support health boards in assessing delivery.

Thank you, Cabinet Secretary. I think we all agree in here how fundamental our GP practices are and our GPs are to all of our constituents, and we all, I think, believe that they should be supported and recognised appropriately. It was concerning, though, that the British Medical Association rejected the 2024-25 Welsh GP contract proposal from the Welsh Government by such a significant margin, with only 1.3 per cent voting to accept and 98.7 voting to reject. This really is something, I think, that the Welsh Government must be reflecting on.

Our GP surgeries, we know, are under huge pressure in Wales, with the chair of the BMA's Welsh GP committee reporting that a recent survey of their members showed that 91 per cent of GPs are routinely unable to meet patient demand due to unsustainably high workloads. Cabinet Secretary, can I therefore ask what further steps the Welsh Government are looking to take to ensure that our GPs in Wales are properly supported, to ensure that every one of our constituents is able to access the support and medical care they need, because at the moment, it doesn't feel like they all are?

GPs provide, obviously, an absolutely fundamental service to people in Wales and are most people's experience of the NHS for most of their life. And since I've come into post, I've met a number of GPs to talk about the experience of general practice and the pressures that can arise in different contexts. I met the chair of the GP committee from the BMA before Christmas to discuss very much the sorts of things the Member was referring to in his question.

Look, I absolutely acknowledge the strength of feeling following the BMA Cymru referendum. What I said at the time, and it's my ongoing commitment, is that I am committed to continuing discussions with the BMA, so that we can make sure that we can realise that long-held ambition of moving more and more into primary care, to make the service even more sustainable and stable into the future, providing a range of services outside a secondary setting, which is what the public want, what we know GPs want, and what we know is the most effective way of doing it. So, the offer that we made to GPs met the independent pay review body recommendation of a 6 per cent increase. So, it met the recommendation and would have also seen an uplift in pay for all members of the practice team, but I'm absolutely looking forward to continuing the discussions that we are having with GP representatives to make sure we have a stable sector into the future.

Finally, question 8, Siân Gwenllian.

I have been assured that vascular services are safe in north Wales. A clinical agreement is in place for emergency and elective open aortic procedures to be undertaken in Stoke. Endovascular aneurysm repair and other procedures are delivered locally. The board will now consider the longer term model by the end of March.

It was mid November when we received the unexpected news that the health board had deferred abdominal aortic aneurysm work in north Wales, and of course this is the latest concerning development regarding vascular services in north Wales. So, when will these specific treatments be restored to north Wales, or is it ultimately the intention not to restore them and to run the service down continually? You talk about a review, which will happen by March, but is it the intention not to restore these services? You need to be entirely transparent on this. Because not restoring these treatments would have very serious implications for patients in my constituency in Arfon and across north Wales, and specifically in terms of medical training in north Wales, too. In terms of that final point on training, do you agree that failing to maintain the full range of vascular treatments would be very problematic indeed in terms of attracting qualified surgeons and trainees to north Wales? Of course, that is the long-term solution for improving vascular services.

At the end of the day, it would be a clinical decision in terms of the kind of decision that the Member is asking about. In terms of context, it's hugely important for every affected individual in terms of this decision, of course it is, but for context, it's around 0.2 per cent of activity by vascular services that is being impacted in north Wales by this decision. I'm not disregarding the experience of somebody within that percentage, but that is the scale of it on the whole.

The board will certainly be transparent in looking at this. They'll be holding a meeting in March, when they'll be looking at the challenges, the opportunities and the benefits that they Member has mentioned today, and we'll look forward to seeing what their considerations are before the end of March.

Thank you, Cabinet Secretary.

There are no topical questions this afternoon.

We will move to the 90-second statements. Carolyn Thomas to make her 90-second statement.

I was absolutely fascinated to learn today that it is National Pothole Day. I had never heard of the existence of that day, and I'm pleased to allow you to enlighten us on National Pothole Day.

Diolch, Llywydd. Today marks National Pothole Day, dedicated to raising awareness of the dangers of potholes, their economic cost and the need for improved road safety. Our highways, whether the strategic road network managed by the Welsh Government, or our local highways managed by councils, have suffered under 14 years of austerity and cuts to public funding, and it's now estimated that there are six potholes per mile on the roads and a backlog of £2.6 billion in remediation work across our entire road network in Wales. In addition to constant use and ageing, our assets are under growing pressure from the effects of climate change. The monsoon-like rain washes away road surfaces, with freezing temperatures then lifting the surfaces and causing potholes and issues with gullies.

Our highways are our biggest and most widespread asset for walking, cycling and public transport. Potholes can cause significant damage to vehicles and serious injury for cyclists. According to Cycling UK, 15 per cent of the cyclists that they help after being injured in a crash were involved in an incident involving potholes. We have made some progress, however, and we can now use AI to help repair potholes more quickly and efficiently. For example, the pothole pro machine, which is currently used in Flintshire, is three to four times more efficient than the standard methods. It's more cost-effective, at £30 a pothole, and it gives a more resilient result, and the workforce thinks it's great. And I am relieved that Welsh Government is providing funding this year to help our roads and pavements and to get rid of some of those potholes.

The next item this afternoon is the debate on the Local Government and Housing Committee's report, 'Private Rented Sector'. I call on the committee Chair to move the motion. John Griffiths.

I'm pleased to open today's debate on the Local Government and Housing Committee's report on the private rented sector. I would like to start by thanking all of those who contributed to our inquiry, particularly those who shared their personal experiences. I'd like to thank Tai Pawb for their help in arranging the focus groups and the members of their champions network, including those whom I met at the Senedd today, for their valuable input into this report. Hearing about people’s personal experiences is so important, and really does add value to our work, so thank you.

Having a safe place to call home, whether that home is rented or owned, is an important part of ensuring that people can live happy, healthy and fulfilling lives. Home ownership isn’t an option for many, and with social housing in such high demand, the private rented sector or PRS plays a crucial role in providing homes for people. It has to work for everyone, tenants and landlords. Landlords need to have confidence that their role is valued and tenants need the security and assurance of knowing that they have a stable home that is affordable and of good quality.

Our report makes 13 recommendations and six conclusions. I’m pleased that 12 of the recommendations were accepted either in full or in principle. One recommendation was rejected, which I will return to shortly. Much of the evidence we received focused on the quality of accommodation available. It’s clear this continues to be an issue. Damp and disrepair were the main issues highlighted, and we know that living in such conditions can have a detrimental impact on people’s health and well-being.

It was concerning to hear of many instances of poor quality housing; tackling this must be a priority for the Welsh Government. The Welsh housing quality standard applies to social rented housing, and while we understand the challenges of extending its application to the private sector, it is difficult to justify why people living in those homes should be any less entitled to quality than those living in social housing. To that end, we support the extension of the Welsh housing quality standard to the private sector, and want to see clarity about when and how this could be given effect. Our recommendations relating to housing quality were accepted in principle, but we are disappointed that the Welsh Government’s response does not indicate any immediate actions to remedy the concerns we heard. Is the Cabinet Secretary able to outline any more immediate plans to improve quality within the private rented sector?

We recommended the development of a property MOT for fitness for human habitation, and in response, the Cabinet Secretary referred to the consultation that’s under way on introducing an annual property condition record. This could be a step forward, but there’s no certainty of that yet. Propertymark, which represents letting agents, has voiced support for this proposal. We note that landlords would self-certify, but I’m not sure whether that goes far enough to address our concerns. I’d therefore be grateful if the Cabinet Secretary could provide more information on this, in particular how we could be confident that compliance would be enforced. We know that local authority resources to undertake enforcement are already stretched. Our recommendation that the Welsh Government and local government work together to increase inspection capacity was accepted in principle. Whilst local authorities are democratically accountable bodies, responsibility for ensuring there’s enough capacity to deliver cannot be left to them alone.

Another theme in evidence was the right of tenants to have a pet. We were very concerned to hear that high numbers of properties are advertised as not allowing pets. Dogs Trust told us that more than half of households in Wales have a pet, but less than 8 per cent of PRS properties are advertised as pet friendly. I understand that having to relinquish a pet in order to find a home can be very traumatic and the committee feels strongly that tenants should not be put into such a situation. The evidence demonstrated that discrimination by landlords against people with pets is real and needs to be addressed.

Although some properties will be unsuitable for larger animals, we believe that, as long as a property is suitable, tenants should not be prevented from having pets. While we recognise landlords’ fears of property damage, we heard compelling evidence to demonstrate that damage is often less than anticipated and that landlords can make more money by renting to pet owners as they are likely to stay in a property longer. There are also various options around pet insurance and flexible deposits to provide greater assurances to landlords. The committee is therefore united in our view that landlords and agents should not be able to discriminate by not including a clause allowing pets in standard contracts without good reason.

The Renters’ Rights Bill includes provisions that would prevent landlords from unreasonably refusing a request from tenants to keep a pet. While some aspects of that Bill will apply to Wales, the provisions relating to pets will only apply in England. While the Welsh Government’s White Paper on adequate housing, fair rents and affordability includes proposals to allow landlords to charge an insurance premium to cover pet-related damage, we do not believe that these proposals go far enough. In our report on the legislative consent memorandum for the Bill, we recommended that the Welsh Government should seek an amendment to extend the provisions relating to pets to Wales.

Dirprwy Lywydd, turning to the recommendation that was rejected by the Welsh Government, as part of our engagement work, we heard from landlords who specialise in working with tenants on lower incomes, including tenants who may need support services funded by the housing support grant. One such private landlord is White House supported living in Newport, which was included in the report as a case study. I visited White House and saw for myself how it accommodates tenants with support needs, many of whom have been homeless, and provides them with stable long-term homes in shared housing. I heard directly from the tenants about the positive impact this has had on their lives, including some who have lived there for over 10 years. We heard that the company receives housing support grant from the council so that tenants each get tailored support to help maintain their tenancy. This model has clearly worked well, and demonstrates that the PRS can work effectively for tenants with complex support needs, provided that the right support is in place.

Can I thank the committee for publishing this report? I’ve only just recently joined the committee, but what a solid piece of work and a thorough piece of work it is. I thank you, Chairman, for presenting that on behalf of our committee.

We all deserve to have a home, be it one that we own or one that we rent. The safety and security of knowing we have a roof over our heads at the end of the day is not something that we should take for granted. But according to Office for National Statistics data published in October 2023, private rental prices paid by tenants in Wales have risen by 6.9 per cent, higher than in both England and Scotland. The simple fact is that successive Labour Governments in Wales have failed to build enough homes, resulting in increased competition for tenants. Furthermore, this has contributed to the 8 per cent rise in households assessed as homeless over the last year. That’s an additional 13,000, I believe. This is all while the number of households in temporary accommodation has reached record levels. We all agree that tenants deserve to have security and the assurance of a stable home. However, we have seen far too much policy-making here being directed against landlords, which has led to a mass exodus, thereby further driving up the competition.

I do welcome a number of the recommendations and conclusions in the report and want to highlight a few key points. I welcome the committee’s work in trying to improve renters’ rights, but that must go hand in hand with ensuring that landlords are not forced to leave the sector. I want to welcome recommendation 1 in particular, because it’s clear that the private rented sector has a part to play when it comes to providing housing stock for tenants, and the Government must work with the sector and not against it. I also welcome recommendation 2, which will put in place training and education for landlords and tenants on the grants and support available through the rapid response adaptations programme. I also welcome recommendation 11, extending tenants’ rights to have pets, as the Chairman of the committee pointed out very well.

I do, however, have concerns surrounding recommendation 6, which will knock the little confidence that remains in the private sector and will further contribute to the exodus of private landlords. Fewer properties on the rental market means higher rents and a larger dependency on social housing that the Government just doesn’t have.

To conclude, Dirprwy Lywydd, the Welsh Government must work with both tenants and landlords to ensure that we have a fair system that does not punish landlords as a deflection from the failure of Governments to build sufficient housing stock here in Wales. But I commend the report. Thank you.

I too welcome this opportunity to contribute to this very important debate and to discuss some of the recommendations that were made by the committee in its report. I too wasn't a member of the committee throughout the inquiry, so I didn't hear all of the evidence submitted.

I will start with recommendation 4. The commitment to extend the Welsh housing quality standard is a positive step, but of course we need to have clear timescales and steps outlined, otherwise there's a danger that the progress that we want to see won’t happen. So, the Welsh Government does need to explain when the reviews will be undertaken, what they will consider, and how the decisions will be made about extending the standard to the private rented sector. But it is about time that this sector has higher standards, to safeguard tenants from poor standards that can be damaging to their health and well-being.

In recommendation 5 there is mention made of developing a property MOT to ensure fitness of habitation as part of the licensing regime with the Rent Smart Wales programme, and I believe that this is an important step. A property MOT could provide crucial consistency in ensuring that homes do meet basic safety and living standards. But once again, we must emphasise the need for timely action, particularly before the next landlord registration cycle in 2026. Annual updates on progress will ensure accountability and enable the Senedd to monitor this aspect closely.

Recommendation 6 mentions the possibility of allowing tenants facing no-fault evictions to retain the last two months' rent as compensation. Now, whilst I support that, I strongly believe that we need to go far further to safeguard tenants, and with the UK Government seeking to eradicate no-fault evictions, through the Renters' Rights Bill, there is a genuine danger that tenants in Wales will be facing weaker rights than those in England. Of course, under the Renting Homes (Wales) Act 2016, tenants have a six-month period of warning by landlords, which is inadequate to meet the financial and the emotional impact of having to leave a home. So, I would like to ask the Cabinet Secretary whether she is entirely convinced that tenants in Wales won't be losing out as compared to tenants in England—as well as in Scotland, of course—as a result of the new legislation that is being discussed at present in Westminster. Are there implications in terms of what's being discussed in Westminster with regard to equality for tenants across these nations?

