Y Cyfarfod Llawn - Y Bumed Senedd

Plenary - Fifth Senedd

03/10/2018

The Assembly met at 13:30 with the Llywydd (Elin Jones) in the Chair.

1. Questions to the Cabinet Secretary for Energy, Planning and Rural Affairs

The first item on the agenda this afternoon’s questions to the Cabinet Secretary for Energy, Planning and Rural Affairs, and the first question is from Llyr Gruffydd.

The Welsh Red Meat Levy

1. Will the Cabinet Secretary make a statement on the Welsh red meat levy? OAQ52689

Member
Lesley Griffiths 13:30:19
Cabinet Secretary for Energy, Planning and Rural Affairs

Diolch. I continue to press for a permanent solution to this long-standing inequity. I'm extremely disappointed that, following my requests, measures to ensure a fairer distribution of the red meat levy were not included on the face of the UK agriculture Bill at introduction. I've made my views clear there should now be a Government amendment to address this issue. 

Well, I share your frustration, because I’ve been a Member of this Assembly for seven years and I’m sure I’ve been asking the same question regularly over that period of time. But the agricultural unions are also concerned that changes in farm payments that you’re proposing in ‘Brexit and our land’ are going to lead to less red meat being produced in Wales and, as a result, there will be fewer animals going through Welsh abattoirs, which will mean that less money will come from the levy to promote Welsh meat. As a result, they will be less promotion of that meat. So, you can see that vicious circle that would develop in light of that possibility. So, can I ask what consideration you have given to the impact that ‘Brexit and our land’ have on meat production in Wales? And what assurance can you give to our producers that the Government will continue to support the red meat industry?

Well, I think I've made my views very clear that we will obviously continue to support the red meat industry. I don't share the pessimistic view of many people around the issues that you've just raised, but I do think it is now time that we sorted out the red meat levy. As you said, you've been a Member here seven years; I've been a Member here 11 years, and it's been an ongoing issue. But we've obviously had an interim solution that has allowed some progress in this area, but I think this is the first agricultural Bill for probably 40-plus years. I think this was a real opportunity to be able to address this issue and, as I said, in my opening answer to you, I was very disappointed it wasn't on the face of the Bill. I've had a couple of discussions with Michael Gove to ensure that it's a Government amendment, because at one time I heard it could be a backbench amendment, and I don't think that would be appropriate. I think a Government amendment is the very least that we should see on the UK Agriculture Bill now around this issue. 

Thank you, Cabinet Secretary, for that answer. As you know, from these benches, we've been very supportive of change in this particular area. We're talking significant sums of money that's lost to the Welsh livestock industry. I do agree with you it's disappointing that it wasn't in the Agriculture Bill and we will use our influence as best we can to obviously try and influence that decision. But what is important, with the current arrangements, is that there is an increase in processing capacity here in Wales, in particular in the beef sector, because at the moment, obviously, the levy is derived from where the animal is processed. We've seen a contraction in processing capacity here in Wales over successive years. What confidence can you have that there will be little or no more contraction in the processing sector and, in fact, that we can move into a period where we will see significant investment in red meat processing here in Wales to increase the ability to add value to product here, where the country fattens that animal? 

I thank Andrew R.T. Davies for saying he will assist in any discussions he can around getting that Government amendment that we really want to see to the UK Agriculture Bill. In relation to the processing industry, I do think our processing industry is functioning well. I think it is a very attractive assessment, and we've had a feasibility study, which I'm sure you're aware of, into the opportunities for investments in parts of our processing plants, not necessarily just meat but also dairy.

One of the things that does concern me around our processing capabilities is the movement of EU nationals. I visited one processing plant where 80 per cent of the staff were EU nationals, So, there is concern, following Brexit, that we won't have the staff. And how do you make those sorts of jobs more attractive to local people? I think this has been an issue and it's something where I'm very happy to work with the sector to address. 

Marine Sites

2. What assurance will the Cabinet Secretary give that the protection of Wales’s European marine sites will be maintained at least at its current level following the UK’s exit from the EU? OAQ52681

Thank you. I am committed to ensuring environmental protections are not eroded as a result of exiting the EU. Using powers under the EU withdrawal Act, we are working to ensure the same protections are in place and the law remains functional upon exit. This includes legislation underpinning Wales’s European marine sites.

I do welcome that commitment and I am fortunate to represent an area that includes a significant percentage of the Welsh marine environment. The marine protected areas in my region are home to some of the most biologically diverse habitats in Europe, and it's critical that it stays that way post Brexit. Many of the MPAs in Wales are in an unfavourable condition, and regular monitoring of their condition is essential to know how we can help them thrive. And currently we're obliged by European legislation to report on site condition and status, and to take action to make improvements where that is necessary. What I'm keen to know is how this will be governed post Brexit. Will there be, for example, an independent body that will take on that role, holding the Welsh Government to account, and to ensure that environmental compliance is adhered to once we leave the EU?

13:35

Thank you for that further question. Having a very clear understanding of the condition of site features, and the effective management of MPAs, is absolutely essential, so that we can achieve their conservation objectives, and delivering our ambition—that we have a very well-managed network of MPAs in Wales. You will be aware of the recently published MPA network management framework, and that sets out the structure for improving the management and condition of the network of MPAs in Wales. And it's been done alongside the MPA management steering group, and that takes us up to 2023, and that will continue to apply once we leave the EU. The framework's also got an action plan alongside it, and that's going to be updated on an annual basis, and that will set out the priority actions identified to maintain and improve the condition of the MPA network.

Questions Without Notice from Party Spokespeople

Questions now from the party spokespeople. The Plaid Cymru spokesperson, Llyr Gruffydd.

Diolch, Llywydd. When your predecessor, Cabinet Secretary, proposed changes to agricultural funding in Wales, the Government published detailed assessments and extensive modelling of the impact that the proposed changes would have on each farm type, on each agricultural sector, even the impact on jobs in all the local authority areas that we have here in Wales. Now, given that your latest proposals in 'Brexit and our land' could lead to the biggest—or will, undoubtedly, lead to the biggest—shake-up in farm support in Wales for generations, can you tell us what analysis and what impact assessments you've carried out so that your view can be as informed as possible, but also that those responding to the consultation can do so in a thorough and robust manner?

So, the Member will be aware that, at the moment, we are out to consultation, and that is absolutely where we are. I've made it very clear that nothing has been decided in relation to the make-up of the schemes. We have said direct payments will be going. But the modelling that I think you will want to see will be on the future policy. So, as we're consulting on the high-level nature of that policy first, I don't want any prejudgments of any consultation exercise. We've got detailed modelling of what Brexit could mean to the agricultural sector, but we haven't done detailed modelling on the points that you've just made.

Well, I think people will be very disturbed by the fact that the Government clearly hasn't done its homework, because you are pursuing particular proposals, albeit in consultation form. So, how can you put those forward without knowing what the implications will be? How can you expect people to respond meaningfully to a consultation when, actually, you're not able to tell them what effect, if any, those changes will have on their businesses, on rural communities and farming families the length and breadth of Wales? And it's been said, of course, and you've alluded to this now, that Brexit could lead to cataclysmic effects in terms of agriculture here in Wales, and introducing the changes that you propose to introduce at the same time could well make things worse, but, 'We don't know yet because we haven't done our homework.'

Now, people are telling me that the proposals, particularly in relation to doing away with basic payments to farmers, could do to our rural communities what Margaret Thatcher did to industrial communities in Wales. We've heard about the Highland Clearances in Scotland; well, if we are looking at family farms going out of business, then it will be the upland clearances of Wales. We're standing on the edge of a cliff, Cabinet Secretary, and in taking away basic payments, you're taking away the safety net that Welsh farmers have. And, I have to say, it must be a very lonely place for you at the moment, Cabinet Secretary, because it's only you and Michael Gove who are pursuing this policy. We know that our principal competitors in the European Union will continue to take over 70 per cent of common agricultural policy support as direct payments. The Scottish Government is maintaining basic payments. Northern Ireland will do so as well. Even Labour's shadow DEFRA Secretary, Sue Hayman, has announced that Labour in England would maintain basic farm payments. Are you seriously still going to pursue this coalition between the Welsh Labour Government and the UK Tory Government even when it contradicts your own party policy?

13:40

Well, you've made some very generalised statements there. First of all, yes, I am going to pursue it. That's the first thing. The second thing is that this is Welsh Labour policy. In relation to what you're saying about Sue Hayman, I know of the comments that she made at the NFU fringe meeting in the party conference. I've seen her speech. I've spoken to her on several occasions. She believes her comments have been misinterpreted by—. It was an NFU Cymru fringe event. I understand that she will be writing to the president of NFU Cymru to make sure that her comments are understood.

I think that most people I speak to would agree that BPS payments have not done enough to improve farm productivity. You say that people are disturbed. This paper, 'Brexit and our land', came out of the Brexit round-table. You will have heard me refer to the stakeholder group many times in this Chamber and in committees. The farming unions both said to me that there were no surprises in that document because they had been part of those discussions for over two years since we had the vote. You say that it's a lonely place. Believe me, I have worked very hard for the stakeholders to bring that document forward, and it is a consultation. I want to make that vey clear, and it's still open to 30 October, and I look forward to receiving people's views.

I'm not doubting when you tell us that your policy is Welsh Labour policy, but I'm telling you that it's also UK Tory policy, which clearly is rather uncomfortable for you and your backbench Members, I'm sure. Now, as well as removing the safety net that I have referred to for Welsh farmers in these turbulent times of Brexit, under your proposals, of course, funding will now become—or is proposed to be—open to all land managers, rather than applying just to active farmers. Now this, of course, will siphon investment away from farming families when we know that every pound that's invested in a farm generates £7 to the rural economy. We could now see, under your proposals, banking institutions, pension funds and other inactive farmers—who make no contribution, frankly, to the local economy or community—benefit from Labour's proposals and the Tory UK proposals as well. Now, Plaid Cymru believes that any new system post Brexit must direct support to active farmers, rather than rewarding land ownership in itself. So, will you reconsider this proposal and ensure that support to Welsh farming is targeted at those active farmers, who are the ones who are taking the financial risk associated with producing our food?

The Member seems very keen to tie two together—the Welsh proposals and the UK Government proposals. If you look really hard, you will see that there are many differences—food production, for a start. We've put food production at the heart of the economic resilience scheme. I absolutely want to keep active farmers on the land. I've made that very clear. You ask whether I will reconsider. It's out to consultation. We've already had, I think, about 3,000 responses up to last week. I'm very competitive. I want to see more responses than DEFRA had, pro rata. So, I really want to encourage people to put their views forward. But, the whole point of this exercise is to keep our farmers farming. We need them to do that, and that's what will happen with our policy.

Thank you, Presiding Officer. It's great when you go second and two of your three questions have already been asked. [Laughter.]

If I could ask you, Cabinet Secretary: as I understand it, at the start of this process, the department took legal opinion as to whether the proposals in the consultation on the reform of the common agricultural policy and payments to farmers in Wales met World Trade Organization conditions. Can you confirm that that opinion was given to the Government, and are you happy that the opinion that was offered to you, if it was given, does make these proposals compliant with WTO rules?

Yes. I certainly questioned officials to make sure that all legal aspects had been covered. 

Yes, but does that mean that, obviously, opinion has been sought and that they are compliant with the WTO rules? Thank you for indicating that, Cabinet Secretary.

On the economic impact assessments, which I think the previous speaker raised, it is really important that, given that those impact assessments have not been done, as you pointed out, there is a clear understanding form the industry and participants in this process that there is a timeline when those assessments will be made. What timeline can you give us today? I think most people would have liked some sort of understanding that these impact assessments had been done already on the various proposals, because that modelling would greatly influence some of the decisions that needed to be taken. But, in the absence of those assessments being done, what timeline are you working to to have those assessments done, undertaken, given the very tight timeline you have imposed on the transition with reforming these policies?

13:45

We have committed to doing, obviously, full impact assessments, and, again, working with the stakeholders on the round table, they're very aware of that. So, the consultation closes on 30 October. We will then have to assess the responses we've had in. I've made it very clear that we will be consulting again in the spring on the proposals that come forward from the consultation, so I would say if—by the end of November, when there is the winter fair, for instance, I would hope to be able to be in a position by the end of November to make a bit more of a timeline that is firm, if you like, for when these proposals come forward. But as I say, we've said the spring, we will consult again in the spring, so it will be between those times. But I do hope to be able to be more specific, probably around the end of November.

I'm grateful for that indication, because it is critical that we do understand when this will be done. As I said, those impact assessments are vital to understanding the various modelling that is currently being undertaken. But what we do know under the current proposals, obviously—'land managers' are not necessarily active farmers. Now, I personally support the point that it should be an active farmer who should be in receipt of this money, and I declare an interest as a partner in a family farming business. However, your proposals, if they're taken through to their ultimate conclusion, will see a huge increase in the number of participants who could potentially benefit from this money that is supposed to support the rural economy. I believe, at the moment, it's about 17,000 to 18,000 people who are in receipt under the basic payment scheme. Potentially, you could be talking 40,000 to 45,000 applicants being dealt with by the department. What preparation are you putting in place as a department to deal with the uptake of the schemes? Because we all remember what happened back in 2005-06, when the intervention board as was, or the Rural Payments Agency in Reading, struggled to come to terms with the new system that the UK Government introduced back in 2005-06 that led to massive delays and huge financial pressures on rural businesses. What capacity building have you in the department, and what confidence can you give us that you will be able to deal with such a massive uptake in numbers that the department will have to deal with?