Recommendation 10 is to be welcomed. It mentions the issue of having a guarantor and the need for months' worth of rent ahead of time. That has a disproportionate impact on low-income households and younger tenants. These practices do create a two-tier rental market, with those with fewer financial resources facing significant barriers in accessing a home. So, I do welcome this recommendation, and I do think that the Welsh Government needs to regulate urgently to ensure that these barriers are eradicated, by promoting fairness and equality of access to housing.

Thank you to the Local Government and Housing Committee for bringing forward this important debate today. I was a member for a short while, before moving on. There isn't enough social housing, so the gap is having to be filled by the private rental sector, which is really supposed to be interim or transient as a provision. Private landlords have asked for help with supporting tenancies. There's usually a housing officer or housing team in the social housing sector that helps with issues arising from tenancies of people with particular needs. The housing support grant has been invaluable in funding that type of wraparound support.

Today I would like to focus on pets. They are part of people's families, they provide companionship and comfort, they help alleviate loneliness, they provide motivation and purpose, and are beneficial for the owner's mental health and well-being. Yet, having a pet can make finding accommodation extremely difficult. There are already many barriers to renting: credit checks; needs for references and guarantors, who themselves need to own a home; the huge lump sum deposit upfront, which is completely unaffordable; and then there are the demands of 'no children', 'no pets', 'no universal credit', which doesn’t consider that some people are working and claiming, and some people are unable to work.

The Dogs Trust Cymru said that Welsh Government statistics showed that 52 per cent of households have a pet, including one in three households with dogs. Despite these figures, a survey showed that only 8 per cent of renters in Wales say that their home was advertised as pet-friendly. The shortage of pet-friendly housing has meant that many pet owners have had to give up their pets and our rescue centres are full.

The Dogs Trust had 118 people enquire about handing their dog over to their rehoming centre in Wales between December 2022 and the end of March 2023, citing a change in accommodation or rental agreement. Worryingly, the committee heard from several stakeholders that some people faced with this decision opt to stay with their pets and end up actually becoming homeless as a result. And Crisis, the homeless charity, told the committee:

'One of our members wasn't able to take a place purely because it had a no-pet policy. She has a dog that has been her only companion through the most difficult time in her life, and she actually chose to sleep in a car, rather than take a place.'

And I’m sure that many of us dog lovers in this Chamber can empathise with this lady at how difficult that decision must have been.

I’d first like to acknowledge the work put in on this report by the Chairman, in particular, of the committee, but also by the committee as a whole. I was a member of the committee for a short while, whilst this piece of work was being considered, and I’m sure I’m sorely missed on that committee these days, but more than ably replaced there by Peter Fox, doing his work on the committee.

I just wanted to—. It just struck me, in Carolyn Thomas’s opening words, framing the private rental sector as a stopgap whilst not enough social housing is in place—. The private rental sector is a significant and really important part of housing here in Wales. There are 215,000 private rental properties in Wales, with 103,000 landlords registered with Rent Smart Wales. It’s far from just a stopgap. Whilst perhaps there’s a desire from the benches opposite for more social housing to be in place, it’s a fundamental, important part of our tenure. [Interruption.] Sorry, Carolyn.

What I was trying to say is, during the committee, we heard from private landlords that they felt that they were filling the social care gap, in a way, with the private rental sector, because there’s a lack of, a shortage of, social housing, and that’s when they were asking for that wraparound support, perhaps, for their tenancies as well, that they can’t always provide.

Okay. Thank you for clarifying that, and I apologise if I was a bit antagonistic with my opening comments there. But I think it is really important, though, that we do make sure that the private rental sector is valued not just in word but in deed as well.

I just want to focus perhaps on a couple of recommendations that are within the report that we’re debating here today. But before I do go on to those recommendations, it is worth recognising the continued demand for private rented homes here in Wales. I think the Zoopla website shows that there are 23 enquiries for every available home to rent in Wales, so 23 times the number of enquiries against the actual properties that are available, which is now three times the pre-pandemic rate. So, we're seeing since the COVID-19 pandemic that demand for the private rental sector increase significantly, but, at the same time, we are seeing fewer private rental homes: a reduction of 1,746 since 2021 here in Wales. So, on that point, I think it’s really important that Welsh Government are very careful with some of the measures they seek to implement and that we don’t see a further reduction in the number of private rental homes available to people up and down Wales as a result of any of those measures.

And one of those particular measures that I think I’d urge some caution on is, actually, recommendation 6 within the report, which seeks to explore the feasibility of enabling tenants who are subject to no-explanation repossessions to be able to retain the last two months’ rent of their tenancy. In my view, this has the potential to unfairly penalise responsible landlords who are working within the law, and it seems to ignore the fact that there are already stringent safeguards in place, such as the rule that no-explanation repossession notices are unable to be served in the first six months of a tenancy, and, not only that, there are already rules that add that tenants are required to have six months' notice for any repossession notice when that notice is issued. So, I’d just urge some caution around recommendation 6 in particular. And I was a little surprised to see that recommendation written in that way within the report, because I think there are some potential unintended consequences if that is not thought through carefully.

There are some recommendations that the committee has put forward that are certainly to be welcomed, and certainly recommendation 1, I think, is really important for Welsh Government to take on board swiftly, to outline a vision for the role of the PRS, so they know that they are valued, as I said in the opening of my contribution here today. I think that positive message to the sector is always welcomed by them and I think the date set in our recommendations report—October 2025—will need to be adhered to.

And I call on the Cabinet Secretary for Housing and Local Government, Jayne Bryant.

Diolch, Deputy Llywydd, and I'd like to, firstly, thank John Griffiths, as Chair of the Local Government and Housing Committee, and those past and present members for contributing today. I know that it does show a lot when we have past members of the committee and those ones new to it to contribute to the debate, but I do very much value the committee for holding the inquiry into the private rented sector.

Deputy Llywydd, I welcome the recommendations that are set out in the report, and our published response to the committee sets out the action we propose to take. I'm pleased to say that we have accepted or accepted in principle all bar one of the recommendations and conclusions of the committee. The only recommendation that we have not accepted is due to the housing support grant not being given directly to private landlords and the funding being tenure-neutral to support all those who may be at risk of homelessness. As set out in my evidence to the committee, the private rented sector plays a vital part in providing almost a fifth of homes for people in Wales. And I'm keen to see how we can support landlords who provide high-quality, safe and affordable accommodation to feel confident to stay and invest in this sector for the future.

The cost-of-living crisis, inflation growth in 2023 and interest rate rises have impacted on both landlords and tenants over recent years. Across Wales, we have seen rents and demand for rental properties significantly increasing, as some landlords have looked to leave the sector. Tenants too have been more reluctant to move within or indeed out of the private rented sector. Data held by Rent Smart Wales shows a steady increase in property registrations during the second five-year registration period, with the average portfolio size of landlords also increasing. So, there are some positive indicators starting to emerge.

Through the introduction of the Renting Homes (Wales) Act 2016, we have secured better consistency in the way that private rented properties are let, ensuring that tenants have written terms and conditions, better security of tenure, with a six-month notice period and certainty that rents can only be increased once every 12 months. Ultimately, what matters to tenants is having the time to plan. Whether a reason is specified or a notice or not, the need to move is not the fault of the tenant. However, I do recognise the challenge of securing an affordable rental property, particularly for lower income households who are in receipt of local housing allowance support. To help address this, we launched our Leasing Scheme Wales in 2022, and I recently wrote to all Members to highlight the benefits of the scheme. To date, we have secured 343 properties, with a current pipeline of a further 165 anticipated to be signed up shortly. Of these, 60 per cent were previously empty properties that have now been brought back into beneficial use. They provide affordable rental homes for lower income households, with the rent capped at the local housing allowance rate.

Will you take an intervention?

Of course.

I am worried about the added expense of insurance, especially if it's taken out by the landlord and then charged to the renters, and also if the renters themselves haven't got that money. So, I was wondering if you could consider it further, going forward.

Diolch, Carolyn. I know that this is something that you have raised. As I said, this is the same approach that's being taken in England in the Renters' Rights Bill. I think with regard to—. We've heard from organisations that talk about that the damage that pets do—or the alleged damage that pets do—is actually very small. It's the other way around, really, isn't it? That is something I'm really keen to make sure that landlords know, through things like Rent Smart Wales. So, on that point, I have asked that we have written, and we have written, through Rent Smart Wales, to contact landlords to highlight the latest research that shows that the cost of any damage in properties rented to those with pets is less than the damage that is caused by those without pets. So, I think that it's sometimes about making sure that those messages get through.

I'm aware of the calls from Members of the Siambr to reconsider rent control measures. We've given considerable thought to this area, and the evidence we have received suggests that rent control measures could have an adverse effect on our core ambitions. They could lead to a reduction in the supply of rental properties, an increased risk of homelessness and higher rents for newly let properties. It's very possible that rent controls would have a detrimental impact on the very people that such measures should be protecting. So, instead, and as set out in our White Paper, we're keen to gather more robust data on private market rents. We also want to look at the ways in which this data can be suitably put into the public domain to allow better understanding of rental levels in particular areas, which will inform better any potential future policy measures. We're also seeking views, as part of the consultation, around proposals for a rent adjudication process, should a tenant consider that a rent increase is unfair. The White Paper also sets out how we're exploring the potential to further increase affordable rental supply, through allowing a property owner to obtain a refund on the higher rate of land transaction tax where a property has been purchased and signed up to Leasing Scheme Wales.

We await the outcome of the White Paper consultation, which closes, as I said, at the end of this month, after which we will be setting out the next steps on taking these measures forward. I hope that that reassures the Siambr that, as a Government, we are listening and acting on evidence from landlords, tenants and wider housing stakeholders. We have invested and continue to invest in increasing the housing supply and tackling homelessness. The draft budget has included an uplift to support the continued roll-out and uptake of Leasing Scheme Wales.

I call now on John Griffiths, the Chair of the committee, to reply to the debate.

Diolch, Dirprwy Lywydd. I thank all Members, and particularly the Cabinet Secretary, for their responses and contributions in this debate today. May I thank Peter Fox for his contribution in trying to emphasise the need to strike that appropriate balance in terms of tenants and landlords and be fair to both of those? That’s certainly the approach that the committee wants to take and, I hope, has taken with the report overall, which does state that that is exactly what we think should be the case in Wales, and we must strive towards that—Welsh Government must strive towards that.

Obviously, we want private landlords to stay in the market, to provide those options for renters in Wales, and we want tenants to have a very good experience in the private rented sector, in terms of quality, security and safety. I’m very pleased that Peter has come on to the committee, given the wealth of experience that Peter has as an ex-leader of Monmouthshire local authority, because that experience and that knowledge is already proving very useful to the committee indeed. So, thanks very much for that, Peter, and we'll certainly continue, I think, as a committee to strive to seek that balance that you emphasise.

Siân Gwenllian emphasised quality in provision. That must be right, mustn’t it? At the heart of what we want to see is top-quality private rented sector accommodation here in Wales. Siân was supportive of the recommendations that would seek to ensure that, extending the Welsh housing quality standard, but wanting that done to an appropriate timescale, emphasising the importance for the health and well-being of tenants. Whenever we talk about housing, we talk about the importance for health and well-being, and there's a wealth of evidence that makes that connection. Siân also mentioned the property MOT approach and, again, the need to make sure that that's taken forward effectively, and also protections around no-fault evictions.

I think there has been a lively debate about this, hasn't there, in terms of the situation in Scotland, the situation in England, and Welsh Government's view that perhaps there's not that much difference between Welsh Government's approach and what we see in England and Scotland in practice, in reality, in as much that it is possible to evict, for example, on the grounds of needing the property for the use of the landlord, or to sell on the open market, when perhaps that might not be the case. So, in a way, it depends on how much faith you have in human nature in terms of the landlords.

But I think what we are concerned about is that there is no disadvantage in practice to tenants in Wales, and we've heard what Welsh Government has said about the two six-month periods. We ask that there is an exploration of the two months' rent in as much as that would be very useful to tenants in terms of finding an alternative property, if they do have to leave their home. That would go some way further to addressing the concerns that Siân Gwenllian expressed.

I'm being generous as your time has well gone.

You have indeed been generous. Can I just say, in closing, that we're very mindful of the need to strike the appropriate balance in terms of tenure, and, as a committee, we would like to see many more properties available for affordable social rent? We believe that perhaps 60,000 new affordable homes for social rent should be built over the next five years or so, which is a major challenge, we understand. But in terms of the overall balance, and the role of the private sector, we feel that the balance has got out of kilter, and in terms of the vision that Members emphasise that we need from Welsh Government, that must be an important part, we believe, in moving forward.

The proposal is to note the committee's report. Does any Member object? No. The motion is therefore agreed in accordance with Standing Order 12.36.

Item 6 today is the Welsh Conservatives' debate on the new UK Government's first six months. I call on Darren Millar to move the motion.

Diolch, Dirprwy Lywydd. I move the motion on the order paper.

Before last year's general election we were constantly told that Labour Governments at both ends of the M4 would be great for Wales. But what we've actually ended up with is a double whammy. Broken promises and failing policies coming down the M4, alongside a passive, silent Welsh Labour Government unwilling to offer a squeak of criticism or lift a finger to defend the interests of the people of Wales.

Let's start with our pensioners. As we move towards what we now know to be an exceptionally cold start to the winter, the new UK Labour Government decided to remove the winter fuel payment from 0.5 million pensioners here in Wales—0.5 million people—many of whom are vulnerable, who are now facing a choice between heating and eating this winter. A cut that, by the Labour Party's own researchers' predictions, would lead to around 4,000 deaths. It's no wonder that ‘it will be freezing this Christmas’ managed to get to No. 1 in the charts in the middle of December.