I think, at the current time, it's about 16,000 people who are in receipt of direct payments. You'll be aware of Rural Payments Wales's excellent performance; we're the best in the UK. I think about 95 per cent of payments went out on 1 December. So, I'm using that group or that team of people within my portfolio, obviously, when we have the schemes in place. There's a huge amount of work to be done before that, but I am confident we do have the capacity.

Diolch yn fawr, Llywydd. I've complimented the Cabinet Secretary many times on her open-minded approach to her job and her determination to rely upon evidence as the foundation of the policies of the Government. Does the Minister therefore accept my disappointment that this approach has been rejected by her in relation to shooting on public land, and the reversal of Natural Resources Wales's policy adopted in July? Does she not realise the damage that this approach is going to do in the countryside, particularly if it's followed elsewhere?

No, I do not accept that. As we made clear last week in answer to a topical question, this was a policy matter. NRW made it clear from the outset they were expecting a steer from Welsh Government in terms of the ethical and wider policy considerations. I put that forward and I'm pleased that the Welsh Government's views on pheasant shooting and associated activities on public land were considered by Natural Resources Wales.

I think the public at large will regard that as a laughable explanation of the decision because, although it's correct that you said last week:

'the Welsh Government's position is a matter for NRW's ongoing consideration and did not bind them to accept and follow our position',

the acting chairman of NRW, Dr Madeleine Havard, said Welsh Government had 'given a clear steer' on the direction for NRW to take. There's no reason for them to do a somersault other than to obey your diktat. So, I think most people out of doors will regard that response as wholly disingenuous.

I think most people in Wales and public opinion would say, actually, they support the end of leasing on the Welsh Government estate. I'd suggest that the Member is out of touch with public opinion, and out of touch with the policy. To refer back to the claims in terms of the impact on the economy, the figures being quoted are for all shooting enterprises across Wales, not just on the Welsh Government-owned estate. This makes up just 1 per cent of shooting enterprises in Wales.

13:50

If, as the Minister says, shooting is unethical on public land, it must surely be unethical on private land as well. So, it's quite clear what the direction of Welsh Government policy is here, and all anglers, all shooters, anybody in country sports generally, now can regard the Welsh Government as their determined enemy. This is the thin end of the wedge; they are all in the Welsh Government's sights.

I think the Member just answered my question for me. I absolutely, wholeheartedly reject that. I think you're just trying to jump on the bandwagon and whipping up a storm. What a private landowner does on their land is for them to decide, but when it comes to the Welsh Government estate, which is managed for all the people of Wales, for the people of Wales, then the Welsh Government will make a decision on that.

Empty Shops in Town Centres

3. What consideration has the Cabinet Secretary given to changing planning laws in order to deal with the condition of empty shops in our towns? OAQ52658

Thank you. Existing legislation and national planning policies support diverse high streets with a range of uses in order to help make them vibrant places for people to work, live and visit. The planning system needs to be flexible to help town centres adapt to change and take action where needed.

I thank the Cabinet Secretary for that answer. But, Cabinet Secretary, during a seminar given by the chief planning officer of Wales, a question was asked of him as to whether there were planning laws that would allow local authorities to force owners to maintain the cosmetic appearance of empty commercial premises. This would, of course, enhance the appearance of town centres, perhaps making them more conducive to attracting new businesses. Disappointingly, his answer was that there are no provisions in the Town and Country Planning Act 1990 other than to act if a premises posed an immediate risk. Could the Cabinet Secretary look at the possibility of providing local authorities with powers to demand this cosmetic upkeep by owners?

Yes, I'll certainly speak to the chief planning officer to see if there is anything we can do. You'll be aware that we've recently consulted on 'Planning Policy Wales', so it could be that we could look to do something there, because I absolutely agree. I know in my own town centre in Wrexham, if there are empty shops, it's much better if they're cosmetically decorated in a way that makes them look attractive for future business. So, yes, I'd be very happy to look into that and I'll write to the Member.

Cabinet Secretary, the increasing tendency for consumer spending to shift online and to out-of-town retail parks has resulted in the closure of many shops in city centres around south-east Wales. The Centre for Cities think-tank has said struggling city centres should end their dependency on retail by replacing shops with offices and housing. They point out that in Newport, more than 40 per cent of commercial space is in retail—much of it is struggling. Does the Cabinet Secretary agree that the future of our high street lies in more than retail and what plan does she have to change planning laws to make it easier to convert retail outlets into housing or office units? Thank you.

Yes, I would absolutely agree with you that we need to look at different uses for our town centres, because, as you say, shopping trends have definitely changed—more people are shopping online, for instance. We've certainly made sure that the planning policy is flexible enough to allow flats to be put above shops, for instance. And, obviously, we need to make sure that our towns are also central for economic and social lives, so we see much more night-time economy in these—. And I think the planning policy is flexible enough to allow that to happen.

Closed-circuit Television in Slaughterhouses

4. Will the Cabinet Secretary provide an update on the installation of CCTVs in slaughterhouses? OAQ52679

All the larger slaughterhouses in Wales have CCTV. Footage can be accessed if it's suspected welfare standards are not being met. Investments to safeguard animal welfare, including CCTV systems, will be prioritised in a grant scheme for small and medium-sized slaughterhouses, which opened to expressions of interest on 30 September.

I welcome your commitment to this, Cabinet Secretary, but I do keep getting, as I'm sure other people do, lots and lots of letters on this very subject from concerned individuals, and I share those concerns. I do remember you saying that you were looking into whether or not you would introduce mandatory CCTV in all Welsh slaughterhouses. I appreciate, as you've just said, that the larger ones already do have that, but I'm keen to know if you've reached a decision on whether you will make it compulsory in Wales, to bring us in line with the recent changes that have happened in England.

13:55

Thank you. You're quite right, initially, I am supporting a voluntary approach and I'm making this feasible through the grant support that I just mentioned, because I was told by some of the smaller slaughterhouses that one of the barriers for introducing CCTV was finance, so it's taking away a large chunk of those funding concerns. I think a voluntary approach is more likely to succeed in achieving the goal of having effective CCTV coverage because I think then the slaughterhouses themselves will take a positive decision. I've had some very interesting discussions with owners of some of our smaller slaughterhouses. I visited with the Presiding Officer one in her constituency in Tregaron and had some very robust and interesting discussions. So, in answer to the question of have I ruled out making CCTV mandatory in the longer term, no, I haven't. I think the uptake of the funding that we've just announced will have an influence on whether I do that. 

Of course, this has been a hot topic in the Petitions Committee, where it has been proven that there is an overwhelming response across Wales for the installation of CCTV. Whilst I appreciate this is progressing, CCTV in slaughterhouses will definitely ensure that mistreatment is detected and dealt with. This is an important step in ensuring that we have very high levels of protection on animal welfare in Wales and that we can set examples to others. You have mentioned the £1.1 million food business investment scheme, a package of grant aid for small and medium-sized slaughterhouses in Wales, but what processes are you going to put in place to ensure that those receiving the grant aid do use that money for installing CCTV, and what are you going to do about the ones who actually are just flaunting this guidance and support for this move, in terms of those smaller slaughterhouses who are just against installing it? What have people got to hide?

I think it's really important to know there are a number of controls already in place in slaughterhouses. Official veterinarians are present in every slaughterhouse when animals are being slaughtered to ensure compliance with regulations. In response to your question about how do we make sure that funding is used for the purpose it's been applied for, obviously, there's very stringent monitoring of this, but we're also working with these small and medium-sized abattoirs in the first place to help them put the bid in and to make sure then that, as you say, that money is used for the correct purpose. We've given extensive guidance, for instance. There are very few slaughterhouses now that don't have CCTV. So, it is possible to work with them on a much closer basis than if there was a large number.

Fly-tipping

5. Will the Cabinet Secretary provide an update on progress in relation to the Welsh Government's strategy against fly-tipping? OAQ52672

The Welsh Government is committed to delivering 'A Fly-tipping Free Wales—Our strategy for tackling fly-tipping'. We continue to fund Fly-tipping Action Wales, an initiative co-ordinated by Natural Resources Wales, while working with partners to secure the long-term reduction of fly-tipping in Wales.

Thank you for that answer, Minister. Sadly, there are parts of my constituency that continue to suffer from extensive problems of fly-tipping. It's quite difficult to understand the mindset of people who will drive a truck up a hill and dump rubbish, causing visual blights on areas of natural beauty like the Gelligaer common. I believe that many of these issues do come from unlicensed operators who've been paid in good faith to dispose of household and building rubbish. If the outcome that we all wish for is less fly-tipping, can you advise me whether the Welsh Government or anyone else has researched the balance between the carrots and sticks in these situations that could encourage a more responsible attitude, and whether, for example, you've considered the cost-effectiveness of lifting charges at disposal sites versus the cost to local authorities of clearing up fly-tipping?

The Member raises a very important point. I know fly-tipping affects many Members' constituencies. I think you're absolutely right. It seems to me to take a lot of effort to just go and dump something when you can actually just take it to the correct site. I think part of the issue of tackling it is to make it socially unacceptable as well, so there is work going on within Welsh Government on a scheme to look actually at how in terms of we're looking at behavioural change in people with recycling, but also behavioural change in terms of how we make it socially unacceptable to fly-tip. In talking about disposal sites for waste, anyone taking their waste directly to a landfill have to pay a fee based on the weight of the material. You make really good points in terms of the carrot-and-stick approach, so it's actually the enforcement and actually making sure we catch the culprits and tackle that and make it socially unacceptable. But, actually, how can we support, perhaps, the local authorities to be in a better position to tackle this? And there are ways and means. Your local authority could apply through, could speak to the collaborative change programme and seek support if there's a specific issue to tackle this in the area. But householders and businesses must not pay for waste to be removed by unlicensed operators. This is a breach of the duty of care regulations. But perhaps there's an awareness-raising exercise to be had around that as well. I think if there's anything really specific you have in respect of your constituency, then I'm more than happy for my officials to liaise with you on that, and any suggestions for taking this forward.

14:00
The 2030 Carbon Reduction Target

6. What is the biggest challenge facing the Welsh Government in meeting its 2030 carbon reduction target? OAQ52669

Thank you. The biggest challenge is our emissions profile, with 57 per cent coming from industrial installations and power stations, where we have limited policy levers. Where policy is devolved, the Committee on Climate Change has identified several challenges specific to Wales in their advice, which is featured in our latest consultation.

Your consultation raises some challenging targets in the context of climate change experts raising the red flag and saying that Government is simply not taking the action that needs to be taken if we're going to avoid rising levels of global warming. There was very distressing information today that the Conservative UK Government has yet again failed to raise the fuel levy, which endeavours to reflect the actual cost of people using private vehicles. And I want to understand how you think you're going to reach the very challenging target of a 43 per cent reduction in vehicle emissions by 2030 in the context of the proposal to invest £1.5 billion in a few miles of road on an M4 relief road, because the Future Generations Commissioner for Wales is arguing that this will increase the numbers of vehicles using that road by 42,000 vehicles every day. So, I want to understand what your strategy is for actually reducing vehicle emissions without reducing the number of vehicles on the road, and instead investing in public transport and active travel.  

The Member will be aware in relation to the M4 that the First Minister is leading on this and, obviously, I will be having discussions with him as he considers the report that's come from the court. You do make a very important point around challenging targets and, as I said, we don't hold all the policy levers so it's sometimes very frustrating to be able to address the challenges that we do have. However, I think it is important to set ambitious targets. I think it's important to set pragmatic and realistic targets, and I think we have a good story to tell in areas where we do have the devolved powers. So, for instance, we've met our 3 per cent target year on year, but as I mentioned in my opening answer to you, the emissions profile that's the real concern is around industry, so I think it's really important that we don't just take these things in isolation, but that we work together across Government to make sure that we do achieve our ambitions. For instance, I've also announced that I expect to have a carbon-neutral public sector in Wales by 2030. I've made very challenging targets around renewable energy, also by 2030. 

Cabinet Secretary, an area where you do have power over is that of the infrastructure for charging electric vehicles—an issue that I raised with you last week and I'd like to return to. I recently visited the site of a proposed electric charging station adjacent to the A40 in Monmouth. The plan also, critically, includes two small-scale on-site power plants, so that the electricity that would be used in the charging station would be generated locally from renewable sources, which is far more efficient and desirable than transporting fossil-fuelled electricity along the inefficient national grid. Do you agree with me that this type of scheme is to be welcomed? It's probably going to go through a planning stage, so I don't want you to comment on the exact nature of this particular scheme, but would you agree to look at the Assembly guidance given to local authorities so that, when schemes like this come along, they are encouraged, so that we can have electricity generated locally in this way, in a way that will help the Government and all of us meet our 2030 carbon reduction target?

14:05

Yes, absolutely, as a general point, I would agree with you, and I think you made a very pertinent point around this during a debate last week. You can't just keep using fossil fuels, as you say, when you're looking at hydrogen, for instance, and electric vehicles. Obviously, I'm concerned about the national grid capacity anyway. I've had some very concerning discussions with National Grid in relation to this, so, yes, certainly as a general point I would agree with you.

Marine Licensing Procedures

7. Will the Cabinet Secretary make a statement on the Welsh Government's marine-licensing procedures? OAQ52684

The Welsh Ministers' marine licensing authority functions have been delegated to Natural Resources Wales, who carry them out on Welsh Ministers' behalf. The marine licensing determination process provides for a thorough and robust assessment of proposed activities, including consideration of the need to protect the marine environment and human health.

Thank you. Cabinet Secretary, it has now been established through legal action that there was no environmental impact assessment to dump mud from Hinkley Point C nuclear reactor onto the Cardiff Grounds. There was no consideration of the effect on the marine environment or public health. It was also established through our legal action that you, as Cabinet Secretary, are ultimately responsible for undertaking an EIA. So, will you now take action and make sure that an environmental impact assessment is done, or will you continue to act unlawfully?

I'm very grateful for the opportunity to set out the EIA process again. A key point to note is that this non-EIA approach does not mean that a full and thorough environmental assessment was not undertaken. A radiological assessment was carried out and supported by experts, as well as the wider environmental and human health assessments needed for the marine licence determination. An EIA was carried out on the Hinkley Point C project overall; it was submitted as part of the supporting information supplied with the application for the marine licence and, as such, was considered in the determination process.

The difference between non-EIA and EIA projects is the length of time for public consultation: 28 days for non-EIA, and for EIA applications this is increased to 42 days.

As you know, Cabinet Secretary, again, the Petitions Committee has taken much evidence on this and has given detailed consideration to the petition calling for the suspension of marine licence 1245ML. This licence has been opposed by so many, including the committee itself. And I want to put on record my thanks to you, Neil, for being so determined to stand up for the people who you believe this is going to affect. And still this licence has not been suspended.

Some of the evidence we took: some of the digging, some of the findings at the appropriate depths, for some of the contaminants have not been undertaken since 2009. We are now in 2018. Now, with that in mind, will the Cabinet Secretary make a statement on why you and your Government are going against so much opposition and what actions you will take to listen to the people who are most affected? And it's no good shaking your head. I sat in those meetings, Cabinet Secretary—

Not you, no, no, not you; this one here—your questions are coming up next.

What actions are you taking to prevent the disposal of what is considered potentially dangerous sediment here into the beautiful Cardiff Bay?

The Member will be aware that this is a live licence and that, as such, this is a matter for Natural Resources Wales. They are the licensing authority, and I'm  limited in what I can say about particular marine licences, given the Welsh Ministers' statutory role under the regime. I'm very grateful to have that opportunity, as I said, to set out the process. I understand there's going to be a debate next week also, but I just want to reassure people that NRW have made their determination based on expert advice in line with the radiological assessment procedure developed by the International Atomic Energy Agency.

14:10

Question 8 [OAQ52670] is withdrawn. Question 9, Suzy Davies. 

House Building in South Wales West

9. What discussions has the Cabinet Secretary had with the Cabinet Secretary for Local Government and Public Services regarding the impact of the planning system on house building in South Wales West? OAQ52695

I have frequent discussions with my Cabinet colleagues regarding how the planning system can support Government priorities, including the delivery of housing. The planning system plays an important role supporting the delivery of new, affordable and market homes to meet the housing requirements of communities across Wales.

Thank you for that answer. The requirements of the communities in Wales, I think, is a critical part of your answer. You wrote to Bridgend County Borough Council making it clear that, in your view, they should be looking to look at their local development plan in conjunction with that of Rhondda Cynon Taf and Caerphilly. Bridgend has already planned its housing building stock for the next five years, it's already in train, whereas RCT and Caerphilly are nowhere near reaching the targets that they have. Now, I think collaborative working is one thing, but this instruction is going to skew the planning system to divert the building of thousands of houses that are needed in RCT and Caerphilly, potentially into the BCBC area where they're not needed. So, as well as the social effects of that, is it right that the council tax payers in Bridgend will also then have to not just go through the disturbance of building, but support the infrastructure that's going to be needed for those houses? In particular, GP surgeries are already stuffed to the gills. 

Thank you. Well, provisions in the Planning (Wales) Act 2015 do enable local planning authorities to bring forward strategic development plans, and I know there are several local authorities looking at that—you've just mentioned a few of them—and it could be an important mechanism at a regional level, but if they don't want to do that, then, certainly, they can just continue with their local development plans. 

Something that animates quite a lot of local people is the fact that there's no mandate within the planning system for facilities for many of those new estates. So, sometimes you have housing estates that are well-kept and they have provision in that regard, but they don't have parks, they don't have any surgeries, they don't have those things that would create a community. The system, therefore, alienates a lot of people who may not mind having those new houses in their local community, but would welcome some investment in the infrastructure around that. So, what more can you do as a Government to look at how we can build in these facilities to the local planning systems, so that we can be assured that when we're creating homes we're creating communities as well?

I think the Member raises a very important point. I was talking to the chief planning officer this morning, for instance, around health boards giving evidence when there are new planning developments. They're not mandatory consultees at the moment, and I'm wondering whether they should be because, clearly, primary care provision is very important. So, it's something we're looking at, and, obviously, I'll be very happy to update Members.

'Brexit and our land'

10. What impact assessments have been completed on the implications of the 'Brexit and our land' proposals for the Welsh language? OAQ52685

As we set out in 'Brexit and our land', we consider the Welsh language to be an inseparable part of the social fabric of parts of rural Wales. A Welsh language impact assessment will be undertaken by the Welsh Government before any final decisions are taken on the design of new schemes.

Thank you very much. That’s what I suspected: no assessments and no intention of doing that until the results of the consultation are collated. Now, it’s clear that a fair bit of officials' time and Government money has already been invested in developing the proposals contained within 'Brexit and our land'. So, isn’t this process, the Government process of developing policy, entirely flawed? Because the risk is that you will reach the next stage after you’ve completed the consultation and find that the proposals are damaging to the Welsh language and other areas, such as the rural economy, and therefore you will have to drop them, and then you will have wasted everyone's time and Government resources and will have unnecessarily caused anxiety among rural communities.

No, not at all, because as I said in an earlier answer—I think it was to Llyr—we haven't done those assessments and that modelling because we are out to consultation. But, I said in my opening remarks to you that we specifically included the Welsh language in that document, and I also think 'Brexit and our land' has a very community and cultural focus, and, of course, the Welsh language is an integral part of that. The agricultural sector is probably the sector in Wales that uses the Welsh language the most, and I absolutely want to protect that. We are committed, as I mentioned, to keeping farmers on the land and to working with them for that prosperous future, and that offer, I think, will ensure that we have a future for the Welsh language, by creating stability and long-term viability for our farmers.

14:15

Well, I agree with Siân Gwenllian. There's no point including a question in a consultation for something that you've not offered any evidence for. A few clichéd words about the place of the Welsh language in rural communities really doesn't count. Did you receive any advice from the Welsh Language Commissioner about how to collate the evidence before consulting?

If we'd have done extensive modelling and impact assessments before the consultation, I would be criticised for that. You just can't please some people and, unfortunately, I think this is the most appropriate way to do it. All the modelling and assessments, as I said, will be done before we go out to consultation in the spring on the specific schemes. There has been contact with the Welsh Language Commissioner at an official level, and also I have had discussions with ministerial colleagues.

Healthcare Providers and the Planning Process

11. What consideration does the Welsh Government give to the views of healthcare providers during the planning process? OAQ52662

Thank you. Local health boards are a specific consultation body set out in local development plan regulations. They provide advice to local planning authorities on the land requirements for the development of their own estate and the ability of new development to be served by existing and proposed health facilities.

Thank you, Cabinet Secretary. You'll know that I've written to you about this matter that, in practice, very little happens in terms of consultation with the health boards. Many of them do not engage with it properly and it certainly doesn't feed down to the general practice level.

In a number of recent applications involving substantial planning developments in my constituency what we actually found out was that the GP practices themselves are not engaged in the process—they are not statutory consultees, even though the ability to provide vital health services in those communities are important. And we've had GP practices telling us that if certain developments go ahead, they will not be able to deliver the level of health service, and it will have an adverse impact. Isn't it about time that we actually changed the process now so that, when we have such applications—and there are many of them going on in the Taff Ely area—there is a direct and statutory consultation process, engaging with those vital public services, in particular the health services that have such vital information to give, to be taken into account when consideration is given to whether or not to give planning permission?

Well, you will have heard me say in an earlier answer to Bethan Sayed that I am looking at whether health boards should be mandatory consultees in this decision making. I think, in many cases, the capacity of primary care facilities is really an important, material consideration when you are planning the merits of having a development in a certain area.

I do expect local health boards to be engaged in the preparation of LDPs with planning authorities, given their responsibility, obviously, for providing primary care services for the local population. I think it's really important that GP surgeries, on an individual basis, feed into that process also.

2. Questions to the Cabinet Secretary for Local Government and Public Services

The next item, therefore, is the questions to the Cabinet Secretary for Local Government and Public Services. Question 1 is withdrawn. Question 2, David Rees.

The Probation Service

2. What discussions has the Cabinet Secretary had with the Ministry of Justice regarding the future of the probation service in Wales? OAQ52694

Member
Alun Davies 14:18:51
Cabinet Secretary for Local Government and Public Services

I met with UK Ministers in July and regularly meet with the head of Her Majesty's Prison and Probation Service in Wales to discuss the probation services provided to Welsh prisoners.

Thank you for that answer, Cabinet Secretary. As you're aware, in 2014, the then Tory-led UK Government decided to privatise the probation service, splitting it in two: the National Probation Service and the community rehabilitation companies, which are also here in Wales. Now, last December, we had a report from the chief inspector of the Her Majesty's Inspectorate of Probation, Dame Glenys Stacey, which expressed deep concern over the failures of the privatisation and the chaos that existed in the system. Last week, she had another report expressing deep and grave concerns over the safety of victims of domestic abuse because of the failure of those private companies to protect those victims from their abusers.

Now, it's time, surely, that these contracts were killed now and that this whole responsibility was transferred to the Welsh Government. Do you agree with me that the UK Government needs to take action—not in 2020, two years down the line when these are going to have been failing for another two years, but now, and transfer these to the Welsh Government so that you can take the actions necessary for Welsh citizens?

14:20

I do agree with the Member for Port Talbot, in terms of the analysis that he has of the failures of the probation service. These are matters I have discussed both with the service itself and with Ministers in the United Kingdom Government. I agree with him also that these matters should properly be held here, and be the responsibility of the Welsh Government. He may be interested to know that the UK Government did announce in July that there would be a consultation on the future of the probation service. The Welsh Government has responded to that consultation. I will be leading a debate in this place on 23 October to listen to what Members have to say about how they want to see the service developed in Wales, but I was very pleased to see that the proposals that the Ministry of Justice are making for Wales are distinct and recognise the distinct position of Wales. I believe they are a first step on the route to the sort of probation service that delivers coherent and holistic services in Wales and delivers for the people of Wales.

The Tories' ideological privatisation of the probation service has been an unmitigated, if not predictable, disaster. It's left existing probation staff feeling demoralised, and it's also increased the danger posed to the public. The Tories should be full of regret and shame for wrecking what was an effective public service. 

In a briefing earlier year, Napo, the trade union representing probation officers, said that the present structure has probably come too far to be reversed, but they have proposed some measures to ameliorate the consequences of probation privatisation. This includes the establishment of a locally accountable commissioning body that could comprise the Welsh Government and our police and crime commissioners. While we wait for the devolution of the probation service, would you be willing to take part in such a body, and can you tell us whether you've begun talks to progress such an arrangement yet?

Presiding Officer, in my earlier answer, I said I've been in discussion on these matters at both a ministerial and official level for some time, and I've made that point clear to Members here on previous occasions. I do recognise the proposal made by the Member for the Rhondda, and I am very happy to enter into conversations about that. However, at the moment, we are looking at the reunification of the probation service in Wales, as a single, publicly accountable service. We are looking at the way in which the community rehabilitation contracts are ended in Wales, and that the service is provided as a single, coherent, public service—and that is the basis of the conversations I'm having at the moment. And it is to further explore Members' views on these matters that I have proposed that we have a debate on this matter later in the month.

Neath Port Talbot County Borough Council

3. Will the Cabinet Secretary outline the Welsh Government's funding settlement priorities for Neath Port Talbot County Borough Council? OAQ52690

The Government’s overall budget priorities, including the funding for local authorities, were set out yesterday. I will announce the provisional local government settlement on 9 October.

A few weeks ago, we heard from the chief executive of Neath Port Talbot County Borough Council saying that they would have to make people redundant unless funding was made available for the teachers' pay rise from the Westminster Government centrally. Now, I’m proud to say that Ben Lake, Plaid Cymru MP, has requested that funding from the Westminster Government in Parliament there, and he has been of great assistance in ensuring that the funding will be made available to Wales. So, can I ask when will that funding be provided to Neath Port Talbot council, so that they don’t have to consider redundancies, and so that they can give the very deserved pay rise to teachers within that council?

There was a statement yesterday from the finance Secretary, stating that Welsh Government will fund the teachers’ pay increase in full, and that will happen as part of the settlement and as part of next year’s budget.

Cabinet Secretary, whilst I appreciate the statement yesterday indicating that the teachers' pay rise will be funded by the Welsh Government, Neath Port Talbot council still is facing a huge deficit in its budget, and will be facing the challenges that they have to come up to with cuts that no-one wants to make to our public services. Will you therefore look at the needs of the communities, because that's the crucial element? Often, we need to reflect upon the needs and the deprivation within the county boroughs to ensure that they get a fair treatment from the Welsh Government so that they can deliver the services that they are tired of having to cut to the bare bones every year. It's time, I think, that we need to support the local councils to ensure that they can deliver services to the local people.   