Now, the Scottish Labour Party at least stood up for their people and criticised the UK Labour Government's decision, yet here in Wales the Welsh Labour Party said nothing. Not a dickie bird. And instead of stepping in to provide its own Welsh winter fuel allowance, they did nothing. They are the 'say nothing and do nothing' Government.

There was also radio silence, of course, on the issue faced by Women Against State Pension Inequality. Up until a few weeks ago, Labour politicians in Wales were falling over themselves to pose for selfies. They made social media posts promising to support the WASPI women, including at events right here in Cardiff Bay, outside the Senedd on the steps. And then, having won the election, Sir Keir Starmer, no longer needing their support, has dismissed them, with a glib comment about reading their mail and noting their comments. And those very same Welsh Labour MPs and MSs who'd been posing for selfies suddenly did nothing, and they said nothing.

And then there's our farmers. They've received similar treatment. Before the election, Sir Keir promised to support agriculture. And our very own Welsh Labour Cabinet Secretary was happy to visit farmers’ markets, cameras in tow, of course, to promise that a Labour Government would stand up for Welsh farmers. But what happened afterwards, following the election, was a hammer blow to rural communities, with changes to inheritance tax that amount to little more than a family farm land grab. And where was the Welsh Labour Government after this attack on rural communities across Wales? Where were they? Well, once again, they said nothing and they did nothing.

I have selected the amendment to the motion. I call on the Cabinet Secretary for Finance and Welsh Language to move formally amendment 1, tabled in the name of Jane Hutt.

Formally.

I think we've had the usual la-la land, if I may put it politely, contribution from the Welsh Conservatives to launch this. I think their real problem, Dirprwy Lywydd, is that people's memories are not as short as they think they are. When they talk about all these issues—not standing up for Wales, allegations about sleaze—people well remember those long Tory years, the 14 years of austerity, all the series of failings that they showed on all the things that Darren Millar has highlighted as failings that he sees at the current time. We had all those years with all of that writ large. People are not going to forget about that as quickly as you'd like them to, I'm afraid, Darren. Those memories will live with people for an awful long time and maybe that's got something to do with why you haven't got a single MP in Wales. Perhaps you ought to reflect upon that before you make the contributions that you made earlier.

Will you take an intervention?

I will.

I'm very grateful to you for doing that. Would I remind you that you should be humble enough to acknowledge that the share of the vote for the Labour Party in Wales also went down at the last general election? So, it was a rather lacklustre performance, if I may say, in terms of the share of the vote for your party. Do you accept that that is largely because of the utter despair and dissatisfaction that the people of Wales feel about the performance of this lacklustre Government?

Darren, you haven't got a single MP in Wales. You know, wake up and smell the coffee. You need a radically different approach to the one that you've been pursuing here in Wales, let alone what your UK colleagues did over those long years of austerity. We thought, actually, on this side that your leadership might bring a change of approach, but I'm afraid all we've heard so far is more of the same, more that we'd got used to from your predecessor. It's not going to wash, it's not good enough, Darren, and you really need to rethink.

What I really wanted to address, Dirprwy Lywydd, was Gordon—[Interruption.] What I really wanted to talk about, actually, was Gordon Brown's report, which I am very keen to see implemented here in Wales, because I think it offers us real possibilities in terms of addressing the terrible inequality that we still see—regional economic inequality, social inequality—across the UK. Countries like Wales need real support and assistance and partnership from the UK Government to build our economy and deal with those inequalities, and Gordon Brown's report offers us a blueprint for some of the most important ways forward—things like bringing more public sector jobs here to Wales, relocated from elsewhere in the UK, mainly the south-east of England.

We want to see more investment in infrastructure, for example in rail, and we do really need to address the historic lack of proper investment in our rail industry in Wales that we've seen over very many years. And we need support for our clusters: for us locally in Newport, for example, cyber security, the semiconductor industry, and the transition that we need to see to green steel. There are many important aspects to that Gordon Brown report, Dirprwy Lywydd, and, of course, they're not all economic; some of them are about dealing with the imbalances of power in terms of our constitution, and where responsibility lies for service delivery and strategy and policy development. So, there are many important aspects to that report. It was a serious piece of work—[Interruption.]—and I hope that we will see early progress in taking it forward. I give way to Sam Kurtz.

Thank you. We're obviously commemorating six months of Starmer's leadership. You mention the Gordon Brown report. Can you point to one thing within that report that's progressed in that six months of Keir Starmer's premiership?

It's very early days, Sam, isn't it—[Interruption.] We are talking about six months—[Interruption.]

Let the Member respond to the intervention, please.

Be sensible and realistic, Sam. We've already heard from our Cabinet Secretaries here: there's been a sea change in relationships between the Welsh Government and the UK Government, and that is very welcome. You really shouldn't try and dismiss that lightly, because we had terrible relationships and a lack of true partnership for so many years under your colleagues at Westminster. Already we've seen a sea change, and that is delivering and will deliver.

What I'd like to say, Dirprwy Lywydd, in closing is that work that Gordon Brown and his colleagues did is a serious body of work. It really does need to be implemented, and if it is implemented here in Wales, we'll see badly needed progress in dealing with those regional inequalities that we see across the UK. It's not just about Wales; it's also about Scotland and the north of England, for example. I hope that we do see that implementation in short order.

Well, it's ironic, isn’t it, that it's the Conservatives who are bringing forward this debate today, as we know how damaging their austerity agenda was for individuals and communities in Wales, and the fact that our communities are still feeling the impacts of that agenda.

After all, it was the Conservatives who were responsible for the mess of Brexit, which is still having a detrimental impact on our economic performance and has undermined so much trade and industry here in Wales. They too are responsible for normalising the need for foodbanks and for introducing damaging and cruel policies that have led to so many living in poverty, unable to afford life’s essentials.

In terms of HS2, they should have presented a fair funding settlement for Wales and delivered the funding owed to Wales. Little wonder, therefore, that voters in Wales decided that no Conservative Members of Parliament from Anglesey to Monmouthshire deserved to keep their seats.

But although we remember the legacy of the Conservative Government, a legacy still felt today, the focus of today’s debate is the current Westminster Government, and despite the Conservatives’ hypocrisy in tabling this debate, we will be supporting the motion today, as we too share the concerns expressed in it.

Labour did promise the people of Wales a change, and many people across the country voted for them, because they craved change for the better. Is there any wonder, then, that so many feel that they have been betrayed by Labour, bearing in mind that the situation for them has changed for the worse? They question why Labour wasn't clearer before the election about some of the policies that have been implemented since they came to power.

We've heard about some of those examples, but also there was the refusal to eradicate the cruel two-child cap that has led to 30 per cent of children in Wales living in poverty, the withdrawal of the winter fuel allowance from half a million pensioners—something that even George Osborne, the architect of austerity, didn't consider, and something that has pushed so many of our pensioners now into poverty this year alone.

Second, of course, the increase in employer national insurance contributions without any certainty of a full refund by the Treasury, which has left our universities, GP surgeries and third sector organisations facing a very fraught financial situation. The changes to inheritance tax reflect a lack of understanding of our agricultural communities; the u-turn in terms of WASPI women.

It's becoming increasingly apparent that the relationship between the Welsh Government and the Westminster Government is not, truth be told, a partnership, because how can you talk about a balanced partnership when one side ignores the other on matters of such importance to Wales? For example, we haven't received even a penny of HS2 funding in the budget, despite the fact that the current Secretary of State used to agree with us that we should receive the funding owed to Wales.

Members, it's very clear that Keir Starmer's Labour Government has been a total disaster in so many ways over the first six months, as was so eloquently described by my leader, be it their treatment of vulnerable pensioners—as we know, the removal of the winter fuel allowance—or the huge hit to businesses and employees through increases to employer national insurance, and, of course, the massively damaging proposed changes to agricultural inheritance tax, an area that I'm going to focus more on.

The farming sector is so fundamental to the economy and fabric of the UK and most definitely here in Wales. It should be acknowledged just how much of a difficult time farmers have faced in recent years, and continue to feel under threat. Our Welsh farmers continue to face and live with the devastating impacts of TB, the rise in the cost of doing business, increased regulation, red tape, ever-growing Government expectations, yet all they want to do is feed us. They're not in it for the money, and that is a fact.

Our farming community now has to deal with two Labour Governments on either end of the M4 who either do not care or do not understand the needs of their rural communities. The entire point of agricultural inheritance tax relief is to give certainty to farmers that they will be able to continue to keep their family-run farm in the family and pass their legacy down to their children. This allows the historical nature of family farms to continue in perpetuity, enabling future generations to continue to trade and to continue to feed us.

Farmers, on paper, are often simplistically seen as asset rich, but we know that they are really cash poor. Given the very marginal income profile of the majority of farms, anyone who inherits a farms is unlikely to be able to meet the inheritance tax liability without selling their farm, or a large part of it, or trying to take out extensive borrowing that they wouldn't be able to service out of the modest incomes they generate.

There are other consequences of the agricultural property relief change as well, as many farm businesses have to rely on rented additional land to remain viable. If the changes to APR take place in 2026, it is expected that the supply of available land to rent in Wales would be severely reduced, meaning that many farmers would lose access to land needed to maintain their business viability. All of these things will threaten our food security and the fabric of our rural communities, and all that goes with that, including the damage to our culture and to our language.

I've been concerned by the number of people who support this tax change, and who have little or no experience of the countryside, who have branded APR as a loophole. It's not a loophole—it's a carefully designed policy that was designed to protect Britain’s family farms from being broken up. And thanks to this new Labour Government, our farmers are facing the very real prospect of having to do just that, to break those farms up. To make matters worse, the president of the National Farmers Union has said that the Chancellor has refused to engage with the union on these inheritance tax changes since she announced the budget.

Isn't it interesting how short the memory is and how things are being projected? There is £14 million in the budget for farmers. Anyone would think we were giving nothing.

I'll move on to looking at some of the decisions that have been taken. We know for certain, it's well recorded, that what the Tories really wanted to do when they were in power, and set about doing it quite well, was to not protect the workers, the poorest paid workers, but to try their very best to make sure that trade unions couldn't operate in the way that was most effective for their members, and to deny trade union voices being heard by not allowing paid facility time, by increasing the threshold for a ballot so that those voices could be heard. That didn't happen, of course, in Wales because we protected people from that deliberate attack on working people.

So, we move on. The gig economy encouraged widespread misuse of zero-hours contracts. Companies thrived while workers were denied basic rights like job security, guaranteed hours, sick pay or holiday entitlement. Workers with precarious livelihoods joined the realms of foodbank users, another shameful Tory legacy. When that party opposite come into power, there were 35 foodbanks across Britain, because mass hunger wasn't the issue that it has become. Now Britain has 2,800 foodbanks, with over 3 million food parcels deliver in the last year. Somehow they managed to have inequality, hunger and poverty becoming the norm under their rule. And it's going to take time to change that. I'm glad that the Children’s Wellbeing and Schools Bill sets out a path to do that.

The Employment Rights Bill will bring much-needed change. It sets out how to ensure gig economy workers are classified properly and granted the rights they deserve, including paid leave and fair wages. It supports flexible working, helping workers who were at the mercy of employers who refused to consider those requests, and amongst those, lots of them will be carers and they will be new parents. It will crack down on companies exploiting young and new staff as cheap or free labour, and it addresses workplace discrimination, with stronger protections for those who speak out against unfair treatment. And it addresses the delays and inefficiencies that have often led to workers being denied any form of justice. Under the previous Government, some businesses exploited the loopholes in the law at the cost of the most vulnerable workers, but those gaps are now going to be closed. This will ensure a fairer, more balanced approach to employment, where all workers can thrive and where their rights are protected. I think that is a huge contrast to what was done under the leadership, or the abuse, if you like, under the Tories for 14 years.

We've all been told, countless times in the year, in the run-up to the election, that a Labour Government here and a Labour Government in Westminster would be a wonderful thing for the people of Wales. A partnership between two administrations at either side of the M4 would work towards a common goal and bring big benefits, we were told, time and time again. Well, Deputy Presiding Officer, I can honestly say that I think we were all led down the garden path on that one.

Residents right across Wales have been clobbered and punished since Keir Starmer entered No. 10 and there's absolutely no sign of any benefits coming our way. We have seen the winter fuel payments snatched away from pensioners, including nearly 100,000 in my region alone of south-east Wales. This payment was vital to so many people, and that's why our motion today calls for a Welsh winter fuel fund to be created. It can be done, Deputy Presiding Officer, as my leader, Darren Millar said, and Scotland have done it. Yet, this Labour Government here in Wales has so far refused to even contemplate it. We have seen Welsh family farms put at risk, as my colleague Peter Fox mentioned, with a drastic and deeply unfair new inheritance tax, and we have seen businesses, charities, local authorities and many other organisations hampered by the Chancellor's recent national insurance hikes. Not only that, but Labour in Westminster have pretty much given away the sovereignty of the important Chagos Islands, blocked a national inquiry into grooming gangs and released violent criminals back on the streets in a bid to free up prison spaces. That is an awful lot of damage to inflict onto our country in six short months, but hey-ho, do not fear—at least Lord Alli made sure Keir Starmer and his top team were kitted out in their top finery and living the life of luxury as they rolled out these cruel policies.

Many people, I'm sure, will be wondering what the Labour Welsh Government were doing whilst Keir Starmer was busy wreaking havoc in Downing Street. Surely, the First Minister and her Cabinet were shouting from the rooftops for the Prime Minister to abort his plans. Surely, the First Minister here was going to be screaming and saying, 'Do better for Wales', but sadly not. In reality, the Labour-led Welsh Government sat on their hands and watched on from the sidelines silently. I suppose we shouldn't expect anything less, given that the First Minister has as much influence on Keir Starmer as she has on Donald Trump.