14:25

I do agree with that, and the Member will know from his own experience that local authorities in Wales have been protected in a way that they haven't been in England. Whilst we have some very difficult, sometimes, conversations at our various meetings with local government, do you know, I am still yet to the local government leaders say, 'What we need is the policies that are being delivered across the border in England'? So, we are doing our best to protect local government, but I also recognise that that is difficult for local authority leaders at the moment, and that it will continue to be difficult for some time in the future. I am confident that the current funding formula and funding structures we have in place mean that Neath Port Talbot, as with all other local authorities, get what they're entitled to—get a fair settlement—although it isn't the settlement that neither they nor I would wish to deliver. We heard from the Prime Minister this morning, saying that the age of austerity was over. Well, I'm looking forward to seeing her cheque book.  

Cabinet Secretary, Neath Port Talbot, like all Welsh councils, are having to roll back social care provision due to massive shortfalls in their budgets. Social care provision is one of the most important services a local authority provides. What discussions have you had with your local government colleagues about measures they can take to protect and enhance social care provision so they can avoid closing services that so many depend on?

Social care is one of those areas of the settlement that we have sought to give enhanced protection to. The finance Minister yesterday made clear that we'll be investing an additional £20 million as part of the funding settlement itself, an additional £30 million through additional grant funding, and another £30 million as part of the social care partnership for health and local government. So, we are seeking to ensure that social care has the funding that it doesn't have across the border. We all know that, across the border—. We've seen significant cuts to social care budgets in Wales. We are seeking to protect those same budgets.

Questions Without Notice from Party Spokespeople

Questions now from the party spokespeople. The Conservatives' spokesperson, Mark Isherwood.

Diolch, Llywydd. This morning you issued a joint written statement with the Minister for Housing and Regeneration on the early prevention, intervention and  support grant. You spoke about planning, commissioning and delivering services reflecting the complexity of people's lives, and the inter-relationships between their support needs. You confirmed what the finance Secretary said yesterday: that the grant would be split in two, between housing-related and non-housing-related elements, with the establishment of a children and communities grant for the pieces falling within your remit. You also said that you'll work in partnership with local authorities and wider stakeholders to take forward the new arrangements, and emphasised the importance of early intervention and prevention. Can you therefore confirm, or will you confirm, whether that funding will now be ring-fenced, as grants generally are, or will it be going into the revenue support grant? If it's not ring-fenced, how will the Welsh Government be monitoring and evaluating outcomes to establish whether this money actually found its way to where it was intended?

Can I, before answering, Presiding Presiding Officer, welcome the new Conservative spokesperson to his place? I hope I gave him a more enthusiastic welcome than some of his colleagues did this afternoon. [Laughter.] I really feel they could do better there. Can I say that I'm looking forward to many conversations and engagement with you, Mark, over the coming period? 

In terms of the grant that you refer to, we have been giving real, deep consideration to how we bring together the integration that we want to see, whilst ensuring that that money continues to reach the recipients who need it, and does so in a coherent way that enables their needs to be met. I hope that the decision we have announced today—in terms of a two-grant model, if you like, which we are giving an undertaking that we will maintain for the rest of the Assembly—is one that will meet the needs of recipients but will also allow local authorities and others to deliver the sort of integration that they require. But, in direct answer to your question, yes, we will ensure that those grants do have their own integrity.

14:30

Well, I'll look forward to exploring that further with you in the future to establish what 'integrity' means in that context. Now, we know—and I know it's not directly in your brief, but I'll get to the relevance—that the Social Services and Well-being (Wales) Act 2014 Part 2 code of practice and guidance puts in place a system where people are full partners in the design and operation of care and support, giving them, quote, 

'clear and unambiguous rights and responsibilities.'

Now, in your statement today—your written statement—you refer to planning, commissioning and delivering services, and I'm regularly having concerns and allegations expressed to me that we're still seeing consultation from above after decisions have been reached and then commissioning on a traditional commissioning model, which can disadvantage local providers.

Earlier this summer, in Flintshire, the council awarded its service contract to provide disability support services to the non-local provider who'd had it previously. I attended their annual general meeting, asked the people present—90 per cent of whom were disabled—whether they had been involved, as the legislation said that they should have been, in the design and delivery of their services, and they all told me that they had not been involved. Given your responsibilities for local government, for planning, commissioning and delivering services, and for voluntary sector and related issues, how do you propose to help local authorities better understand that this isn't an option, it's a requirement of Welsh Government legislation that had the support of all parties here in the last Assembly, and that they must start doing this? 

We will be evaluating the pathfinders and looking at many of the issues that you've raised this afternoon as a part of that. The interim report was published today, and we will continue to work with the independent evaluators to understand some of those issues before their final report is published, which, I hope, will be in the early summer of next year. 

But the purpose of bringing together these grants, creating the housing support grant and creating the children and communities grant, is to pilot and to drive new ways of working—sure, involving people in designing these grants and designing the projects and programmes that support those people, but also integrating different functions, integrating services and integrating organisations to work more closely together. It is exactly the sort of reform programme that we want to see in local government where we are able to invest in people but actually achieve far more than we could have done if we were working in silos under the previous system. 

Well, I hope the Welsh Government will help local authorities better understand how they're supposed to reconcile commissioning and procurement requirements with co-production and co-design of services with local people, where the co-design may be different to the commissioning choice. 

My final question relates to poverty—again, not a matter in your brief, although many of the key agencies and services are. In the middle of July, I went to a Wales Centre for Public Policy event in Bangor University, 'Reigniting Debate on Rural Poverty: Evidence, Practice & Policy Implications'. This emphasised the importance of the third sector, it highlighted a lack of integrated rural policy, an asset-based approach in line with the well-being Act being required, the need to value expertise and reach the voluntary sector and wider community through local empowerment and the Welsh Government's leader approach, and identified a gap between policy and practice, with good intentions not followed through.

Similarly, last week, you might have seen that the Bevan Foundation circulated a report from the Social Metrics Commission, which is an independent commission that has brought to bear thinkers from across the political spectrum to look at a new approach to measuring poverty. They tell us that the remeasurement will have more accurate estimates of things like housing, childcare, disability, the length of time a family's been in poverty and so on, that 24 per cent of the population of Wales live in poverty, and a higher proportion of people live in poverty in Wales than any other nation. And they say they welcome—the Bevan Foundation welcome—the launch of the new measure, and the new measure provides a much more realistic and nuanced understanding of poverty in Wales. But how do you respond to their statement that this should be used to inform a comprehensive and practical action by the Welsh Government, local authorities, businesses and other bodies, such as those referred to in the rural poverty report I mentioned earlier, to solve poverty in Wales? 

14:35

I would respond by agreeing with the Bevan Foundation in their analysis. Clearly, we do need to have that level of understanding of the human impacts of poverty, if we are to address it in a more holistic way. Perhaps I could answer the question with an illustration that is actually within my portfolio, which is in terms of the Valleys taskforce, where we are looking at exactly that range of indicators to understand both the nature of poverty in our communities, but also the tools and levers we have that can best be used to address those issues of poverty. Let me say this: it is important that we are able to attack poverty at its root. That is why we're seeking to both create work, but fair work, and then to ensure that we don't simply address the economic aspects, but we look at all the community, social, family, and cultural aspects of poverty as well, so that we can address poverty in the holistic way that I suspect the Bevan Foundation is seeking to describe, and which I hope the Conservative spokesperson is also seeking to describe.

Diolch, Llywydd. One of the consequences of the Well-being of Future Generations (Wales) Act 2015 has been the creation of public services boards. As you know, Minister, the main purpose of the PSBs is to strengthen joint working across all public services in Wales. How do you assess how well the PSBs are operating, and have we seen an improvement in joint working across the public services?

I hope that we are seeing joint working. The public services boards have now completed their planning period and have programmes that they're now seeking to deliver. Clearly, each programme will have its own objectives, and we—and, I hope, Members across the whole of this Chamber will be holding their own public services boards to account for delivering on those programmes and those objectives.

Yes. Thanks. I hope so too. We had a scrutiny session on the Equality, Local Government and Communities Committee on the PSBs just before the summer recess, so we did have a snapshot from various organisations as to how well things were working. One point that was made by various witnesses was that we have several PSBs that aren't chaired by someone from a local authority. This can be a good thing, because we don't want the PSBs to feel as though they are dominated by the local authority. On the other hand, there is a potential problem in that, if they are not led by the local council, then the council may send a relatively junior figure to the PSB meetings, who may carry little delegated authority. This would obviously hinder the PSB from operating effectively. How do you think this problem can be resolved?

I hope that what we are seeing is a different dynamic with the public services boards. I believe that they're more constructive than the local service boards that preceded them. We've seen their local well-being plans. I think there's a broad variety there, which reflects the different ambitions from PSBs across Wales. I welcome that variety. I welcome the fact that PSBs are discharging their functions with a level of creativity and co-ordinated and joint working that perhaps has been missing from elements of the public sector in the past. I look forward to a period in front of the committee—I suspect it's later this month—and I look forward to debating these issues with you. I also look forward to understanding what the committee's evidence has been and its conclusions, and I look forward to reading the committee's report.

Yes. Thanks. We will see a variety of different working methods, I'm sure, and it may not be the same from one area to the next. Hopefully, they will work effectively. Now, the public services boards in Gwent—or what used to be Gwent—may be a good model. We were told on the committee that many PSBs in Gwent may be local authority led, but they don't feel as though they are local authority dominated. Another part of the public services boards is the voluntary organisations or the third sector, as we now often call them. A couple of the witnesses at the committee scrutiny said that PSBs have felt quite bureaucratic thus far, and haven't felt close to the third sector. Do you feel this to be the case, and how can this be improved going forward?

I don't want to use that sort of terminology to describe the way that PSBs are working. Can I say this? I think there is a great deal of complexity in the way we govern and the processes and structures that we have. One of my ambitions and objectives is to reduce our complexity in Government and to reduce the amount of governance, if you like, that we conduct in Wales. I want to see more streamlined structures that enable the public to hold clearly identifiable politicians to account for the decisions that they take, and I want to see public service workers feeling that there is very clear leadership from the political leadership locally and in this place. So, I want to see a far more streamlined way in which decisions are taken in Wales. I want to see fewer meetings and more action, and I hope that what the PSBs are doing is starting to deliver that. But I do feel that, having seen the well-being plans earlier in the summer, it is right and proper that we now allow those PSBs the freedom and the opportunity to deliver on the objectives that they have set themselves.

14:40

Minister, can you indicate how confident you are that, if a fire breaks out in a high-rise block of flats here in Wales, we won't see a tragedy that we saw in London?

Ever since the terrible tragedy at Grenfell Tower, Welsh Government has been working very hard, first of all, in the first instance, to identify all of our high-rise buildings, and then to work with those to understand whether or not they had the ACM cladding on them. So, I can confirm that Welsh Government now has a personal relationship, actually, with each of those high-rise buildings that we have in Wales to try and ensure that the residents within them are as safe as possible and that we're able to provide them with the best advice possible. We've been working very closely with the fire and rescue services and with the local authorities that have high-rise buildings in their areas in order to ensure that we can be as confident as possible about the safety of those buildings and the people living in them.

Thank you for the answer, but I'm frankly not as reassured as you. In our local government committee last week we heard evidence from the fire service, and they said there are people who are undertaking fire-risk assessments who are not competent, that people are taking off fire doors from flats and replacing them with those that are not as safe, and that there is no money for either the fire service or local authorities to monitor safety. In fact, three witnesses made it clear, because there was a lack of expertise, a lack of those resources, and confusion over responsibility across the board, that they weren't sure that they could be keeping the resources where they needed them to go.

I think it's worth me quoting one of those who came to give evidence, Dave Holland, head of shared regulatory services between Bridgend, Cardiff and the Vale of Glamorgan, who said, and I quote:

'In 1991, when the regulations first came in, it's an oddity that we had a community of capable enforcers in the trading standards service, reasonably well resourced, but a set of regulations that were difficult to apply. That's now turned itself upside down; we have a fairly robust set of regulations, but we don't have the competent enforcers and the resources anymore.'

Now, isn't it clear to you, and to me standing here, that, if we're going to cut council resources even more, they won't be able to get out onto the building sites, which they want to do? How can you be assured of the safety of residents if vital checks are simply not taking place?

I've taken a real interest in the evidence that your committee has received on this and I look forward to giving my own evidence to the committee next week. What I will say is much of the evidence that committee has heard only serves to reinforce the concerns that Dame Hackitt put forward in her report—so, issues about capacity, issues about the knowledge and expertise that there is in order to enforce and review and check that the correct safety measures are in place, and so forth, and even wider issues that I know the committee has heard about in terms of how can we make sure that what is designed and what is approved is actually what's been built. That has come through, I know, strongly in the evidence you received.

The First Minister asked me to chair and bring together a new expert group in order to advise us as to how we take forward those concerns that Dame Hackitt put forward in her review. So, how do we look at the concerns? Are they relevant to Wales? We believe they are. We think that the issues that she identified are as applicable in Wales and as important in Wales as they are in England, where the review took place. But also to explore whether her suggestions as to the way forward are the right suggestions and the right way forward for Wales—so, we need to be looking, really, at developing a whole-system approach that's coherent and complementary, with clear lines of responsibility, tight standards, monitoring and enforcement, and, of course, a real voice for the residents who live in these buildings as well. So, we're working to identify priorities, and I look forward to making a fuller statement on the work of the expert group in January, which will outline then a programme of work and a direction of travel going forward. But there's no complacency whatsoever in terms of how seriously Welsh Government takes building safety and the safety of residents. It's an absolute priority for us.

14:45

I look forward to hearing from that expert group, because I was sincerely disturbed by the fact that those council officers told us that they hadn't been out on site for 20 years, when they used to go out all the time. So, I would like for the message that you're giving here today to resonate throughout all the local councils here in Wales.