With my new education hat on, I was following the UK Government's new plans for education closely last week to see what bold initiatives Labour had up its sleeves. And what was the big plan for England? It's to introduce the Children's Wellbeing and Schools Bill, which will see school standards in England drop to levels seen here in Labour-led Wales, where the average 15-year-old scored lower than pupils in any other UK nation in key subjects. It also involves the scrapping of successful academy schools and the reversion of control back to bureaucrats and away from schools.

I want to speak specifically about the reference in the motion today to the winter fuel allowance, because while Plaid Cymru agrees with the contents of the Conservatives’ motion today, in terms of regretting that the Labour Westminster Government has withdrawn this vital support from 0.5 million pensioners in Wales, and while we also agree that the Welsh Government should call on their partners at the other end of the M4 to restore the allowance, it must be said, as we on these benches have previously highlighted time and time again in discussing this issue, the Conservatives’ lack of irony in making this call points to breathtaking levels of amnesia, because the austerity measures designed and implemented by your party when they were in power in Westminster have deepened inequality in our society, have pushed tens of thousands of children and older people into poverty, have exacerbated the hardship felt by people on low incomes—so many of whom are pensioners—while allowing the wealthiest to shoulder the lightest burden. And you can't choose to forget your support for measures that asked the poorest to pay more than their fair share to ensure that the interests of the wealthy were protected, now that that it is politically expedient. The tragic thing is that six months of a Labour Government in Westminster to date are having a similar impact.

We will, therefore, be supporting this motion as we believe that it is disgraceful for any party to follow an ideology of austerity, and it's disgraceful that Westminster’s actions can mean that the Welsh Government has to step in to support the people in Wales who are suffering as a result of policies such as withdrawing the winter fuel allowance and the two-child cap. And we believe that it is also unacceptable that so many households in Wales have lost hundreds of pounds-worth of support, with all of the anxiety and suffering, illness and death that that will cause.

I remember a Member from the Labour benches, who is not here today, giving short shrift to the claims made in the last debate we had on this matter regarding the number of older people who would be at risk of death as a result of this cruel and unwise decision. The figure was 4,000 people according to the older people’s commissioner. We can’t know how many people will die, according to him, because we don’t know yet how cold it will be. Well, many of us on these benches expressed our shock and disappointment at hearing a Labour Member trying to soften the blow of these unwise and unfair policies by arguing over the number of pensioners who are at risk of death. Well, I can say to him today—he's not here—it has been exceptionally cold over the past few weeks, hasn’t it? Our health service was in a state of crisis, with respiratory conditions, which are of course exacerbated by the cold, partly responsible for that.

I'm pleased to be speaking today on this debate that looks at the first six months of a UK Labour Government. And six months ago, people in Britain voted for the empty slogan of change, but the only change that has been delivered so far is far from the change that they were promised. We've seen economic instability, tax hikes, pensioners punished, alongside broken manifesto promise after broken manifesto promise. Let's look at a few examples. In May of last year, just two months before the general election, Keir Starmer recalled the time he went to Dewsbury and spoke to an 84-year-old woman who had, and I quote, worked all her life and didn't want to get out of bed until midday because she didn't want to put her heating on. Sir Keir said, in the same clip, that this was an awful position for a pensioner to be put in, and then what was the first thing that he did when he got the keys to 10 Downing Street? Cruelly took winter fuel payments away from those very pensioners. And let's not forget that the winter fuel payment was also once a commitment supported by the Welsh Labour Government. But what has happened since? Not one single word of condemnation of this cruel Starmer decision from the Welsh Labour Government. Labour's own figures show that 4,000 pensioners could die as a result of the decision, and we've barely seen a shrug of the shoulders from Labour here since. Absolutely shameful. Let's be clear, that wasn't a difficult decision that had to be taken, as the Labour spinners would have you believe. We heard claims that there was a £22 billion black hole when they assumed office, but the independent Office for Budget Responsibility literally couldn't find it. It was nothing but a smokescreen to pay off the receipt issued to them by the union paymasters after the election.

And guess what else we heard in the election? No more taxes on working people, and then in true socialist style, we heard the taxes on working people were going up, when the UK Government announced an incoming increase to employers national insurance, a jobs tax that has meant fewer jobs and lower wages. Another tax bombshell to fund Labour's spending sprees of other people's money.

And in Wales not only do we have the highest business rates of any UK nation thanks to this Welsh Labour Government, but now they've got to give more of their hard-earned income back to a Government spending copious amounts of taxpayers' cash on socialist vanity projects. And these hikes hit not only our businesses, they hit our charities too. Tenovus Cancer Care's called the rise devastating, warning they'll pay an extra £0.25 million per year towards the increased NI contributions. That's a huge sum, which otherwise would have gone towards vital research needed to save lives.

I'm sure that's a great comfort to Darren Millar, because the last Tory leader that Tom supported didn't end so well, and he had quite a hand in it, as I recall. This is like being stuck in a bad sixth-form debate, Dirprwy Lywydd. Clearly, the Conservatives have learned nothing, but clearly morale is very low and this is designed this afternoon to gee them up a little bit.

It's worth remembering January 2025 was when we could have had a general election; it was the last date the Conservative Government could have called an election. They could have stayed in office until this month. And the reason they didn't is because they'd run out of puff, because Rishi Sunak was facing yet another challenge from his backbenches, the letters were going in yet again to the 1922 committee to challenge him. He had just announced spending plans that he had no way of funding. The Resolution Foundation said that, if Jeremy Hunt had had to give another budget, they'd have to find £20 billion they simply didn't have.

It's worth reminding ourselves, because this is only six months ago, what a horror story we have lived through for 15 years, of a Conservative Party at war with each other, embarrassing our country and making us a laughing stock abroad—[Interruption.]—to the point that their denial extends to Liz Truss sending a legal letter—

I would like to hear the contribution of the Member, and the opposition benches, please, can keep quiet so I can do so. Lee.

The denial isn't just in this Chamber from the Welsh Conservatives; we heard last week about Liz Truss sending a legal letter to the Prime Minister because he'd repeated that she'd crashed the economy, something even George Osborne admits, that Liz Truss crashed the economy. They are all over the shop.

In the last six months, we've seen a new Labour Government inherit an absolute mess. Just as a Labour Government in 1945 had to come in and pick up a mess, the Labour Government in 1964 had to come in and pick up a mess, the Labour Government in 1997 had to pick up 18 years of broken public services, again the Labour Government is called upon to rescue a terrible legacy. In the first six months, we have ended the doctors' strike, which they seem to be saying now is giving in to Labour's paymasters. That's how much they value public servants. After 15 years of austerity, keeping down the wages of our key workers, it's taken a Labour Government to deliver a pay rise for key workers and an increase in the minimum wage. We've ended the rail strikes, we've created Great British Energy, we've abandoned the ban on windfarms across England. We've brought in an Employment Rights Bill to support good employers by levelling up standards of fairness at work, and we've brought credibility back to our standing across the world. None of that was happening under the last UK Conservative Government. The people of Wales knew that good and well; that's why they turfed out every single last one of the Welsh Conservative MPs.

But I was reminded when I was thinking about this yesterday of a quote by Paul Johnson. Older viewers may remember Paul Johnson in his later years, when he was a Thatcher cheerleader, but, in his more liberal phase, when he was editor of the New Statesman in the 1960s, Paul Johnson said, and I've often thought about this, about Conservatives,

'on occasions, endearing—but liable to turn very nasty at short notice.'

That's exactly what we've seen in the last few months, egged on by billionaire media moguls, Paul Marshall, who bought GB News, now Elon Musk, whom they're playing footsie with, trying to get the funding that Nigel Farage may have let exceed his grasp. It was a story by GB News, digging up the concern about grooming gangs, that the Conservatives have seized upon shamelessly in the last couple of weeks, despite the fact that Kemi—[Interruption.]—no, let me finish—that Kemi Badenoch—[Interruption.]—no, I won't—that Kemi Badenoch, when she was children's Minister, did not once mention the issue of grooming gangs, did not once mention what the Government was going to do about the Professor Alexis Jay inquiry, took no action to implement any of those recommendations, unlike the Welsh Government. The Welsh Government, when we had the recommendations of the inquiry—we had six recommendations—we immediately set out what we were going to do. That's the difference in the approach of this Government and their Government. And instead, what are they doing? They're trying to divide; they're trying to look for issues where they can generate some heat, and, with GB News, get a whole lot of misinformation, which is dragging the whole tenor of public debates down.

Lee, you need to conclude now, please.

I will.

—extended a hand to children who turned up with no-one, who turned up with nothing, and didn't have the privilege of inherited wealth and the private education that Andrew R.T. Davies had. But he doesn't care about the people; all he cares about is inflaming debate with shameless, scurrilous, disgusting claims, using schoolchildren, and his party stands behind him—[Interruption.] For shame on them all.

I—[Interruption.] To Members on the opposition benches, I cannot hear the contributions from the Member, because you are making so much noise. If you let me listen, I can make some comments, but you don't let me listen, okay. Llyr Gruffydd.

Thank you, Deputy Presiding Officer. And for the record, I would like to align myself with the comments of the Member from Llanelli. But I will address elements in the motion particularly, and I want to speak about, obviously, the inheritance tax issue that has been raised in the motion, which is impacting Welsh farms. It's something we've raised previously, as many of us have here in the Chamber.

Now, I'll say it again: I don’t believe that the Welsh Government or the UK Government appreciate how far-reaching the consequences will be in relation to this policy. Inheritance tax reliefs, like agricultural property relief and business property relief, actually provide vital certainty that farms can remain within families across the generations, and if you disrupt that fragile financial ecosystem, then you do so at your own risk. Because we hear regularly the Welsh Government telling us how important farmers will be in the fight against climate change and reversing biodiversity loss. The whole thrust of the sustainable farming scheme is about keeping farmers on the land but doing it in a way that mitigates many of the challenges that we all need to meet. We know about the cultural and linguistic contribution; the fourth pillar of sustainable development in Wales, a key, key component of that, as far as Welsh farming is concerned. And economically, of course, we know about the £9 return on investment for every £1 that goes into agriculture, creating employment and economic activity in some of our most marginal communities. So, we really need to tread carefully if we're going to mess about with succession and farming and allowing further and future generations to continue with food production and all of the other advantages that they bring. The unique nature of farming businesses means that the loss of relief will severely threaten the viability, and even, potentially, the survival, of many businesses. It's not like forcing somebody just to sell off some assets; you're forcing people, potentially, to sell off their livelihoods and the livelihoods of their future generations. So, I don't want to see an undermining of Wales's family farm structure.

Now, yes, speculative investors who buy land to avoid tax, that is an issue that needs to be addressed—of course it is—but genuine working family farms shouldn't be caught up in that. Now, the Treasury claims, and we've heard it before, haven't we, that only one in four farms will be affected, but, of course, we know as well that smallholdings and households with limited grazing inflated the numbers of farms falling below that threshold, masking the real impact or distorting the figures. The Central Association of Agricultural Valuers has estimated that 20 per cent more farmers will be affected by inheritance tax due to inflation. When APR and BPR were introduced, the nil-rate band covered about 56 acres of farmland. Today, it covers barely half that—29 acres—due to inflation. So, the Welsh Government really does need to work with the UK Government, either to reverse the policy or to amend it or, at the very least, to mitigate the impact of some of these changes to family farms, particularly.

I call on the Cabinet Secretary for Finance and the Welsh Language, Mark Drakeford.

Diolch yn fawr, Dirprwy Lywydd. As we've heard many times around the Chamber this afternoon, there was a new Government elected for the United Kingdom in July of last year, and thank goodness, Dirprwy Lywydd, for that—a Government elected with an overwhelming House of Commons majority, and with the support of 27 of 32 Welsh Members of Parliament—27 of 32; a result that the leader of the opposition, with the analytical grasp that he showed during the whole of his contribution, described as 'lacklustre'. How much he must dream of a lacklustre performance by his own party, even though he sees exactly such a performance every day all around him.

Now, the overriding ambition of that newly elected Government was, and is, to restore growth to the United Kingdom economy. Of course, it’s possible to take issue with individual strands in the policy of any Government, and we have heard some of that this afternoon. But what surely is not up for negotiation is the ambition itself—the ambition that we should restore to the UK economy the levels of growth that we were able to enjoy for that long, golden boom of more than 40 years, from the end of the 1940s through to the end of the first decade of this century.

I agreed very much with John Griffiths’s contribution, Dirprwy Lywydd—that alongside the ambition for growth must go the ambition for reducing inequality in the United Kingdom economy. That is the Gordon Brown prescription: to make sure that we have growth, but we have growth that is spread to all parts of the United Kingdom, not concentrated in just one corner of our geography, but available to everybody, wherever people may live.

Now, the urgency of that ambition was highlighted by a series of contributions during the debate, because we have suffered through more than a decade of austerity, combined, as Heledd Fychan said, with the economic disaster of Brexit. That has left the United Kingdom economy trapped in a cycle of falling investment, struggling public services, real-terms reductions in wages, taxation at a 70-year high—and all of that combined with the lowest growth rate since the industrial revolution. Now, the political amnesiacs of the Conservative benches try to pretend that none of this ever happened. They've forgotten that any of this had ever been part of what they, themselves, were responsible for. But if they'd listened to Joyce Watson this afternoon they would have learned exactly what their record had meant for the people who live here in the United Kingdom.

Will you take an intervention?

Of course.

Obviously, one of the significant concerns that's been raised about the budget is the quantum of cash that the Welsh Government and public sector employers will have to send back to the Treasury as a result of the additional employers' national insurance costs. We're only just weeks away now from the end of the financial year. Have you estimated those costs yet, and, if so, what are they?