My third and final question is to do with the private sector. I've asked on many occasions what is happening in this regard. We know that you've given money to social housing—that's great and that's fair enough—but we know that leaseholders will be facing the bill, potentially, if they don't get support from Government. Some of these leaseholders may be on benefits, some of them have different roles and responsibilities in life, some of them just simply will not have the money to replace any cladding or any problems that emanate from those housing problems.

We've heard, again in committee, in evidence from Australia, that they have been able to get loans out and that they can pay that back through their council levy. That's happening in Australia at the moment. What schemes are you looking at so that we can help those people who are residents of Wales too? We cannot ignore the people who live in private housing who will need to be supported just as much as those people in social housing are.

Well, I would start off by saying that Welsh Government fundamentally disagrees with your assertion that it should be the leaseholders who pay for this. Welsh Government is clear, and has been clear throughout, that, actually, it's the building developers who should be responsible for the remediation work. And that's why I met with all of the developers and managing agents of the private sector high-rise buildings in Wales to ask them about their plans to remediate the ACM cladding issues, and to also make clear again the Welsh Government's position on funding this work—that we don't want to see the leaseholders left to pick up the bill. So, I'm pleased to report and see progress on two of the buildings, where work is either complete, pending certification or at an advanced stage and is anticipated to be finalised next month.

I also understand that further tests have been commissioned on ACM at a further two buildings, and, again, this is because we have a good relationship and a casework approach—we're being kept very up to date on progress there.

But I am frustrated, though, that, whilst plans have been drawn up to replace cladding on the remaining buildings, which are under one developer, action to do so isn't yet in place, and this is because of the financial complexities and the interplay between those interested parties. But, again, safety must come first and we've been very clear with them that we expect to see action soon. If there's not action taken soon, then, of course, Welsh Government will continue to liaise with the developers, but also with the relevant council and fire and rescue service on these matters, who do have significant enforcement powers should they be concerned about the safety of the residents. 

Local Councils Service Cuts

4. What advice will the Cabinet Secretary give to local councils that are facing service cuts? OAQ52691

I recognise the pressures on local authority budgets and the difficult decisions councils have to make. We will continue to engage with local authorities to address the challenges of austerity together in the wake of the budget that has been given to us. It is more important than ever that authorities engage local people on local priorities and in those decisions.

Thank you for that response. Of course, you will know as well as I do that the reality is that councils are facing the very difficult position of cutting services on the one hand and increasing council tax on the other, and Conwy council is the latest authority to have talked about increases of up to 11 per cent while, simultaneously, there are hardly any non-statutory services left to cut.

With councils on their knees and more cuts on the horizon next year, and given what’s happened to some authorities in England, such as Northampton, where they have failed to continue to deliver front-line services, can I ask whether the Welsh Government has a process in place to deal with such a situation if it were to arise in one of the local authorities of Wales? Would you be prepared for such a situation?

I wish to emphasise that I agree with your analysis that authorities are facing an extremely hard time, and one of the most difficult jobs in politics currently is that of leading local authorities—I have no doubt about that at all or about the challenges that they face. But may I say this, too: the policies that led to what occurred in Northampton are not being implemented in Wales. In Wales, we have a different policy, direction and philosophy—a philosophy that appreciates local authorities and decisions taken locally, and which appreciates the concept of taking decisions at a local level and the delivery of public services.

But, to answer your question with regard to the statute book, yes, we do have the powers necessary should a council collapse. We do have such powers, but I’m not certain that we have each of the powers required if that did not happen. It’s something that I have discussed with the—. We have the working group on the reform of local government, which has met in the last week, and one of the things we discussed is what would happen should a council face a challenge that it cannot resolve and is therefore in dire need of support. Whether we have each of the necessary powers, I’m not certain. That is something that we will address during the discussions on the next Bill, which will be introduced in February.

14:50

Cabinet Secretary, you've just acknowledged the difficult challenges that local authorities have across Wales, and I appreciate that, but rural local authorities receive the deepest cuts to their revenue support grant year on year. Powys County Council, for example, has received the joint deepest cut for the past 10 years. You will appreciate the challenges that rural local authorities have in delivering services across a large geographical area and the extra costs associated with that. So, what positive news can you give to rural local authorities in terms of the revenue support grant?

I'll make announcements on the revenue support grant next week. I understand the points that have been made, and I do certainly understand the pressures facing many rural authorities across the whole country in continuing to deliver excellent services across sometimes very sparsely populated geography. But I will say this to him: I was also sitting in two Valleys council offices last week, where I was told in no uncertain terms, with some very colourful language, that it was Valleys local authorities that had suffered the worst cuts and why this was. 

The impression I get, speaking to people across the whole country, is that there is this sense of, 'The cuts are harsher here than there.' What I will say to people, wherever they happen to live, whether it's in an urban area or a rural area, or north, south, east or west, is that we do have a way of delivering funding to local authorities that I believe is fair. We have met local authorities in two sessions in the last two weeks, in what we call the distribution sub-group and the finance sub-group—there are many of these meetings throughout the year—and I have not heard any request to fundamentally change the formula and change the way of funding.

The finance Secretary spoke at the WLGA council meeting last week and I do not believe that any request was made there to change the way in which we fund local authorities. Presiding Officer, we've had this debate on a number of occasions in this Chamber. I tell the Conservative group that their councillors do not want Conservative policies in Wales; they are delighted to have a Welsh Labour Government delivering support and funding to local authorities that Conservative councils in England could only dream of. So, when I meet Conservative councils, what they tell me is that what they need is a Labour Government.

Preventing Electrical Fires

5. Will the Cabinet Secretary provide an update on work to prevent electrical fires? OAQ52682

I published in-depth research on domestic electrical fires in July. Our fire and rescue authorities are working with us and with Electrical Safety First to understand their causes and to help prevent them.

I was really pleased to see a recent report that shows that fires in Wales are now at an all-time low. The research shows that they have been steadily declining over recent years, and the fire and rescue services have done some fantastic work through education and community engagement, and that has played a major part in that. But I am concerned to see the report that domestic electrical fires have bucked that trend and have actually increased. That mainly includes fires that originated in electrical supply in homes, such as wiring, fuse boards and sockets. Cabinet Secretary, in light of that finding, I'm eager to know what obligations private landlords have to ensure that their properties are as safe as possible from domestic electrical fires?  

14:55

The Member will be aware of the provisions that have been made under the recent renting homes legislation, and it is our intention to ensure that those provisions are enforced. If the Member has any evidence they're not being enforced, then I would be very happy to take that forward with her. What I will say is this: we've seen a significant decline in fires in the domestic setting in Wales for a long time, and they are now at an all-time low. Sustaining the trend requires a full understanding of the changing risks of fire. Presiding Officer, Members will be aware that I made a written statement on this matter before the summer recess, in July. We're continuing to work with fire and rescue authorities to ensure that we have both the understanding of why fires are being caused and why there's been an increase in electrical fires, and also to ensure that we're able to take the enforcement work necessary to ensure that people are protected in their homes.  

Joyce Watson has covered most of the bases of this question with her supplementary question. I've also read the same report and I think it was interesting if you look at what is not causing this rise in domestic fires as much as what is causing it—e-cigarettes have been ruled out, an ageing population has been ruled out, and smoking. So, it's a very specific increase, from a low base admittedly, in one specific area of fire as a whole in Wales. This must come back to raising awareness and it must come back to education. This can't simply be left to firefighters, who often have to pick up the pieces when it comes to dealing with the fire at the end of it. I wonder if you could tell us a little bit more, Cabinet Secretary, about how you intend to raise awareness and how you intend to educate the population, possibly working with the Cabinet Secretary for Education, possibly from an earlier age to make sure that people are aware of the dangers of out-of-date electrical installations, of the dangers of out-of-date equipment, and of the need to make sure that there is monitoring going on in the home to make sure that we eliminate all the possible causes of domestic fires.  

I absolutely agree with that. We have for some time funded three fire and rescue authorities in Wales to provide home safety checks completely free to householders. These checks will cover all aspects of fire safety, as well as other hazards such as falls, and I understand that there are something like 60,000 such checks taking place each year, and that focuses on the greatest risk of fire in the home. But the wider point made by the Member for Monmouthshire I think is well made. We have seen a decrease in the incidence of domestic fires, and that means that we do now need to ensure that we can continue to work to inform the population of ways in which they can ensure that their risk is reduced still further. The role of firefighters and the fire authorities in doing so I think remains quite central to that, and we are pursuing conversations with the firefighters and with the fire authorities about how we can do that, including looking at the changing role of firefighters for the future.   

Public Services Boards

6. What is the Cabinet Secretary’s assessment of the performance of public services boards? OAQ52668

Positive progress has been made by public services boards to meet their obligations under the Well-being of Future Generations (Wales) Act 2015. Now that all local well-being plans have been published, PSBs are now firmly focused on their delivery.

Cabinet Secretary, I appreciate that we've already touched on these issues in the Chamber today. I think it is clear that public services boards have a vital role to play in working with communities to work up their well-being plans and strategies, and then to make sure that they're properly implemented, working in that cross-cutting way across public sector bodies. And, of course, we have the work of the local authorities' scrutiny committees and, indeed, the future generations commissioner in ensuring that they are effective in that way. I just wonder what you would say about the role of Welsh Government in taking an overview of the effectiveness of the work of public services boards, and whether there is a need for that additional layer of scrutiny and help, if it's necessary, to make sure that, right across Wales, the public services boards are working effectively and efficiently.

15:00

We do, as a Government, provide a package of national support as well as a programme of targeted support for regional funding, and regular drop-in sessions to enable PSBs to test their emerging thinking. We also work with the future generation commissioner's office to ensure there's a consistency of approach to PSBs across the country. We're seeing some very positive early examples of this. I and the Member for Newport East will be aware that the Gwent PSBs are driving forward on their Thriving Places project and programme, and I'm looking forward to seeing that succeed. In Neath Port Talbot, the children's community projects pilot in Sandfields West is something where there's a very real focus being brought to bear in that community. The Presiding Officer will be especially interested in the work taking place in Ceredigion on climate change, and we look forward to seeing the results of that work.

But I think the Member does identify an important issue, and that is of scrutiny and to ensure that scrutiny does occur of the work of public services boards and that that is done in an appropriate way and an appropriate fashion. I hope his committee, when it reports on these matters, will reflect on these issues, and I certainly look forward to reading the report of the committee on this, and I undertake to take forward the considerations of the committee in a positive way.

Cabinet Secretary, one of the aims of the Caerphilly public services board is to improve the health of everyone living in this area and to require public bodies to think about the long-term impacts of their decisions to prevent persistent problems such as health inequalities. What advice would you give to Caerphilly public services board on how to react to the council's plans to close more than half of the leisure centres in the borough, with the effect of depriving people of convenient access to leisure facilities at a time when levels of childhood obesity in Caerphilly are above the Welsh national average, please?

It has long been my approach in this role not to comment on individual decisions of individual authorities; I don't think that's a right and proper way for a Minister to respond, or to provide commentary on the decisions of local authorities as we go forward. But I will say this—I will say that improving health outcomes is an absolutely essential role for all PSBs, and the way in which they do it will reflect the priorities of that particular area.

Youth Homelessness

7. Will the Cabinet Secretary provide an update on Welsh Government work to tackle youth homelessness? OAQ52675

Welsh Government commissioned the Wales Centre for Public Policy to produce research on youth homelessness prevention. Their report, due to be published next month, will help inform future policy and funding decisions, including the allocation of the previously announced additional £10 million for youth homelessness. 

I thank you for that, Cabinet Secretary. The launch of the new ministerial group in June, the purpose of which is to tackle youth homelessness and oversee the housing first projects, is a very welcome way forward, and it does demonstrate a commitment by the Welsh Government to ending youth homelessness, and working collaboratively will also help to achieve that aim. At the beginning of the year, I recall you saying that you had approved funding for a number of those projects within various local authorities and that those would be used for the first model in terms of that housing. I know that it's extremely early days, but I am keen to know if you have any feedback from those projects as yet and, if you do, how you intend to progress that and roll that out more widely across Wales.

Thank you very much for the question. We have been having regular feedback from those initial pilot projects, and we're using what we're learning from them now to fund a further series of what we're calling housing first trailblazer projects, and I was able to announce the first of those earlier on this week.

I'm aware, actually, of some discussions that are taking place in the Mid and West Wales region, particularly with one local authority and their partners, to explore how they could potentially bring forward a working housing first model. I very much welcome that and, obviously, offer any support Welsh Government can provide in those discussions, and encourage others within the region to come forward with their plans as well. It is important, as you say, that housing first takes a collaborative approach, which is why the ministerial task and finish group does contain or include representation from across Welsh Government, but also those organisations that work with young people and vulnerable people; the justice service is involved and so on. So, we will continue learning what we can from the pilot projects and having those discussions with the experts on the group to see how we can take things forward. I would encourage the local authorities who haven't yet rolled out or had the opportunity to roll out housing first in their area to look at the housing first principles, because it's important, actually, that we do stick to those principles.

I had the real privilege of meeting Dr Sam Tsemberis last week. He's the person who actually invented housing first in New York city. It was really good to have the discussion with him about how housing first as a model and an approach to supporting complex people with complex needs is just as relevant in New York city as it is to the most rural parts of Wales, and he was saying that the thing we have to remember is it's housing first, but not housing only. And, so, it's important that when local authorities and their partners are rolling out the housing first model they stick to the housing principles and also work in that collaborative way you described to ensure that the support is there for people at the point when they're ready to have it.