There are estimates of those costs. I've shared them in a letter to the Chair of the Finance Committee, and I'm sure that that letter can be made available to the leader of the opposition, if he hasn't had time to read it as yet. It's been available for several weeks now, so I'm sorry he hasn't had that opportunity to avail himself of information that the Welsh Government has put in the public domain.

Now, the Welsh Conservative motion in front of the Senedd this afternoon concentrates entirely on matters that are not the responsibility of this Senedd. And agree or disagree with them—and it's absolutely open to opposition parties to oppose them—there is no vote or decision of this Senedd that can change any one of them. What we can do, and what this Government is focused on, is using the opportunities that we have with our responsibilities, and that come our way now as a result of the Chancellor's determination, to invest again in our public services, in the fabric of Welsh life, and to make our contribution, through growing the Welsh economy, to the future prosperity of us all.

Natasha Asghar told us that nothing at all—nothing—was coming the way of Wales from the UK Government. Just let me remind Members—. I wrote it down when she said it, Llywydd, 'Nothing is coming our way.' So, she must have missed the £1.5 billion extra—must just have missed it—that is now available for investment in Wales next year. She may have missed it, of course, because nothing like it came our way for the 10 and more years of austerity that she and her colleagues supported. And that is what this Welsh Government is focused upon, not, as the First Minister has to explain so often, on matters for which others are answerable, but the decisions that we now make for ourselves: that £1.5 billion that committees across the Senedd are currently scrutinising, and which will provide a level of opportunity that we have not seen for many long years.

Thank you so much, Cabinet Secretary. I do appreciate you quoting my contribution, but will you accept or deny in front of this entire Chamber that you, the Labour Government, who have been in power here in Wales, sent back £155 million that was destined for the people of Wales? You were not picking up a phone, but you're standing here telling me about what your Labour Government is doing.

I'll explain exactly to the Member what happened there, which was that her Government delayed and delayed making allocations to Wales. [Interruption.] No, no, this is absolutely the case. This is absolutely the—. She may not be—

Let the Minister—

I understand it's not convenient for the Member to understand what happened. Her Government delayed and delayed, as they did year after year, until the very final part of February, the final estimates, and they decide, at that point in the cycle, that there is money that is coming to Wales, which we'd not been told about for 11 of the 12 months of the financial year, and lo and behold, it's not possible, in the few short weeks, and they knew what they were doing. It was the most cynical way of making sure that money they could claim came to Wales was never really coming to us at all.

Dirprwy Lywydd, I would say very briefly that, of course, as well as the opportunities that come to Wales with £1.5 billion, we have £3 billion-worth of capital expenditure that we will have next year, and there are the other opportunities that come now, such as chances to speak to our colleagues in Westminster—more chances in five months than we had in five years under the previous Government. And we take those opportunities—of course we take them—all the time, to speak up for the things that we know are important here in Wales: coal tip safety, HS2, the Crown Estate, devolution of justice. Every time the First Minister has an opportunity, every time my colleagues have that opportunity, we make sure that we pass on those concerns and those ambitions for Wales, on the things that are in the hands of, and should be in the hands of this Senedd, to our UK colleagues.

Those are the things that will make a genuine difference to people in Wales, Dirprwy Lywydd, not the sort of debate we have heard this afternoon, the dreadful penny-in-the-slot contributions of the Welsh Conservative party. [Interruption.] Nobody is listening to you. Penny in the slot. You put a penny in the slot and out comes the speech. There's not a minute's thought behind it. These are the speeches of people who are just reading out the tired old clichés of many years, and let me tell you this, let me say this to the Welsh Conservatives—[Interruption.]

Can the leader of the Conservatives please allow the Cabinet Secretary to complete his contribution without interruption?

Let me explain to the Welsh Conservative Party: nobody is listening to you. Because while political parties can change many things—they can change their leader, they can change their policies—what they cannot change is their history. And your history is burned deep into the minds of people here in Wales. It was what led to the defeat you suffered in July of last year, and until you are prepared to learn the lessons of that, and to look seriously at what it means for you as a political party, we will listen to the contributions you make here this afternoon, but nobody out there is listening to you at all.

Reject the motion and the tired thinking that goes with it. Support the amendment put down by this Labour Government, and let us take advantage of the opportunities that now come our way.

Before I call the Member to respond, can I ask that the leader of the Conservative Party reminds himself that he is now the leader of the group, and therefore I would hope that he would allow others to contribute in these debates without interruption or too much heckling?

I call on James Evans to reply to the debate.

Thank you, Deputy Presiding Officer. I'd like to thank all Members that took part in this very important Welsh Conservative debate, even though the Cabinet Secretary doesn't think this is a very important debate this afternoon.

The debate was opened up by Darren Millar, and he highlighted that we were told that two Labour Governments working either side of the M4 would benefit Wales, but we're seeing none of the benefits. Let’s talk, as Darren Millar did, about the cut to winter fuel payments: 4,000 pensioners would die. That's what your own party said before the last election, that 4,000 pensioners would die. Your party said that. You promised the public you wouldn't do it. You betrayed them and went back on your promise.

Darren Millar talked about WASPI women. Welsh Labour Members and Labour Members in Westminster promised they would support WASPI women. You all queued up for pictures, as Darren Millar said. When you got into power, you turned your back on the WASPI women. And then there's the betrayal of our farming communities as well. You said in conferences, and so did your Secretary of State, that you would support farmers. You've not supported farmers at all. You've turned your back on them like you're turning your back on everybody else.

We've had the betrayal on HS2 funding. We went against our own political party here in Westminster and stood up for Wales. What have you done? You've talked the talk, but you didn't walk the walk. You did nothing and you said nothing, and when it matters, you say nothing at all.

John Griffiths then talked about Tory sleaze. I want to talk about free-gear Keir; an anti-corruption Minister who, before she was sacked, walked away; all the free concert tickets; line skipping. There's plenty going on in the Labour Party about sleaze, you don't need to look over here. I think you need to look a bit closer to home, John Griffiths.

The Gordon Brown report, John Griffiths mentioned. Gordon Brown, the man who almost bankrupted the country and sold gold at the bottom of the market. I don't think we'll take advice from Gordon Brown. You also mentioned constitutional issues. The people of Wales don't want to talk about constitutional issues. They want to talk about fixing the NHS, fixing our education system and fixing the economy.

Heledd Fychan talked about HS2 funding and how Plaid Cymru have stood up for Wales on this, and we joined you in that, demanding HS2 funding. It's a shame that the Labour Party now have turned their back on the people of Wales. You also talked about national insurance pressures, and the pressure that is going to put on our GP services and our third sector organisations across Wales. I totally agree with you there. This Labour Party supports them on NI rises, but they didn't look at the unintended consequences of what they were doing.

You talk about trade unions and I'm a huge supporter of trade unions, all trade unions, whether it's the farming trade union that you quote repeatedly, whether it's Unite the Union—

Joyce, you'll have to tell your Members to be quiet; I can't hear you.

—whether it's the GMB union. We hear a lot of talk about trade unions here and I welcome all the contributions from all the trade unions, but when you talk about trade unions, you're talking about the trade unions whose membership is for the multiple of employees in Wales. That's what you're doing; you're differentiating what you mean by a trade union. I don't do that.

No, I support the workers; I don't support trade unions who try and hold Government to ransom. [Interruption.]

Then we went to Natasha Asghar who told us about the false lines that were fed to us by the UK Government. [Interruption.] I can't even hear myself speak, Llywydd.

Yes, I agree, James Evans, we need to be able to hear you. Can we hear James Evans and his conclusions to the debate?

Thank you. And Natasha Asghar did mention about the betrayal of our pensioners as well—100,000 pensioners in your region alone—and the need for us in Wales to have our own winter fuel payment, so we can support those pensioners who paid into that system their whole life. They don't ask for much, but what Labour do is take it away from working people yet again. They don't support workers even though they say they do.

And you also mentioned that early release from prisons. What a botched job that was. The people who shouldn't have been released were released, then you had the police running around the country trying to pick people up who would then be done for abusing people and violent crimes. Not a very good start for the Labour Party.

Sioned Williams also talked about the winter fuel payment and I agree with what you said about that, and also referenced the 4,000 pensioners who were going to die because of those decisions. And we wouldn't actually know the true extent of that because of the climate that we're living in, the weather and how cold it's going to be.

Tom Giffard talked about Keir Starmer again and all the lies that we were fed by the Labour Party about our farmers, and also about the £22 million black hole that was created because they gave in to trade unions, and that was peddled then and supported by the mainstream media and the Labour Party's media machine.

And then we went on to Lee Waters. What can I say? [Interruption.] The way you are funding things is by taxing hard-working people across the country—taxing our businesses, taxing our farmers, and making sure that working people can't get on. And you also mentioned about your obsession with the ex-leader of the Welsh Conservatives, Andrew R.T. Davies, about him apparently spreading lies and divisions about grooming gangs in Wales. I'd like to show you the evidence here that there are grooming gangs operating in Wales. I think you owe the ex-leader of the opposition an apology.

Llyr then also talked about the need to support our farming families across Wales and the need for the Welsh Government to work with the UK Government on this matter.

Then, we moved on to the ex-First Minister and Cabinet Secretary for finance. He opened and mainly through his whole contribution, in his usual condescending way to Members, singling individual Members out like Darren Millar and Natasha Asghar, talking down to them like they're complete and utter idiots in here and don't know what they're talking about. I thought it was a very poorly judged way that the Cabinet Secretary was condescending towards people.

The proposal is to agree the motion without amendment. Does any Member object? [Objection.] Yes, there is objection. Therefore, we'll defer voting under this item until voting time.

Item 7, the Plaid Cymru debate on NHS waiting times, is next. I call on Mabon ap Gwynfor to move the motion.

Diolch yn fawr iawn, Llywydd. Since the First Minister was appointed back in August, waiting lists in Wales have increased by nearly 2,000. That's an extra 12 pathways for every day that the First Minister has been in office. Furthermore, the waiting list backlog has hit record highs for each month of the First Minister's tenure so far, and has done so for each month since March of last year, to encompass one in five of the entire population of Wales. Whereas two-year waits in England number a little over 100 people in a population of over 55 million, there are over 24,000 such waits here in Wales.

I've decided to start today's debate with these statistics to illustrate an inescapable reality. However much the Government may try to indulge in obfuscations and creative accounting on these figures, the evidence is clear: they are utterly failing to deliver on what they have consistently assured us is their top priority, namely to reduce waiting lists. This is under a Labour Party, supposedly heirs to Aneurin Bevan, who you'd think and hope would pull out all the stops to fix the NHS. But instead, what we're seeing is entrenching a two-tier health system, with patients increasingly having to look to private providers to tackle their illnesses. Those who can afford to go private do so, while the majority, who are on a low income, struggling with the cost-of-living crisis and limited job opportunities, are left to languish in pain on lengthening waiting lists.

And what's been the response of this Government? Firstly, to blame everybody else: blame the patients, blame health managers, blame royal colleges, blame everybody and deny responsibility. After 25 years of governing, they decided to go on a listening exercise and hear people telling them what they should have known years ago. Then, each month leading up to Christmas, a new strategy was put in place, and each month, the numbers on waiting lists were increasing. So, we need a serious plan, designed by people with skin in the game, that can be implemented quickly and provide positive results.

I won't pretend that these proposals that we've put together are new; these are all examples of best practice that is currently being used in isolation in parts of Wales, thanks to the foresight and experience of some of our excellent clinicians and health managers, but that needs to be rolled out nationally in order to really make a difference. As I mentioned during the launch event yesterday, this isn't a plan driven by dogma; it consists of pragmatic, practical steps informed by the extensive conversations we've been having with the royal colleges and other relevant stakeholders. Because, unlike Members of this Government, we don't believe that the royal colleges are part of the problem. Rather, they must be key players in moving us forward towards a long-overdue solution.

Firstly, we're calling on the Government to roll out regional hubs specifically targeted and designated for elective care, enabling an industrial-scale approach to low-complexity treatment and ensuring that emergency care doesn't use up all of the bandwidth within our hospitals. We also need to address the disjointed and inefficient nature of the referrals process between primary and secondary care, whereby patients are often placed by default on pathways that don't necessarily represent the best course of action for them, which in turn lead to costly and time-consuming knock-backs from hospitals back to surgeries. This is a problem that largely stems from the chronic neglect of the primary care sector, which, despite being responsible for over 90 per cent of total patient contacts with the health system, is currently over 500 GPs short of the Organisation for Economic Co-operation and Development average.

I have selected the two amendments to the motion. If amendment 1 is agreed, amendment 2 will be deselected. The Cabinet Secretary for Health and Social Care now to move formally amendment 1.

Formally.

Amendment 1 has formally been moved. James Evans to move amendment 2.

Diolch, Llywydd. I move the amendment tabled in the name of Paul Davies. I'd like to thank Plaid Cymru for the debate today, and for taking a lot of the ideas from our last manifesto. I was very pleased that you were already looking at what we can do.

Before diving into the challenges we face, I want to extend my deepest gratitude to the incredible NHS staff right the way across our nation. However, despite their unwavering commitment, our NHS staff are being let down by a Government that is failing to provide the support and leadership that they need. The First Minister and her Government, along with the Cabinet Secretary, are presiding over a health service in crisis. As of January 2024, over 700,000 patient pathways were waiting to start treatment, with more than 23,000 people waiting over two years for treatment. These are not just numbers; it represents thousands of individuals enduring prolonged suffering due to systematic failures.

In October 2024, only 50.4 per cent of life-threatening emergency calls received a response within eight minutes—well below acceptable standards. A recent poll indicates that only 24 per cent of people in Wales are satisfied with Welsh NHS services, reflecting a significant decline in public confidence. Overcrowding in hospitals has become the norm. More than 1,600 adults are occupying hospital beds despite being clinically optimised for discharge, and 15 per cent of beds are estimated to be taken up by patients who no longer need to be there.