15:05
Allocating Money to Councils

8. What discussions has the Cabinet Secretary had regarding a needs-based formula for allocating money to councils? OAQ52674

We and local government continue to work in partnership to explore ways to improve the existing needs-based funding formula, to better reflect authorities’ relative need to spend.

Thank you, Cabinet Secretary. Since returning to this place, I've received a number of representations from local authorities in my own area, particularly in my own region and particularly in Powys, who contend that—and this will not be a new point made to you, I'm sure—the current formula creates difficulties for people in rural areas. For example, if you are a family on low wages living in rural Powys, you need two cars in order to be able to access employment at all. Will you continue to keep the formula under review, Cabinet Secretary, and will you give consideration, particularly with the concerns that people have about the potential impact of Brexit on rural Wales and on the rural economy—will you look again at some of those factors that might be indications of wealth in more urban communities, but are simply indications of survival in rural ones? 

The Presiding Officer will be aware that one of my first acts as a Member here back in 2007 was to undertake a review of rural poverty and deprivation in rural communities and the memory of that investigation stays with me today. We understand that poverty in rural Wales can be very different to poverty in urban communities. We understand that very well. The formula does seek to review those issues and does seek to ensure that all authorities receive fair funding that meets the needs that they have. We recognise that the quantum available to us this year and next year is not what we would wish it to be, and the responsibility for that lies not with the formula but with the failed austerity policies pursued by the United Kingdom Conservative Government. We were told by the Prime Minister this morning that austerity is over. My fear is Brexit will mean that, for rural Wales especially, austerity will be deepened and broadened and lengthened, and not ended in the way that the Prime Minister has somewhat naïvely believed.

3. Topical Questions

The next item is the topical questions, but no topical questions were submitted. 

4. 90-second Statements

So, we move to the 90-second statements. Mark Isherwood. 

Diolch, Llywydd. October is Cerebral Palsy Awareness Month, and next Saturday is awareness day. Cerebral palsy is the most common childhood disability in the world, affecting one in every 400 children across the UK. Around 70 babies born in Wales this year will have cerebral palsy. It affects posture and movement as a result of brain damage. It can also affect sensation, perception, cognition, communication, and eating and drinking. It makes activities such as walking, talking, dressing and fine motor skills, which most of us take for granted, difficult.

Well, Bobath children's therapy centre Wales, a specialist centre for the whole of Wales providing therapy for children who have cerebral palsy, are developing a cerebral palsy register. They would like Wales to have the benefits that other countries with registers do, such as: knowing the size and distribution of the population of individuals who have cerebral palsy in Wales; being able to map services against populations; the ability to plan care and services for a known population; the ability to incorporate hip surveillance into the register and reduce the incidence of dislocating hips and the need for surgery; being able to include Wales data and population research into cerebral palsy and interventions; and increasing the voice of people who have cerebral palsy.

We therefore call on the Welsh Government to help make this happen and engage with the cerebral palsy community and Bobath to help many children, parents, carers and families in Wales on this basis. Diolch.

15:10
Motions to elect Members to Committees

The next item is the motion to elect Members to committees, and, in accordance with Standing Orders 12.24 and 12.40, I propose that the motions to elect Members to committees are grouped for debate and voting. I call on a member of the Business Committee to move the motion formally—Julie James.

Motion NDM6822 Elin Jones

To propose that the National Assembly for Wales, in accordance with Standing Order 17.3, elects Caroline Jones (Independent) as a Member of the Culture, Welsh Language and Communications Committee in place of Neil Hamilton (United Kingdom Independence Party).

Motion NDM6823 Elin Jones

To propose that the National Assembly for Wales, in accordance with Standing Order 17.3, elects Neil Hamilton (United Kingdom Independence Party) as a Member of the Health, Social Care and Sport Committee.

Motions moved.

The proposal is to agree the motions. Does any Member object? The motions are therefore agreed in accordance with Standing Order 12.36.

Motions agreed in accordance with Standing Order 12.36.

5. Motion to amend Standing Orders

That brings us to our next item, which is the motion to amend Standing Orders. I call on a member of the Business Committee to move the motion formally—Julie James.

Motion NDM6817 Elin Jones

To propose that the National Assembly, in accordance with Standing Order 33.2:

1. Considers the Report of the Business Committee ‘Amending Standing Orders: Implementation of the European Union (Withdrawal) Act 2018’ laid in the Table Office on 26 September 2018.

2. Approves the proposal to revise Standing Orders 21 and 27, and to introduce new Standing Orders 30B and 30C, as set out in Annex B of the Report of the Business Committee.

Motion moved.

Thank you, Llywydd. I welcome the opportunity to speak on this debate about the changes to Standing Orders that arise as a consequence of the European Union (Withdrawal) Act 2018. In July, my committee reported on operational matters relating to the scrutiny of regulations that will arise as a result of the 2018 Act. We made 12 recommendations, nine of which had implications for Standing Orders.

Our report focused on three areas of the Act that enable the making of regulations by the Welsh Ministers and UK Ministers. First, we looked at the powers of the Welsh Ministers to deal with deficiencies in UK law arising from the UK’s withdrawal from the European Union, including the mechanism for a committee to sift certain regulations to see whether they should be subject to the affirmative rather than the negative procedure.

Secondly, we looked at the powers of UK Ministers to act in devolved areas and how they should be scrutinised. And, last but not least, we considered how we should scrutinise regulations made by UK Ministers to restrict the National Assembly’s legislative competence, having regard to the inter-governmental agreement between the Welsh and UK Governments.

Overall, we are content with the changes being made to Standing Orders and welcome that the Constitutional and Legislative Affairs Committee will take on responsibility for sifting regulations arising from the 2018 Act. I would, however, like to draw the Assembly’s attention to two aspects of the changes being made.  

In respect of our second recommendation, namely that criteria for sifting regulations should be published, we have since written to the Government, effectively accepting their proposal that they should be included in Standing Orders. This reflects an earlier recommendation in a report we published in February about the legislation as it was being scrutinised in the UK Parliament. 

We remain disappointed, however, that our third recommendation has not been reflected in the new Standing Order proposals. Our recommendation related to the sifting mechanisms and the circumstances in which the Welsh Government does not agree with a committee's recommendation to require the application of the affirmative procedure to the making of regulations, rather than the negative procedure. The aim of our recommendation was to require that the Welsh Government should make a statement explaining why they do not agree with a committee recommendation before the regulations are made—i.e signed into law. To that end, it sought to mirror provisions in the 2018 Act that apply to UK Ministers. The Act’s provisions did not apply to the Welsh Ministers because there was insufficient parliamentary time for the UK Government to obtain the National Assembly’s consent for the changes.

Having accepted our recommendation, the Welsh Government suggested an approach to the Business Committee, namely of laying a statement as part of the explanatory memorandum. For regulations subject to the negative procedure, an explanatory memorandum is laid after regulations are made. The Business Committee’s report on the changes to Standing Orders indicates that the benefits of our recommendation were outweighed by the practical advantages of the Welsh Government’s alternative proposal, which is now replicated in Standing Order 27.9B.

The timing of when a statement is laid may seem trivial, but the parliamentary process and trust in that process are a vital part of our democracy. There is a clear and important point of principle here, which is why it's important that this matter goes on the record. If the committee were to recommend to uplift regulations from negative to affirmative procedure, then under the proposed Standing Order, Assembly Members will only be made aware of a Welsh Government decision to reject the recommendation after the regulations have been made, and therefore signed into law. So, this potentially nullifies the purpose of the sifting mechanism. That mechanism was included in the 2018 Act as a means of preventing an excessive transfer of power from the legislature to the Executive. In our view, practical advantages of process should not be at the expense of constitutional propriety and good practice, so we have therefore sought a formal explanation from the Welsh Government for suggesting its alternative approach, and we look forward to receiving a written response in due course. We will also keep a close eye on the quality of the statements made by the Welsh Government as to why they disagree with a recommendation of the committee, if that situation arises. We note that poor-quality statements could increase the likelihood of Assembly Members tabling motions to annul negative resolution regulations. So, in the meantime, we intend to keep a watching brief on the impact of Standing Order 27.9B, and we may, if we consider it appropriate, suggest changes in the future.  

Turning briefly to two other matters, I'm very grateful to the leader of the house for advising us, in line with recommendation 4 of our report, that some 50 regulations will be required to correct deficiencies in domestic EU law, and we look forward to receiving an update on the number of regulations that will be required to correct deficiencies in directly applicable EU instruments. Planning our work programme to accommodate the increased number of regulations because of Brexit will be essential, and it is for that reason that recommendation 6 of our report suggested that we enter into an agreement with the Welsh Government about managing the scrutiny of Brexit-related regulations. It is therefore very pleasing that the committee and the Welsh Government have agreed the terms of a protocol to enable the scrutiny of correcting regulations to be as efficient and effective as possible. And I'd like to thank the Cabinet Secretary and the leader of the house for the very positive and constructive discussions that we've had, and we've been able to achieve what I think is an important, and groundbreaking for this Assembly, protocol. So, on behalf of the committee, I look forward to working with the Government on this important constitutional legislation and the challenges that we will be facing up to as a result of Brexit in due course.

The Deputy Presiding Officer (Ann Jones) took the Chair.

15:15

Thank you, Deputy Presiding Officer. Just simply to say that, of course, we hope that—. We're very happy to have worked very closely with the committee; we did indeed have a very constructive meeting about a number of these issues. On the one area that remains slightly contentious between us, we are, of course, very happy to provide an explanation to the Assembly as to our reasons, if we should decide not to follow the procedure recommended by the sifting committee. Of course we hope this will not happen. There will be numerous opportunities in the course of the discussion of the SI where an early warning system could possibly be put in place, and I am very happy to say to the Member, and to all of the Members of the Senedd, that we will keep this under close review, and should it prove to be any sort of problem, we will of course work with the committee to review the Standing Orders. But it's very much a stop-gap provision. We hope it will not happen. We consider that the inclusion of the information within the explanatory memorandum when the SI is laid will assist Members. They will have all the information in one place to decide on the response. They will have 40 non-recess days to table and lay an annulment motion, and the early warning system will list forthcoming negative resolution SIs in any event, so the committee will be able to identify those where a sifting recommendation has not been followed, should such a thing happen—which we very seriously hope it will not. So, on that basis, Deputy Presiding Officer, I commend the motion to the house.

Thank you. The proposal is to agree the motion. Does any Member object? No. Therefore, the motion is agreed in accordance with Standing Order 12.36.

Motion agreed in accordance with Standing Order 12.36.

6. Debate on the Petitions Committee report: Petition P-04-682 Routine Screening for Type 1 Diabetes in Children and Young People

We now move to item 6 on the agenda this afternoon, which is the debate on the Petitions Committee report, 'Petition P-04-682: Routine Screening for Type 1 Diabetes in Children and Young People'. I call on the Chair of the committee to move the motion. David Rowlands.

Motion NDM6814 David J. Rowlands

To propose that the National Assembly for Wales:

Notes the report of the Petitions Committee on Petition P-04-682, 'Routine Screening for Type 1 Diabetes in Children and Young People', which was laid in the Table Office on 13 July 2018.

Motion moved.

Diolch, Dirprwy Lywydd. I'm pleased to open this important debate on behalf of the Petitions Committee. The circumstances behind the petition that we are discussing today have been extremely moving for all the members of the committee. The petition was submitted by the family of Peter Baldwin. Peter, who was 13 and from Cardiff, tragically died in January 2015 from the effects of undiagnosed type 1 diabetes.

Type 1 diabetes is an autoimmune condition under which the pancreas does not produce insulin. The body requires insulin in order to convert glucose from food into energy and, without it, that glucose remains in the bloodstream leading to high blood sugar levels. Though type 1 diabetes can occur at any age, it is most commonly diagnosed under the age of 15. There are approximately 1,400 children with diabetes in Wales, the vast majority of which—around 96 per cent—have type 1 diabetes.

Some of us in this Chamber today will know that the onset of type 1 diabetes can be extremely rapid, as well as extremely dangerous. Unfortunately, awareness of type 1 diabetes and the most common symptoms of the condition do not have a high enough public profile, and improving both the recognition and the diagnosis of type 1 is the primary thrust of this petition. As the effects of undetected type 1 diabetes can be fatal, early diagnosis of the condition is absolutely critical. However, it is also the case that the common symptoms can easily be mistaken for other less dangerous conditions. Those symptoms—known as the four Ts—are crucial to this afternoon’s debate. They are: toilet; thirsty; tired; and thinner. And, I feel that, as we may have more than those people just in this Chamber listening to this debate, I'd like to reiterate those four Ts: toilet—an increased need to urinate; thirsty; tired; and thinner. Given that we would hope that we would have a wider audience than this Chamber, I shall again reiterate those points: toilet—an increased need to urinate; thirsty; tired; and thinner.

Because of the difficulties in diagnosing type 1, and because of its relative rarity, around a quarter of the cases are not diagnosed until the patient is in diabetic ketoacidosis—I'm sorry if I haven't said that correctly—or, commonly known as DKA. Tragically, this was the situation faced by Peter and his family. Peter was given an on-the-spot diagnosis of type 1 diabetes and DKA by a rapid-response paramedic who had used a finger-prick blood test, on New Year’s Day 2015. Twenty-four hours earlier, Peter had been seen by a GP who had diagnosed a chest infection, based upon his symptoms, and prescribed antibiotics, but who had not used a finger-prick test. The paramedic immediately called an ambulance, and Peter was admitted to hospital. Despite the treatment he received, it was too late to save his life.