This isn't just inefficiency; it's a symptom of a deeper problem and the chronic underfunding and neglect of our social care system. A robust and well-funded social care system is essential to ensure patients can be safely discharged from hospital, freeing up capacity for those in need, yet this Government has consistently failed to invest in the integrated care system that Wales desperately needs. The Government has celebrated that it pays social workers the real living wage, where in reality, those social workers, doing a fantastic job, could earn more money stacking shelves.

The time for excuses is over. It's clear the First Minister and her Government are failing Wales. Labour's approach to our NHS has been categorised by complacency and a lack of ambition, leaving patients and staff across Wales to pay the price.

The First Minister promised to eliminate long waits, yet the situation has deteriorated. The new Cabinet Secretary for health has promised that he'd take an opportunity to take bold action, but since taking post, he's barely tinkered around the edges, failing to address the root cause of the crisis. Excuses have ranged from COVID, to flu, to unprecedented demand. These have been seen across the United Kingdom, but the NHS in Wales is lacking direction, it's underperforming, and has significantly worse outcomes than in England.

NHS Wales works hard to deliver high-quality care, whilst being under significant pressure. GPs in Wales receive 2.3 million calls and deliver 1.6 million appointments every month for a population of just over 3 million people. That's a lot of people. The draft budget 2025-26 includes more than £600 million extra revenue and capital for health and social care, which will support the NHS to continue to reduce long waiting times. The extra budget from the UK Government has been really welcome.

The Welsh Government is taking action to tackle waiting lists and has invested and extra £50 million to tackle the longest waiting lists. This is providing more evening and weekend clinics, more diagnostic tests, and more operations between October 2024 and March 2025, going forward. We're seeing progress on this issue. Two-year waits have fallen by two thirds since their peak in the COVID pandemic. The average wait time for referral to treatment has dropped from 29 weeks to 23 weeks.

There is still some way to go, we know that, and we would like to move forward on the waiting times, but I'm pleased to see the Welsh Government has agreed to funding of up to £29.4 million for a new orthopaedic hub in my region of North Wales at Llandudno. It will help reduce orthopaedic waiting times by delivering a planned 1,900 procedures a year. There’s the development of a regional orthopaedic centre in Neath Port Talbot as well, in the hospital there, and a diagnostic and surgical centre at Llantrisant.

Health boards, hopefully, are now going to be investing in IT now that they've got some capital funding going forward. Investment in training places for recruitment into our health service are now being provided across north Wales at Wrexham University and the North Wales Medical School in Bangor. Coleg Llandrillo are training social care workers, and we've got the Bangor dental academy. We have well-being hubs in communities and investment through the ICF in step-up, step-down care, which is making a difference.

It's important to remember what Wales does well when it comes to our health service. Wales invests 7 per cent more in health and 37 per cent more in social care than in England. I know we've got an older and sicker population, and it's needed, but we will always support the NHS and social care. Taken together, the Welsh Government have provided around £1 billion extra in 2024-25 and 2025-26, and there is also no tax on illness in Wales. Prescriptions and hospital parking are free in Wales. Meanwhile, in England prescription fees have risen to £9.90 per item. There are more healthcare professionals working in the NHS in Wales than at any time since devolution, including a 16 per cent rise in nurses and a 26 per cent rise in consultants, which is in part thanks to the fact that Wales didn't cut their NHS bursary in 2017 like England did. We carried on providing it, and we also provide a social work bursary.

Long waiting lists are not merely a symptom of a health service on its knees, they also reflect deep-rooted inequalities in the provision of healthcare, which are becoming increasingly stark. No-one seeking medical treatment should have to choose between having to wait for months or even years on end, often in pain and discomfort, to be seen in the NHS, or having to shell out extortionate sums of money to go private, but that's the appalling situation facing thousands of Welsh patients.

Over recent years, we have seen an alarming rise in the use of private healthcare in the nation where the NHS was born. According to latest figures, there were around 8,000 admissions to private hospitals in Wales during the first quarter of 2024 alone, up from 4,500 during the same period five years previously. Meanwhile, 58 per cent of Welsh people have either accessed private healthcare or know friends or family who have done so, which is higher than the UK average. And we should not be fooled into thinking that this is simply a matter of choice, when it comes to how you receive treatment. The fact that the predominant payment method for accessing private healthcare in Wales is self-pay—in other words, the use of savings or loans or credit, other than insurance schemes—underscores that these are decisions being made from a position of sheer desperation. Of course, for many individuals living with the reality of poverty and deprivation, even that option of taking a hit to your personal finances is beyond their reach.

Those of us who believe in safeguarding the future of the NHS and the future of the progressive principles on which it was founded should be very concerned about this. My mother, a miner's daughter, can remember Wales before the NHS. She remembers the days when her family had to decide what item on the prescription was most important and what would have to be done without. The ability to pay should never determine the treatment you get, and we must guard against this becoming culturally and politically acceptable, not only because it helps pave the way for the disastrous destination that is the US health system, where commercial interests always trump the best interests of patients, and care is denied to those who are most in need of it but can least afford it. But also because private healthcare—clinics, hospitals, general practices—is creating what has been called a vicious cycle of detriment, contributing to the recruitment and retention crisis in the NHS. So, without urgent action such as that set out in Plaid Cymru's plan, the emergence of a two-tier health system whereby wealth determines the quality and timeliness of care is inevitable.

It's a pleasure to be speaking in this debate this afternoon, and I thank Plaid Cymru for tabling it, although it brings me no pleasure that the Welsh Government is still grappling with the spiralling waiting times in Wales, with no indication that they have a grip on this situation. I'm pleased that the Member for Llanelli sees it as a laughing matter, but many people in Wales don't, and I'm sure that your constituents don't, either.

It was raised earlier with the Cabinet Secretary for health that there is still an ongoing situation with the lack of synchronisation between health boards and local authorities. Members from all parties have been raising this issue for a considerable amount of time, yet the NHS Confederation estimates that approximately 15 per cent of Welsh NHS beds are occupied by people who should no longer be there. A 2022 NHS Confederation survey also highlighted that over 80 per cent of healthcare leaders agreed that a lack of social care capacity has a very significant impact in driving urgent care demand. You've had long enough to deal with this problem, yet we've seen no results.

Getting a patient out of the NHS into the social care system will no doubt put pressure on this, on the patient pathway. So, two-year waits have increased to over 24,000 compared with fewer than 150 in England. The First Minister has pledged year after year to eliminate these waits, but they continue to balloon. And I've said before that no other developed nation on the earth would put up with this service and the level of incompetence and complacency shown by those responsible in Government. When the Senedd election comes around in 2026, next year, the people will have their say on the Labour Party's record on health, and I don't think that that verdict will be very kind to Welsh Labour. The Welsh Conservatives have been calling on the Welsh Government to adopt technology that will fix many of the backlog issues blighting the service and bring efficiency. We're not calling for anything extravagant, yet the Welsh Government have refused to keep up with the English NHS trusts on the adoption of technology. If you want to earn the trust of the Welsh people back, we need tangible commitments from the Welsh Government, but I suspect that they will not be forthcoming.

So, to summarise, are the Welsh Government finally going to provide something tangible? Will they finally agree to expand the number of surgical hubs and diagnostic centres, which the Welsh Conservatives have been calling for for years? And are you going to increase the number of available beds in the Welsh NHS by finally fixing the social care backlog, which has been holding the system back for nearly three decades and crippling our local health services in all of our constituencies and regions? Thank you very much.

I want to pursue two particular issues, one of which certainly isn't given the attention it deserves, and that is waiting lists in terms of neurodevelopmental issues. Now, the situation in north Wales, in my region, is frightening, if I'm honest. I received data from the Betsi Cadwaladr health board before Christmas under the freedom of information legislation, and that highlighted how critical the service is. There is a whole generation of children and young people with conditions such as ADHD and autism being let down by the failings of this service.

Now, some of these children spend a lot of their time waiting on lengthy lists for an assessment. Over 62 per cent of those waiting have waited over a year, but there were 50 children last year who had been waiting over four years for an assessment, and one child specifically had been waiting over five and a half years for an assessment. Now, that is a whole high school career simply waiting for an assessment. How can this Government justify letting a whole generation of our most vulnerable children down by leaving them on endless waiting lists such as these?

Now we know, then, of course, about the dental health provision in Wales, which is well known to be terrible when it comes to service availability. Fewer and fewer of our people are receiving NHS treatment. Only 40 per cent of the population have been able to access treatment in the 24 months up to last June, and I have to say that the Government is actually lying to itself by not understanding the reality of the situation. The Cabinet Secretary for north Wales in this Chamber just a few weeks ago said that there were 11 practices in the Wrexham borough taking on NHS patients with open arms. Well, you also said, Cabinet Secretary for health, in correspondence to me, that over 77,000 new dental patients received treatment under the health service. I've been in touch with the practices in north Wales, and of the 55 dental surgeries that I've spoken to that do provide services on the NHS, only three are taking new patients on the NHS. One of them says you'd have to wait three years, another said you'd have to wait two years, and the third goes from month to month, offering so many appointments, and once they're gone, they're gone: 'Sorry, you'll have to come back in a month's time.' You're shaking your head; if you don't believe me, then listen to the BDA, the British Dental Association, who have accused the Welsh Government of 'cooking the books' when it comes to patient numbers.

So, I just want to highlight those two specific elements. I don't know how that is in keeping with the Welsh Government's objectives of creating a healthy nation. I don't know how leaving children and young people, particularly, waiting for so long sits with the preventative agenda, because we know with the preventative agenda that it's far more important, far more efficient at the beginning of young lives. And whilst attention is given quite properly to waiting lists in the health service more generally in the media, do bear in mind that developmental conditions and the situation of dentistry are also appalling. People are tired of waiting for treatment, they're tired of waiting to see doctors, they're tired of waiting to see a dentist, they're tired of waiting for diagnosis. Well, do you know what? They're also tired, I believe, of waiting for a change of Government and a change of direction on the NHS, and I hope we'll have an opportunity to do that in 18 months' time.

Chronic underfunding by successive Conservative Westminster Governments has been catastrophic for our NHS in Wales. Our workforce has felt stretched, undervalued and undersupported. Some patients have been left waiting far too long for treatment, which just isn't good enough. This has only been made worse by rising demand year after year. In a country of 3 million people, NHS services in Wales handle 2.2 million face-to-face contacts every month. That's a huge number, and it shows just how vital these services are to everyone in our communities. Despite these challenges, we've seen real investment and innovation in our NHS to reduce waiting times and improve care. In Cwm Taf, we've got projects we can be really proud of. Y Bwthyn is a specialist palliative care centre with a team that includes doctors, nurses, physios, dieticians, speech therapists and more. The care they provide there is second to none; I know this personally because they made sure my own mother was as comfortable as possible in her final days.

There's also the Snowdrop Breast Centre, a facility dedicated to breast cancer care, offering everything from diagnosis to follow-up appointments under one roof. This joined-up care means patients are seen far sooner, and their treatment plans can be more effectively managed. We've also had the lung health check pilot in Ysbyty Cwm Rhondda, where over 500 residents were invited for CT scans. The pilot saved lives by catching lung cancer earlier, at stages 1 and 2. The data from this is now helping to shape a nationwide roll-out.

More recently, we've seen a diagnostic and treatment hub at the Royal Glamorgan Hospital. The temporary MRI facility there has cut waiting times by 50 per cent—a huge achievement, especially in these tough financial times.

And finally, we have the brand-new community care team, hospital at home, where 80 carers are supporting patients at home across the health board area, cutting the time spent at hospital. There are thousands of people working tirelessly every day to cut waiting times and provide care for residents across Wales. I have to give a special thanks to pharmacists like Dai at Central Pharmacy and Gareth at Tynewydd Pharmacy for taking pressure away from GPs through the common ailments services.

Over the past few months, I've been speaking directly with NHS workers in Rhondda. I'm grateful for their feedback, and it's clear there's still work to do. Twenty-four years of underfunding can't be fixed overnight, but, with the recent pay rise, hundreds of millions announced to tackle long waits and the ambitious women's health plan, there's real reason to be optimistic about our NHS in Wales, an NHS where workers' voices are heard, respected and actioned. Diolch, Llywydd.

Buffy Williams and I represent the same region—there's innovative work, excellent work being done there, but certainly there is a genuine impact being felt, and we can't ignore the case work that we receive either. And as part of the frightening statistics about our waiting lists, it's important that we don't forget the true impact of what we are discussing on those we represent. Labour has been responsible for the health service for 25 years now. We can't blame all of this on the Tories. There are fundamental issues at stake here; it's not just about funding, it's about how the service is being run.

I'm sure that all of us receive every day messages from people who share their experiences as patients, but also as relatives of patients, those who are waiting for treatment, or perhaps it's too late for the person in question because they haven't received the treatment they needed. The cost of these waits is far-reaching. In the past fortnight, I've heard about a 50-year-old woman who is a secondary school teacher waiting for treatment for two cataracts; the optician said that this was needed as a matter of urgency, or her eyesight would decline so much she wouldn't be able to drive to work. She's been on a waiting list for five months after this diagnosis, and no news as to when the treatment will be provided. Because of this, her classes of pupils could lose their teacher before their GCSE and A-level exams, potentially having a negative impact on their outcomes.

A young man contacted me, 30 years of age, he said:

'I'd like to raise an issue with you as my representative. I was referred for an adult ADHD diagnosis three years ago, and I only received confirmation of being on the waiting list last year. So, I have no idea how long I'll be waiting for. This is getting to be an intolerable situation, where I feel helpless to get the help that I need. I appreciate the immense pressure the NHS is under, but I can't afford to both pay for a diagnosis and then pay through the nose each month for private prescriptions.'