I want to pay a tribute to Peter’s family at this point. The petition was submitted by Peter’s grandfather, Anthony, and the compassion, drive and clear-sightedness of the whole family has been apparent to the Petitions Committee through our deliberations. In particular, Peter’s parents, Beth and Stuart, and his sister, Lia, have courageously strived to ensure that the tragedy experienced by their family should lead to improvements for others. It is also notable how they have conducted their campaign in an extremely positive way. The petition is just one aspect of their efforts to raise public awareness of type 1 diabetes, as well as significant funds for Diabetes UK Cymru. I am convinced that these efforts have already had a major impact, and the whole family should be immensely proud of everything they have achieved so far.

Turning now to the committee’s report on the petition and to our recommendations, we have considered a wide range of issues in relation to the identification and diagnosis of type 1 diabetes among children and young people. The petition was first received in March 2016. Although the petition refers to 'routine screening' for type 1 amongst children and young people, the committee established that the Baldwin family’s primary focus is on the need to improve early diagnosis of type 1 diabetes, and awareness of the condition amongst both health professionals and the public. It has been agreed by all involved in the petition that this would be best achieved through ensuring that the appropriate tests are carried out when a person presents with the four Ts symptoms of type 1.

In our report on this petition we have made 10 recommendations to the Welsh Government. We believe these would assist the timely diagnosis and treatment of type 1 diabetes. The committee welcomes the fact that the Cabinet Secretary for Health and Social Services has accepted, at least in principle, all of our recommendations. We hope this indicates a shared commitment to making progress in this field, although I will be seeking some further information on some aspects of his response during this afternoon’s debate. 

As I have already said, timely diagnosis of type 1 diabetes is of critical importance. DKA is both a life-threatening condition and an extremely traumatic experience for children and their families. Indeed, the Welsh Government’s diabetes delivery plan highlights the need for an urgent blood glucose check and an immediate referral to specialist services if diabetes is suspected. However, our investigations identified several barriers to early diagnosis. These include: low general awareness and recognition of type 1; potential deficiencies in staff knowledge and training; and concerns over a lack of access to rapid testing equipment in primary care.

Our recommendations seek to address these barriers. Recommendation 1 calls for the Welsh Government to seek to ensure that the four Ts symptoms are routinely asked when unwell children present in primary care, and that appropriate testing is carried out if required. Our second recommendation relates to the implementation of the National Institute for Health and Care Excellence guidance on this subject. In accepting these recommendations, the Cabinet Secretary has endorsed the NICE guidance and emphasised the need for healthcare professionals to use their clinical judgment.

We are pleased, of course, that the Government has accepted the thrust of our recommendations. Nevertheless we know, not least from the case of Peter Baldwin, that clinicians do not always ask specifically about the four Ts and parents may not mention them without being prompted. I therefore want to reiterate the committee’s view that GP consultations represent a crucial opportunity to identify type 1 diabetes. We believe the Welsh Government should take all possible steps to ensure that the right questions are asked in primary care, in order to seek to avoid further cases where type 1 diabetes is not identified until it is too late.

In this regard, a major step forward during the lifetime of this petition has been the development of a national referral pathway for type 1 diabetes. It emphasises the four Ts and that any suspected case of type 1 diabetes should be treated as a medical emergency. Developed by the children and young people diabetes network, and piloted in Cardiff and Vale health board, this pathway has now been issued to all health boards. The committee welcomes the fact that this has been rolled out so quickly.

In accepting recommendation 6 in our report, the Cabinet Secretary has stated that the Welsh Government will seek assurances from health boards that the pathway is being adopted locally. I hope that he will also be able to confirm today that he expects health boards to offer training to GPs to accompany the new pathway, as we understand that this was a strength of the pilot exercise in Cardiff and Vale. 

Concerns were also raised with us about the availability of testing equipment in primary care. The petitioners have called for all GPs to have immediate access to finger-prick blood glucose testing equipment, and the committee recommended that the Welsh Government should seek assurances from health boards in this regard. We are pleased that the Welsh Government has accepted this recommendation. The Cabinet Secretary has stated that guidance has already been issued and that those assurances will be sought. The committee would welcome any update he can provide today on this work.

Recommendation 7 in our report referred to the need to monitor progress in relation to the diagnosis of type 1 diabetes. In his response, the Cabinet Secretary refers to the pre-existing national paediatric diabetes audit. The committee’s understanding is that this includes an indication of the number of cases diagnosed when DKA is already present. However, it doesn’t capture detail about the process of diagnosis and our recommendation seeks to challenge how the Government and health boards can monitor improvements at this stage of the process. Therefore, I ask the Cabinet Secretary to address how this monitoring could be conducted. One mechanism could be through the annual monitoring of the diabetes delivery plan. Whilst this plan highlights the importance of early detection of type 1 diabetes, the most recently published statement of progress lacks any detail about diagnosis. So, perhaps the Cabinet Secretary will consider how the Government can better report on progress in this area in future updates on the diabetes delivery plan.

The final matter raised by the Baldwin family and our report is public awareness of type 1 diabetes and its symptoms. We have recommended that the Welsh Government should do further work to highlight the symptoms of type 1 diabetes and to provide additional information in material provided to expectant and new parents, such as through the personal child health record, otherwise known as the 'red book'. 

Whilst both of our recommendations in this regard have been accepted in principle, the narrative supporting this does not appear to indicate much in the way of new or different activity. The justification given for us is that the symptoms of type 1 diabetes often appear some considerable time after birth. Well, whilst we acknowledge this is truth, however it is the committee’s view that parents are very receptive to child health messages in the early years and the four Ts are a simple message that can be easily retained, in the same way as has occurred with meningitis, for example. We and the petitioners would appreciate that the avenues for disseminating messages about the symptoms of type 1 diabetes to parents and others in contact with children and young people are fully explored. We consider this to be extremely important in the light of the need to act quickly when the signs of type 1 diabetes appear.

In conclusion, Llywydd, I want to emphasise that considering the circumstances of this petition has been both a very sobering and sad experience for the Petitions Committee but also a real privilege. The tremendous courage of Peter’s family in seeking to see positive change arise out of such terrible circumstances should command enormous respect. I thank them all on behalf of the Petitions Committee for their ongoing work. I also welcome the positive responses to our recommendations from the Cabinet Secretary, and I hope that he will give consideration to the additional points raised by the committee and by other Members this afternoon. Diolch yn fawr.

15:30

Can I first of all start off by congratulating David Rowlands on an excellent speech to open this very important debate, which summarises the situation very well indeed, and also the powerful campaign that we know has been run by the Baldwin family now for a long time because we do need change?

Now, I don't know if I've mentioned before that I've been a GP in Swansea for the last 34 years, but if I haven't, I put it out there again, and obviously type 1 diabetes, especially in very young children in their diabetic ketoacidosis phase, is really a terrifying disease that I get confronted with about once every seven years on average. You've just got to think about it as a GP and just check the blood sugar with a pinprick there, because the classic 4 Ts are not always there in a very young child, in the toddler and in the baby. The situation there is that a child can just present with a chest infection when the rest of the family have got a chest infection; the child can just present with diarrhoea and vomiting when the rest of the family have diarrhoea and vomiting. What makes you check the pinprick blood sugar? Well, there's an innate sort of gut feeling and stuff. So, yes, in older children, you have the 4 Ts: the children have been drinking gallons, they have been passing urine by the gallon, they have lost weight, they are ill and tired and feel dreadful. Those are the sorts of symptoms that we need to highlight and get out there, as David has very eloquently stated, in terms of awareness raising.

But in terms of the GP and the primary care response to this, we have to have pinprick glucometers on our desks, and in our medical bags when we do house calls. Because when there's an ill child, we check the blood sugar—it should be there automatically. Thinking ill child—and particularly a child who is more ill than I would think it should be with the diarrhoea and vomiting—check the blood sugar. Yes, about once every seven years, it's going to turn out to be diabetic ketoacidosis, rather than the ordinary gastroenteritis. But, as we hear, the tragic conclusions and legacy of not making that diagnosis lives with families, and the professionals concerned, forever more.

So, the main thrust is to run with the recommendations from an excellent report by the Petitions Committee. Frankly, in terms of pinpricks, and we're talking resources for primary care—the Cabinet Secretary will always know that I'm banging on about the shift of the resources to primary care—this should be happening anywhere. So, I'm not going to be particularly harsh on the Cabinet Secretary this afternoon. We should be having the pinprick glucometers, the glucose testing in practice anyway. Every GP should do that as a measure of professional excellence. And we owe it to our patients, because sometimes the clinical picture is not clear-cut—you just have an ill child. And I would recommend to my GP colleagues: an ill child, you can't work out what's going on—check the blood sugar.

Support the motion. Diolch yn fawr.

15:35

Type 1 diabetes is the most common chronic condition in children and young people. As we know, if left undiagnosed, it can be fatal. I commend the Petitions Committee for their work on this petition, and I welcome Welsh Government's response in accepting the majority of the committee's recommendations. One of the concerns raised by the Baldwin family and Diabetes UK Cymru was that there wasn't sufficient equipment in GP surgeries to allow them to check for type 1. I'm pleased the Welsh Government is committed to taking action on this point, by seeking assurances regarding the availability of equipment in primary care.

The recommendations touch on the importance of raising awareness of the symptoms of type 1 diabetes. I'm again pleased to see Welsh Government has taken steps to highlight the symptoms with health boards, but hope that this becomes a regular occurrence in future Welsh Government communications, and I'd be interested to hear more from the Cabinet Secretary today about how he intends to monitor that awareness.

In the meetings I have had with the family of Peter Baldwin, I have seen and heard how type 1 can devastate a family. I want to pay tribute to the Baldwin family for their tireless and courageous campaign to ensure that no other family suffers in the way that they have. Indeed, we know that the Know Type 1 campaign has already resulted in families being diagnosed safely with type 1. So, it has already saved lives.

We all in this Chamber have our part to play, not just those of us who are GPs. I hope that everyone in this Chamber is now aware of the 4 Ts of diabetes—toilet, thirsty, thinner and tired. And I encourage you all to spread this message as far and wide as you can.

I speak as another member of the Petitions Committee who heard the evidence that was given to us. Can I also thank Beth Baldwin for her commitment and tenacity on this subject? She and her family have courageously strived to ensure that the tragedy experienced by their family should lead to improvements in awareness and identification of type 1 diabetes in children. Without her, we would not be having this debate today. For that, we owe thanks to Beth Baldwin and her family. It is also notable how the Baldwin family have conducted their campaign in an extremely positive way. The petition is only one aspect of their efforts, and along with it they have continued to raise public awareness of the symptoms of type 1 diabetes and raise very significant funds for Diabetes UK Cymru. They should be immensely proud and, again, I would like to personally thank them, and I’m sure that the whole of this Chamber would.

Type 1 diabetes has touched my life twice: once with fatal consequences and once with a happy ending. Whilst working as a relatively young college lecturer, I had a student who continually drank water and frequently visited the toilet. He was generally fit and apparently healthy. He went away on holiday for two weeks one Easter, was taken ill, had complications as his diabetes had not been identified—it was too late, and then he died. The second case concerned someone who I worked with who also drank water continually. A colleague suggested he visited a doctor to be tested for diabetes. After several days of nagging—not just from the one colleague, but by the whole office, the original colleague kept on, but so did the rest of us, including me and others there—he made an appointment with the doctor. When he visited the doctor, he was treated as if he was wasting the doctor’s time—he was young, fit and slim, active, weight lifting, doing all the things that young fit men do. The doctor eventually agreed to test him for diabetes. Twenty-four hours later, he was in hospital. He is now back to normal and with his diabetes under control. He owes his life to his colleagues and his own tenacity.

Diabetes is a serious lifelong condition where your blood glucose level is too high, although I’ve been told by people—I’m sure other people have—‘I’ve got a bit of diabetes’, as if it was a cold or a minor virus they were suffering from. We know the common warning signs—as I say, we know the four Ts—but does everybody out there know them? And I think that's a challenge to all of us: if you’re going to do something useful in society, it’s to get across as often as you possibly can—thirsty, tired, toilet, thinning—'Any two out of four, go and get it checked.' Most likely, it isn't diabetes, but the result of you not testing it can be fatal.

I welcome the Government’s response when they say the importance of the early detection of type 1 diabetes is acknowledged in their diabetes delivery plan for Wales. There are clear guidelines in place to support healthcare professionals in the investigation of suspected diabetes, and the complications of diabetes are reported as part of the national paediatric diabetes audit. I further welcome the acceptance that the Welsh Government should seek assurance from health boards that appropriate blood glucose testing equipment is available in all relevant primary care settings and that all GPs have access to equipment that will help to identify potential cases of type 1 diabetes upon presentation.

The key is to work with health boards and other key partners to ensure that the four Ts campaign is promoted. But it’s not just in hospitals, it’s not just amongst health professionals—other partners are needed in schools and colleges. School and college staff need to know what to look for. Can I just say how much I wish I had known what to look for that time, as I’m sure my colleagues do? I do not want a case like the first one I described for anyone else to be talking about. Thank you.

15:40

I’d like to thank the chairman for presenting our committee report in the manner he did, and thank the clerk and my fellow Petitions Committee for actually having such a proactive approach on this issue. Acknowledgement must go to the late Peter Baldwin’s family for helping our committee and for seeking to use their own tragic circumstances to ensure no other family has to endure such a devastating loss.