Another constituent told me about their child, a 12-year-old, who suffers with scoliosis of the spine and was told by a physiotherapist in November 2024 that, due to the level of pain and growth they were experiencing, they needed an urgent appointment with a consultant. An appointment was scheduled for January 2025. This has now been cancelled and a new date offered in April 2025. Five months of being in pain as a 12-year-old, an intolerable situation for a child trying to go to school every day.

So, the actual cost of having so many people on waiting lists for treatment, people who are not able to live their lives as normal due to waiting for treatment and surgeries is almost impossible to quantify. Where do you draw the line? The lost hours of work for the employer, the increased costs for families of a temporary disability like needing equipment, special food, extra heating in the home, childcare, transport when they can no longer drive, the loss of wages, sometimes loss of a job, throwing dependents into poverty as well as themselves, the loss of leisure opportunities for themselves and their children, loss of after-school clubs for the children due to transport or poverty, loss of the chance for their child to attend the residential school trip, loss of self-esteem due to all of the above, loss of mental health due to the inability to plan for better times, loss of confidence in their skills as they slowly deteriorate, not able to do what they should be able to do and not knowing when that support, or diagnosis, or treatment may come.

In terms of the NHS, I worry when I hear '2.2 million contacts.' There are so many contacts. Is that a good thing? Because, actually, is that not signifying that there's a real issue, that people on those waiting lists are actually having to make more frequent contacts as they deteriorate, that they are getting in touch—an increase in patients making contact—because they want to know when that appointment is taking place? And unfortunately, there are instances—I'm sure we've all received them in terms of casework—of people even dying before that operation or diagnosis.

It probably won't be a surprise that I want to speak to point 3(e) of our amendment today, which calls on the Welsh Government to provide Powys Teaching Health Board with additional finance to support their situation, so that they will not move forward with their proposal to ask providers across the border to increase waiting times.

I thought there should be some context to this as well, for those who don't know. But, for my constituents in Powys and for James Evans's constituents, most of our constituents go across the border for their care, to be treated in NHS hospitals in England. Of course, Powys health board have a proposal to ask English providers to delay treatment because they can't afford to pay; they, effectively, want to push that payment into the next financial year. Currently, the health board have deferred that decision for a further health board meeting, which is at a date unknown, but it's a huge cause of concern for Powys patients. And the position is this. The position is that, in Shrewsbury or Telford hospital, a Welsh patient could be sat talking to a consultant and the consultant tells them, 'We've got capacity to see you. We would see you if you were an English patient, but we're not able to because Powys are not able to pay for your treatment.' And that position, I think, is a ridiculous position to be in. And, of course, one of the First Minister's top priorities is to reduce NHS waiting times. So, it wasn't really a surprise to me when I outlined the situation to the First Minister yesterday—I was pleased with the First Minister's response—that the First Minister said that what I outlined was not acceptable. Of course, it can't be the case, because it doesn't align with the First Minister's priorities.

But there's a wider issue here as well. Of course, the Cabinet Secretary will say, and the Welsh Government will say, that health boards have to operate within their budgets—I understand—but, of course, Powys health board is in level 4 escalation for finance and planning. So, I would expect the Cabinet Secretary and Welsh Government officials to be working alongside officials at Powys health board to ensure that we don't get into this position in the first place.

There's also another wider issue here, and I would ask, perhaps, the Cabinet Secretary to comment on this in his remarks in this debate: to what extent is what is happening in Powys happening in other health boards across Wales as well, where there is capacity, capacity exists within those health boards to treat people, but treatment is being delayed for financial reasons? I'm pleased that the health Secretary is nodding, saying he doesn't think it is happening, but, of course, in Powys, we know it's happening, because that decision has to be made at a public board meeting. Other health boards don't have to do that. So, I would hope that the Cabinet Secretary could comment on that, and, if that is happening, how he is addressing it and how he is challenging those health boards in those areas.

I agree very much with what Heledd Fychan said. We have to say ‘no’ to finger-pointing and ‘yes’ to concrete proposals for improving things. There’s nothing more depressing for health service personnel than to hear that people are criticising them for the work that they're doing, and they're working incredibly hard to deal with the huge surge in demand. Demand isn’t the same as need. It’s slightly different. But understanding how to differentiate between the two is quite complicated. Friends and family of mine who visit north Wales are always astonished at how easy it is to get an appointment in a rural practice in north Wales—so much easier than where they come from in London. So, this idea that everything is worse in Wales than in the English health service is a myth that needs busting. One of the reasons for that is that that particular rural practice is one of the least deprived practices in Wales. The practices that have the most challenges are those that are serving the most deprived communities, who are also, of course, those who are least likely to seek help for an illness until it has become much more difficult to treat.

So, these are some of the complexities that all doctors have to deal with every single day when people are calling, saying, ‘Can I see the doctor?’ Because we have to triage who a clinician is seeing based on their need. If the GP services are on their knees—and I'm not saying they're on their knees, but they are suffering some challenges, particularly in Blaenau Gwent, where this disgraceful private practice is, obviously something that we need to rectify—. If people can’t get to see their GP, then some of them turn up in the emergency department, and that’s one of the reasons why there has been a significant increase in the last full year for which we have records. It was five times higher in 2023-24 than the level seen in 1959. Some of that is because we are quite a sick population. We have to remind ourselves that, although smoking remains the biggest cause of early death, diet-related disease is now rising up the agenda and increasingly the second cause.

Just on that point, smoking being the biggest cause of death, do you therefore support the calls for ASH to be funded properly, so that they can continue with their good work?

No, I support the banning of smoking, so that future generations don't take up this horrendous habit. But we have to understand that one of the surprising things is that emergency department attendances are higher in the summer than in the winter. I think that it would be difficult to argue that people are sicker in the summer than in the winter, because we know that, obviously, the cold can kill elderly people, and that's one of the things that we're all worrying about at the moment. But there are also many more attendances in daylight hours than at night, which is obviously when services like pharmacies and GP practices are open. So, that's one of the complexities of the system.

I do recall that, when Communities First was still operating in Cardiff, they used to meet on a monthly basis to analyse who were the most frequent attenders in the emergency department and to put in place alternative services for people who were coming to the emergency department for reasons that didn't require the—

Jenny, will you take an intervention?

Yes.

Do you think that some people who do attend A&E departments, some of these people are also lonely people as well, aren't they? People, if they had better care packages at home, would be able to remain at home, rather than turning up at our A&E departments, our GP practices across Wales. So, if we invested more in our social care system, it would relieve a lot of the pressure elsewhere.

Thank you for cueing me in on that, because I was about to come to social care. I agree with Gareth Davies that there are many more people in hospital who would be better looked after in the community. I also agree that we want a well-funded social care system. But it is really disappointing that we've spent the last 20 years talking about this without getting to grips with how we're going to fund this new free-at-the-point-of-care social care system, because otherwise we are constantly going to be having a variety of battles that we can revisit another day. And so I am very disappointed that the UK Government hasn't asked Louise Casey to report on this until 2028. It needs to happen now. We all understand the reasons, but we all can't resist the political back-and-forth that goes with it, which is all about who is going to pay and at what point in their lives.

I need you to come to a close now.

Okay. I just want to say that I think that the Welsh Government has done a great deal to bring down waiting lists, simply because you will see from the amendments put forward by the Government that these surgical hubs that we are delivering is definitely the way in which we are going to get people who need elective care, and not urgent care, getting throughput of treatment much more quickly than they ever will in an emergency hospital, like the Heath, where always the emergency patient is going to displace the person who merely needs a new hip or a new cataract operation.

The Cabinet Secretary now to respond to the debate—Jeremy Miles.

Thank you, Llywydd, and thank you for another opportunity to set out how the Welsh Government is helping the health service to reduce long waiting times. The First Minister and I have been entirely clear that reducing the longest waiting times is our main priority. Since March 2022, the number of people waiting over two years for treatment has reduced by two thirds; 3 per cent of people on the waiting list are waiting more than two years, as compared to almost 10 per cent when the figures were at their peak. The long waiting time for diagnostic tests have reduced by 35 per cent. Also, the waiting time on average between referral and treatment has reduced from 29 weeks to a little under 23 weeks. The health service is making progress despite the increasing demands upon it, but there is much more to be done in order to ensure that people are treated sooner in accordance with their wishes.

To support the health service, we're providing more than £1 billion in recovery funding during this Senedd term. At the end of October, we provided another £50 million to target the longest waiting times. This funding is being used to increase the number of staff working on weekends and in the evenings, establishing more regional clinics and improving capacity to provide treatment. It's also used to support more treatments and tests, and more appointments for out-patients. Where needed, too, it is used to take advantage of capacity in private hospitals in order to treat people. Over recent weeks, more than 5,000 people from the south-east have been offered cataract treatment using commissioned services, and this includes a regional centre at Nevill Hall Hospital.

Of the 5,000 who've been offered cataract appointments in the last few weeks, just over 3,200 have already accepted their appointment. A small number have been removed from the list. Llywydd, the NHS is working very hard to treat people. This includes working to reduce the numbers of those who did not and cannot attend, which are too high. So, of the 1,800 or so who haven't accepted their appointment yet, the NHS is phoning them up so that they don't lose the opportunity. Our system can't, of course, make an unlimited number of offers of treatment, but, by encouraging people to turn up, that will help, and then making those places available to those who can, failing that.

Llywydd, we know these short-term waiting list measures will not be enough to bring the planned care system back into balance on their own. While new investment is important, we need to transform the way that we provide health and social care in the community and in hospitals. Work on transformation, improved efficiency and productivity has to be undertaken in parallel to reducing long waits. This will help put us on the path to a sustainable health service for the future. The extra funding is designed to support this.

We've made some good progress in this area. To his credit, the Plaid Cymru spokesman had the good grace to acknowledge that his plan doesn't contain anything that is new, and I recognise that point. The development of Neath Port Talbot Hospital as a regional centre for orthopaedics has contributed to a 73 per cent reduction in long waits across south-west Wales, an area where regional working between Hywel Dda and Swansea Bay health boards is maturing, and this is without the need for emergency legislation. I've been clear that I will be prepared to use ministerial direction powers to bring about regional solutions where we need to do that. We've heard already we're investing just under £30 million to develop the Llandudno orthopaedic centre for the region, due to open later this year. We're supporting, I think, a vision for the future of the NHS, with regional plans for a diagnostic and surgical hub in Llantrisant, but it's not just new buildings or new legislation that will transform care. Changing pathways, how care is provided, is more fundamental. At the moment—and I do agree with the point the Member made opposite; I've been saying this myself since I took up these responsibilities—there is too much variation across the system in both pathways and patient outcomes. The new national planning guidance that I issued shortly before Christmas makes it clear that all NHS organisations must implement recognised best practice identified in the guidelines through the principle of adapt, adopt or justify. We'll be supported in this improvement work by the ministerial advisory group on performance and productivity. It's visiting health boards to understand issues at the local level before submitting its advice and recommendations to me.

Llywydd, in my statement in November about waiting times, I highlighted the use of Telederm alternative out-patient review pathways and the advice and guidance work of Consultant Connect as examples of transformation and innovation to help improve planned care and cut waiting times. In the year ahead, I expect to see these ways of working become routine, and other changes such as eye care design supporting our drive to treat people in the community where clinically appropriate. We've invested an extra £30 million every year to move more eye care out of hospitals into primary care so only the most specialist care needs to be seen in hospital. Another area for further roll-out is the use of super-out-patient clinics, which review large numbers of new pathways in general surgery, resulting in up to 45 per cent of pathways being discharged without people having to go into hospital.

Mabon ap Gwynfor now to reply to the debate.

It's been a really good debate with some really interesting examples of best practice. Now, we started off with James trying to take credit on behalf of the Conservatives for the policies that we put forward. But, you know, be honest. At least we're being honest here, saying that these aren't Plaid Cymru motions; these are things that are put forward by clinicians. These are experts that have put forward these policies, and be honest about that.

Carolyn was valiantly trying to defend the Government, putting forward examples of the number of contacts with GPs and 111, but that's not the win you think it is. As Heledd said, that's the problem—so many people contacting the NHS because they're on waiting lists. Take one woman in my constituency who's been waiting for gallbladder treatment, and she's been knocked back six times. And every time she has to go back to the doctor, every time they have to increase the medication she's on. That's at least a dozen if not 18 times that the NHS has been contacted. [Interruption.] Go for it.

Thank you. I just wanted to make the point that, when we hear such negativity about the NHS, I don't want to put people off contacting the NHS if they've got a problem, if they've got an issue. It's really important, because the NHS does actually deal with many people every day and help them. So, it's really important not to forget that.

I agree with you but you can't put your head in the sand and deny that there's a problem. There are 700,000 people waiting for treatment; one in five of the population of Wales need to be seen to get their treatment. And you also referred to the Llandudno orthopaedic hub, which hasn't opened yet, and it's one. We have the need for far more than just one permanent. We've put forward plans for temporary hubs across Wales. Now, you've said that it's important to remember what Wales does well. Yes, fine, and if you take responsibility for what Wales does well, take responsibility for what's gone wrong as well. Accept the crisis and do something about it.

Buffy highlighted the problems in the NHS under a Labour Government. Absolutely—I don't deny that and good to hear it, but you did, fair play, point out good examples in Cwm Taf, and I'll just refer to one good example, the Snowdrop example—a really good example, but why is it limited to that area? This is part of the problem with the Welsh Government. We've got best practice—that's the point we're making here. We've got best practice. Why isn't that Snowdrop centre, as an example, rolled out in Betsi where I live, and in Hywel Dda, in other places? We need leadership to make sure that best practice rolls out across Wales so that everybody benefits from it.

And, Jenny, you were right in saying that cold will kill people during the winter period. Absolutely. That's why it was so shocking to understand that the UK Labour Government had a means-tested winter fuel payment, so I don't know how the Labour Government here can justify that, and that will lead inevitably to more contacts with the NHS.

Will you take an intervention?

Yes, go for it.

And how do you explain why there are more attendances at A&E in the summer than in the winter? [Interruption.]

Yes, in Betsi Cadwaladr, we've got a lot of people attending north Wales, visiting north Wales, and if you talk to Llais, you'll see the statistics of the number coming and going into our hospitals because of those, amongst other factors as well.

And the Cabinet Secretary's response, and I'm grateful for the response, but at times it sounds like this Government is once again in complete denial about what's going on in Wales, out of touch with people here and not realising the problems that our people are facing. All is seemingly well.

Now, to give the Labour Government credit, they do talk a good talk. Week in and week out, we hear claims that they're doing all these great things in the face of overwhelming evidence that whatever they're doing is not working. Yesterday, the First Minister said that you already provide a triage service and the only difference with our plan is that we've put the word 'executive' in front of it, to great laughter from your backbench Members. This isn't a laughing matter, and you'd do good to read, listen and understand what our plan is. You clearly don't appreciate or understand the level of this crisis. There's the fact that some 60 per cent of children don't need to be on a paediatric waiting list, in some cases, which has a detrimental effect not just on their health, but also on their education. We've heard the claim that the Government are already delivering on these proposals, with the Cabinet Secretary himself today saying, 'Tick, tick, tick, tick, tick' against each one. This is nothing more than an exercise in gaslighting. If you're really delivering on these proposals, then why are clinicians and health managers telling us that these things are not happening and they need to be implemented? You forget, or you ignore, that these are plans presented by clinicians and health experts.

Technology, you said 'tick'. Really? So, why is it that many allied health professionals are not even furnished with a laptop or an iPad when they go out to the community? How can GPs share information with consultants when they have competing software that doesn't talk to each other? So, no, you're not delivering.

Executive triage service, 'tick' you said. Categorically no. If you were delivering this, then how come 60 per cent of paediatric patients who don't need to be on a waiting list are still on those lists? Why are clinicians telling us that thousands of dermatology patients don't necessarily need to be on those lists?

'Co-operation', you said. I can guarantee you that there are clinicians and managers and patients listening to this debate who will have been angered by this claim. If you're delivering on this, then please explain why a patient in Maesteg can expect different outcomes to a patient 8 miles away in Port Talbot?

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

That brings us to voting time and unless three Members wish for the bell to be rung, then we will move directly to our first vote. The first series of votes is on item 6, the Welsh Conservatives debate on the new UK Government's first six months. The first vote is on the motion without amendment, tabled in the name of Paul Davies. Open the vote. Close the vote. In favour 24, no abstentions, 26 against, and therefore the motion is not agreed.

Amendment 1 is next. I call for a vote on amendment 1, tabled in the name of Jane Hutt. Open the vote. Close the vote. In favour 26, no abstentions, 24 against. Therefore, amendment 1 is agreed.

The next vote will be on the motion as amended.

Open the vote. Close the vote. In favour 26, no abstentions, 24 against. The motion as amended is agreed.

The next series of votes is on item 7, the Plaid Cymru debate on NHS waiting times. The first vote is on the motion without amendment, tabled in the name of Heledd Fychan. Open the vote. Close the vote. In favour 11, no abstentions, 39 against. The motion is therefore not agreed.

The next vote is on amendment 1, and if amendment 1 is agreed, amendment 2 will be deselected. I call for a vote on amendment 1, tabled in the name of Jane Hutt. Open the vote. Close the vote. In favour 26, no abstentions, 24 against. Amendment 1 is therefore agreed, and amendment 2 is deselected.

Therefore, the final vote will be on the motion as amended. Open the vote.

Close the vote. In favour 26, 11 abstentions, 13 against. Therefore, the motion is agreed.

That concludes voting for this afternoon.

We will now move on to the short debate. Today's short debate is to be presented by Alun Davies. If Members could leave the Chamber quietly, we will move on to the short debate. Alun Davies.

Thank you very much, Presiding Officer. I'm grateful to you for the opportunity to speak on this matter this evening. The current sections that have been completed on the A465 Heads of the Valleys road certainly run through the Heads of the Valleys, but in many ways they also run through the history and geography of Wales, from the old washeries of Tower colliery, the final deep mine in Wales, above Hirwaun in the west, to the outcrop of what the colliers of Brynmawr used to call Farewell Rock in the east. You can stand in Rhigos and look across to the Beacons and then down to the Valleys, to the Bristol channel. At its highest point, near Clydach, it reaches 1,350 ft above sea level.

All too often, it is described as the border between industrial south Wales and rural mid Wales, but what I want to focus on this evening is what it connects today and what it can connect tomorrow. Certainly, it connects the Clydach gorge with the Neath valley: two parts of our country that have extraordinary history. The Clydach gorge, of course, is part of that ring of iron and fire that created the industrial revolution. Some of the first ironworks in the world were actually in the Clydach gorge, and the Neath valley, of course, takes us from the hills and the mountains of Bannau Brycheiniog down to the coast in Neath, but it also connects the communities of the Heads of the Valleys with the UK motorway system, and provides a new connection between Wales and the midlands of England.

But, it does more than this; it does more than simply talk to us of our history and our geography. I hope that it will also connect us with our futures. Because this wasn't a road built because of either congestion or gridlocked infrastructure; it was built as an investment in our futures. In total, when it is completed later this year, it will be one of the biggest investments ever made by the Welsh Government, and it fulfils a promise that I and others have made to the communities of the Heads of the Valleys. It is a great engineering feat, and I think, as we look towards completion now, we should say 'thank you' to everybody who has worked on the project, and also to the people who have had their lives affected by the construction phase.

But now is the time to look ahead. The Welsh Government has been very innovative in the way it's looked at this project and completed this project, from the debates we had with the former Deputy First Minister, which the Presiding Officer will remember, about some of the construction contracts that were let at that time, insisting on apprenticeships as part of that construction project, back—. I think it was about 15 years ago now. I don't want to age either of us, but it was a while ago. But we certainly had that conversation about how the road would be built and not simply why it would be built.

But now is a time to look ahead, and the purpose of this debate this afternoon is to call on the Welsh Government to deliver an industrial strategy for the Heads of the Valleys that will maximise the impact of this investment. In Blaenau Gwent, we have seen the Tech Valleys programme, which, over the last few years, has seen significant investment in the business infrastructure of the borough. But it's time also to move forward and to look beyond this programme to what comes next.

The Welsh Government has invested in our communities and our people. We have seen new colleges built in the time that I've been a Member here, in Aberdare, Merthyr and Ebbw Vale, delivering new skills for people. The new Hive development will be completed in Ebbw Vale later this year, and that was delivered with funding from the former UK Government. And the former Secretary of State for Wales took time out to visit Ebbw Vale and to see for himself what that investment was delivering. It will deliver a new level of skills development, working with employers and investors in providing new opportunities for people throughout Blaenau Gwent.

We've also seen investment in new infrastructure, in my constituency in the works site in Ebbw Vale, but also in Bryn Serth and Rhyd y Blew. But the completion of the dualling project this year now means that we need to move faster and to describe our compelling vision for the future in concrete terms, which will deliver not simply skills, but also a comprehensive programme of infrastructure investment.

But we've seen the investment taking place in the south Wales metro, connecting the Heads of the Valleys with the heart of the capital city, from the new services to Newport on the Ebbw valley line, to the electrification and new services across the Valleys, from Rhymney to Aberdare, Merthyr and Rhondda. Never in the last century have we witnessed such a scale of investment in our transport infrastructure in the Valleys of south Wales, and it is only the Welsh Government that has had the vision and the determination to deliver that investment.

So, all of these things are coming together, and this is why today, now, is the time that an industrial strategy needs to bring together all of these existing plans with a new ambition and a means to deliver it. We need to bring together the communities of the Heads of the Valleys to realise this vision. Shared priorities for a shared future. Our priorities need to be about hard infrastructure, but also about our communities themselves, investing in our culture, our health and well-being, our people. And I still, Minister, Cabinet Secretary, want to see the Welsh Government deliver on my priorities for a Valleys regional park.

Thank you to Alun Davies for the opportunity to contribute to the short debate this afternoon.

I was really touched by your speech this afternoon, Alun, about the wider impact that infrastructure projects can have on communities. We often talk about, and I have as well at length, freight moving goods, but let’s not forget the movement of people and the benefit of good infrastructure in the movement of people. In Pembrokeshire, only 0.8 per cent of our road network is dualled. Less than 1 per cent is dualled. That’s where we have two ports connecting us to the Republic of Ireland. We have intermittent rail services through to Pembroke Dock. What’s interesting there as well is that goes underneath the Landsker Line, connecting rural Welsh Wales—Whitland, above the Landsker Line—through to south Pembrokeshire, going through Tenby, which has historically been one of the busiest train stations in Wales due to the increase of passengers, but post COVID that’s deteriorated.

There have been some good developments on the A477, but again nothing has been done around dualling, as well as the A40. It has left Pembrokeshire and west Wales unable to maximise its opportunities in the travel of people and the travel of goods, given its connectivity elsewhere. That for me is a badge of shame. We look enviously at the Heads of the Valleys road and the investment that’s been had there. There has been investment, and if the Cabinet Secretary for transport was here I would congratulate him for the investment around the Llanddewi Velfrey bypass in the constituency. Like you, Alun, I’d like to thank those who’ve worked on it, but also thank the patience of those who’ve been living in those areas when those disruptive works have taken place. I hope that that road opens soon.

When we talk about infrastructure, infrastructure shouldn’t be seen as a dirty word. Infrastructure is a really good thing, it’s one of the best rudimental levers we have to create economic prosperity, as long as we maximise the opportunities that come from it. On the point around the HiVE, I’m really excited by the discussion that the Member and I had previously around this last week. That’s something that I think all of us should be aware of, all of us should be celebrating. I commend the Member for bringing this forward and being a champion for not only Blaenau Gwent but the Heads of the Valleys and the road infrastructure as well.

I call on the Cabinet Secretary for Social Justice to reply to the debate—Jane Hutt.

Diolch yn fawr, Llywydd. I'd like to start by thanking Alun Davies for bringing forward this short debate and recognise that the Member tirelessly campaigns for improvements to his Blaenau Gwent constituency. I want to pay tribute to the work that he's done. It was a magnificent speech, as Sam has said. It needs to go beyond this Chamber, I believe.

I'm very pleased to respond today confirming, of course, that the A465 road scheme will be completed this summer. The A465, often referred to as the Heads of the Valleys road, is that vital link that you identify that connects towns and communities—Monmouthshire, Blaenau Gwent, Rhymney, Merthyr and Rhondda Cynon Taf—and its improvement is long awaited and transformative. It will not only enhance our transportation infrastructure, but also fuel economic growth across the region, which, as you say, is the heart of the infrastructure that we need to develop to benefit our people and communities.

But also we must recognise that it represents one of the most significant infrastructure investments, not just in the Member's constituency and region, but in the whole of the UK. Members will be fully aware that it's been a complex project that has not been without its challenges. When you consider the topography, the COVID pandemic, Brexit, the crashing of the economy and the several years of austerity, it has been a real battle. We could have given up after completing the first few sections, and as a testament to the benefits of devolution, we didn't. We delivered it.

Ken Skates put on the record last week—and it bears repeating—that he was extremely grateful and thankful to the tens of thousands of people who've endured disruption as a result of the works. But our view is that the work has been worth it. Once completed, the final section between Hirwaun and Dowlais will alone have delivered 17.7 km of new dual carriageway, 6.1 km of side roads, more than 14 km of active travel routes, 38 new culverts, 30 new bridges and 28 retaining walls. It's a monumental build.

As well as connecting communities by linking the Valleys of south and west Wales to the English midlands and beyond, the final section of the project has created significant opportunities for the local economy. I do recall visiting, when I was finance Minister—and you may have come with me on that occasion—to see the benefits of the 2,000 new jobs that were created, with over half of those employed living in the local area, employing 158 apprentices, with just under half from the Valleys region, supporting more than 66 community initiatives, delivering more than 22,000 hours of pupil engagement—that was all part of the community benefits offer and delivery—and spending more than £200 million in the Valleys supply chain.

The project will reduce travel times and improve traffic flow by addressing congestion, upgrading critical road sections. It's created already a more efficient transport route for commuters, businesses and tourists alike. And this means quicker access to major industrial areas and urban hubs, providing not just transport, but economic benefits, which directly impacts productivity and reduces operating costs for businesses.

Will you take an intervention on that point, Cabinet Secretary? I'm grateful to you for that, and I'm grateful to you for your generous remarks earlier. If Cabinet Secretaries are meeting to debate and discuss these matters, it would be useful if the Members for these constituencies were involved in those conversations as well.

Thank you very much, Alun Davies, and I will take that back to the Cabinet Secretaries. It is very much cross-Government, the response, which is very encouraging, but also engagement with the local Members and constituency Members. I will ensure that they also, their officials indeed as well, link up with you so that you can be engaged in discussing those options that will be taken forward. Because it is about opportunities to realise the wider benefits to the economy of the region.

In conclusion, Llywydd, the A465 road project is not just a transportation upgrade. It is, as the Member has said, much more than a piece of tarmac, and must be much more than a bypass. It is an investment in the economic future of our region. By improving efficiencies, supporting local businesses, creating jobs, enhancing tourism, fostering long-term growth, and promoting community engagement and environmental sustainability, this project will have a transformative impact on south Wales for years to come. As we continue to support this initiative, let's keep in mind the immense potential it holds for all of us. Let's work together to ensure that we maximise its economic benefits, not just for today, but for generations to come. Diolch yn fawr.

That brings the short debate to a close, and that brings our proceedings to a close, too. Thank you.