I am pleased to see that the Welsh Government intends to accept in principle the 10 recommendations made by the Petitions Committee, and I have confidence that if these are implemented, the detection rates of type 1 diabetes can be improved to prevent families like the Baldwins from undergoing the tragedy of losing loved ones to misdetection.

Approximately 1,400 children have diabetes in Wales, 96 per cent of which have type 1. The key aim of this report is to make sure that when any child shows symptoms of the four Ts—toilet, thirsty, tired and thinner—they get the right diagnostics. By making sure children and young people get a quick diagnosis and early treatment, we can avoid them becoming seriously ill with diabetic ketoacidosis. What we need is for GPs to be aware of the symptoms and considering that the test is so inexpensive to test children who show any sign of these symptoms. I would also like to see the Cabinet Secretary increase his own department’s awareness of the scale of this problem, so that no child ever is let down because a simple test was not administered.

Recommendation 3 sees the Welsh Government commit to seek assurances regarding the availability of glucose meters in primary care. I'm really grateful that this recommendation has been accepted. However, I am concerned that the Cabinet Secretary finds no financial implications to this. The Welsh Government should be ensuring that all GP surgeries have at least one testing kit. There are nearly 435 GP practices in Wales. And, at a little cost, I would say the financial implications would be worth you ensuring—your department ensuring—that there is one in every single practice. Every single one of these needs this testing kit.

Recommendation 7 asks that the Welsh Government implement a means to monitor improvement with regard to diagnosis of type 1 diabetes. The Cabinet Secretary advised that the diagnosis of type 1 diabetes is monitored and reported through the national paediatric diabetes audit. However, for reference, information in the report from the NPDA highlights that, in England, diabetic ketoacidosis occurred in just over 20 per cent of new cases of type 1 diabetes, a figure that has only risen slightly between 2012 and 2015. Alternatively, the figures given for Wales fluctuate from 30 per cent to 18 per cent to 24 per cent, all in a three-year period. So, if I was the Cabinet Secretary, I would be wanting to find out more about that. So, this makes me question whether the NPDA has access to the appropriate information and whether the Welsh Government should do more to find out why these numbers fluctuate in the way they do.

This is a common occurrence throughout the Cabinet Secretary's response, whereby recommendations are accepted 'in principle' only to be passed over to other organisations or charities. Diabetes UK Cymru claims that Wales has the highest prevalence of diabetes in the UK. Therefore, the Welsh Government should do more, should accept more responsibility and be more proactive. Let's not forget that this petition started because a family lost a son due to missed diagnosis and not giving a simple and inexpensive test much sooner. Overall, I am glad that the Cabinet Secretary accepted or accepted in principle all the recommendations. It is however very important that we improve and monitor the processes we rely on in detecting diabetes as soon as possible. 

Peter's legacy will live on through the work that you have done, though the awareness you've raised here in this Senedd and throughout Wales. Diolch yn fawr iawn. Thank you.

15:45

Thank you very much, Deputy Presiding Officer, for calling me to speak in this very important debate on the Petition Committee's report on the routine screening for type 1 diabetes in children and young people. Firstly, like everybody else, I'd like to thank my constituent Beth Baldwin for all the hard work she's put into getting this petition to the point where we're debating it now here in the Assembly. I know it's been a long hard road for her, and the tragic circumstances in which she lost Peter, who was just 13 when he died, I know, have been—. It's from that we are here debating this issue here today. I know that Stuart and Lia are also here, because this has been a huge effort by this family. I'm so glad that they're here in the public gallery today to hear us debating these very important issues. I hope these will be preventative—we will help prevent something happening that's happened so terribly to them. I'm sure that the Cabinet Secretary, when he replies, will agree that Beth and her family have shown amazing courage in campaigning on this issue. 

Peter had type 1 diabetes, but the diagnosis, as others have said, was missed by the GP and, by the time his condition had deteriorated so much that it was an emergency, it was sadly too late to save him. What Beth and the people at Diabetes Cymru and the Children and Young People's Wales Diabetes Network want is quite simple: they want any medical professional or anyone who comes into contact with an ill young person to stop and think, 'Do the symptoms point to type 1 diabetes?' I think Dai Lloyd raised that very strongly in his contribution. 

I know that Beth and the campaigners are pleased that the Government has accepted or accepted in principle all the recommendations in the committee's report. I think it's important to recognise that it is one of the most common chronic childhood diseases and its incidence is increasing. I think there is an average of one child per school in Wales that has this condition, and the number is rising by about 4 per cent each year, and rising more rapidly in children under five. Beth and the campaigners would like to see health visitors, physiotherapists, GPs and practice nurses carry out the routine simple finger-prick test to see blood glucose levels. At the moment, 25 per cent of cases of type 1 in children are diagnosed in an emergency. With more routine testing, I'm sure that we would all agree that the figure must decrease. 

They want to know that there are enough blood glucose testing kits for these people to routinely test unwell people, so we need to know that those kits are there, and I'm pleased to see that the Welsh Government accepts recommendation 3 of the report on this point. Yes, guidance about testing at the point of care has been issued, and this has been reiterated as part of the referral pathway, but who is tasked with monitoring the availability of blood glucose testing equipment, not just as a one-off but on an ongoing basis? Who will they report to, and will this information be publicly available? I don't know if the Cabinet Secretary would be able to answer those questions.

Do we know how many GP practices currently do not have the equipment they need to carry out the single test and analyse the results? I've heard anecdotal evidence that, even now, GP practices sometimes struggle to find the testing equipment. It may be in the back of a cupboard. Test strips may be out of date, or staff haven't done a test in such a long time that they're not confident in using the equipment. So, I think we've got to make absolutely sure—we've made such a lot of progress, but we've got to make sure that, practically, it is possible to carry out the test in the way that the campaigners want. 

So, the other issue is, in terms of when things go wrong, who is accountable? I think that, through this debate, through this very good report from the Petitions Committee, we have been able to highlight these issues that are so important, and I'd really like to end, really, once again by thanking Beth, thanking Stuart and Lia, for all that they've done for taking this cause forward—so, diolch yn fawr.  

15:50

As the chair of the cross-party group on diabetes, I'd like to thank the Petitions Committee and all those who were involved in the journey of this petition through the Assembly. I'd particularly like to pay tribute to the Baldwin family for their hard work, tenacity and dedication to such an important and very personal campaign. Beth and the family are watching from the gallery today, and I know that they feel it's been a huge team effort. You cannot underestimate the power of sharing your experiences of the devastating loss of Peter. You have shown such strength and courage throughout this campaign. We're all really proud of you, and Peter would be so proud, too. Like many others, I've been touched by the stories of children who have been saved because they were able to get diagnosis as a result of your work, so I thank you, Beth, and your family, for everything you've done in Peter's name. It's a really beautiful legacy.   

I'm glad that the Welsh Government responded so positively to the report from the Petitions Committee, and that the Cabinet Secretary has given the recommendations the consideration that they deserve. Type 1 diabetes is the most common autoimmune condition in the UK. it's estimated that around 19,000 people are living with type 1 diabetes in Wales. Many people live well with type 1 diabetes for many years. Countless people have also shown that type 1 is no barrier to living active lives, from individuals running marathons to Team Oarstruck from Caerleon rowing the Atlantic, the hardest rowing race in the world.

Key to living well with type 1 is good management of the condition, and this can only be achieved if the person knows that they have it. Diagnosis is absolutely critical. And yet one in four children in Wales are diagnosed with type 1 later than they could have been. I'm sure everyone here will agree that this number is too high. We know that there have been improvements within our health service. I've recently heard of work being carried out on a new reporting system that will ensure that lessons are learned from late diagnosis. By sharing information across teams, I hope that missed opportunities to diagnose earlier will be taken in the future. I've also heard of excellent research being done here in Wales on whether digital prompts in primary care could improve the rates of earlier diagnosis. I hope that this will be successful in supporting doctors in early diagnosis.

We can also be pleased that a new pathway has been rolled out across Wales, as stated in the written response from Welsh Government. I'd like to acknowledge the brilliant work being done by the Children and Young People's Diabetes Network in making this a reality. The implementation of the pathway will be key to its success, and I'm glad that the Cabinet Secretary has committed to seek assurances from all seven health boards that this is being adopted and that primary and secondary care will be working together on the delivery of the new pathway.

But, as ever, more can be done. I believe that we all agree that every child, every young person, deserves the opportunity to live a happy, healthy life, with or without diabetes. The 4 Ts campaign— thirsty, tired, toilet, thinner—to raise awareness of the symptoms of type 1, has been well received by healthcare professionals, families and schools, but no organisation, doctor or family can solve this issue alone. That's why I hope the Cabinet Secretary will again commit to working with health boards and other key organisations to ensure that the 4 Ts campaign is promoted in all appropriate settings.

There have been a number of studies looking at the effectiveness of awareness campaigns, and their findings suggest that the most targeted campaigns have the biggest impact. Simple messages can save lives, and today's petition is a call for action, and Wales can lead the way.

15:55

Thank you. Can I now call on the Cabinet Secretary for Health and Social Services, Vaughan Gething?

Thank you, Deputy Presiding Officer. I'd like to start by apologising to the Chamber for being late for the first minute of this debate, but in particular to apologise to Peter's family for missing part of what is a very important and emotionally charged debate about the work done by Assembly Members considering their petition, and indeed not just the response by the Government but more importantly the response of our national health service. And so I would like to thank the Petitions Committee and every Member who's contributed today, whether on the committee or not. Many others have been struck by not just the story of Peter Baldwin but actually that determination to then try to make sure that the family's determination to make sure that it leads to improvement actually drives the conduct of politicians in this place and beyond. 

And that's been helped by the work of the petitioner and the wider family, together with Diabetes UK Cymru, to help improve awareness of type 1 diabetes amongst the public and, crucially, amongst healthcare professionals in Wales. And all of us can empathise with the grief and the upset for Peter Baldwin's family, but, more than that, like every other Member who has spoken and those who have not, I really do admire the courage that the family has shown in talking about their experience, which is difficult and painful in itself, but in trying to make a difference for other families too. 

The Welsh Government notes the report and the motion, which we will be supporting. We did not support the original petition, because of the absence of evidence for the effectiveness of a population screening programme. And that's a point that's been acknowledged through the life of the petition and the committee's work by both the petitioner and Diabetes UK Cymru. However, I do welcome the specific recommendations that were made by the committee after their inquiry. Again, like other Members, I acknowledge the importance of the early detection of type 1 diabetes and, as has been said, it does feature prominently in the diabetes delivery plan for Wales. So, I was pleased to accept or accept in principle all of the recommendations made by the committee. They are very much in line with work that is already under way or has been completed by health boards in Wales to improve diabetes care.

We accept in principle recommendation 1. The Government endorses the recommendations of the National Institute for Health and Care Excellence, NICE, and that does guide healthcare professionals and organisations on the identification and investigation of suspected diabetes. But their guidance does not recommend that all unwell children are asked about the symptoms of type 1 diabetes. As the Chair said in his introduction, clinicians must use their clinical judgment, based on their training and available guidance, to guide investigations of unwell children, and that includes the additional training that we are rolling out through the service. And that is consistent with Diabetes UK Cymru's evidence that finger-prick testing should follow if any of the symptoms are present.

Health boards in Wales have routine processes for disseminating NICE guidance, and clinicians are aware of their responsibilities in relation to the use of such guidance. In addition, the referral pathway has been issued to all health boards, and that reinforces the criteria and the approach to the assessment of suspected diabetes amongst children and young people. The diabetes delivery plan for Wales commits us to a public awareness-raising campaign led by Diabetes UK Cymru as partners on the diabetes implementation group, and that has been delivered in conjunction with Diabetes UK Cymru, the petitioner and the wider family.

The Welsh Government accepts recommendation 2, as a national referral pathway based on NICE guidance, as well as awareness of materials developed by Diabetes UK Cymru, has been issued to every health board.

The Welsh Government also accepts recommendation 3, and this is a point that a number of Members referred to in their contributions. The guidance on point-of-care testing has already been issued to health boards, and it was recently reiterated as part of the dissemination of the referral pathway. The Welsh Government is seeking assurance from assistant medical directors for primary care regarding the availability of glucose meters in primary care. Our understanding is that they are widely available, but assistant medical directors are considering a survey for all practices to include this point-of-care testing equipment, and I'll be happy to report back to Members on this point to confirm the action taking place to provide that reassurance, but also the results of that exercise.

The Welsh Government accepts recommendations 4, 5 and 6. We've already written to health boards regarding the national referral pathway and, in doing so, we've highlighted the availability of awareness-raising materials and e-learning for type 1 diabetes in children and young people. That includes specific training provided for GPs by the Primary Care Diabetes Society.

The Welsh Government accepts recommendation 7, as a diagnosis of type 1 diabetes is monitored and reported to the national paediatric diabetes audit.

We also accept recommendation 8. Health boards should already report suboptimal diagnosis as patient safety incidents. That's not so much about that accountability; it's actually to promote learning amongst healthcare professionals. It's in our interest for healthcare professionals to be open when things have gone wrong, to learn, and to try to make sure that we actually reduce, minimise and eliminate those incidents in the future.

We accept, in principle, recommendation 9, and this was dealt with in the Chair's initial contribution. The provision of symptom information to parents during pregnancy or early years for what is acknowledged as a relatively uncommon condition—and it typically presents long after childbirth. So, the available evidence is that it's unlikely to support the earlier identification of type 1 diabetes. However, Diabetes UK Cymru has delivered a public awareness campaign, as committed to in the diabetes delivery plan, and we do want to help draw parents' attention to the relevant symptoms.

We also accept, in principle, recommendation 10. We will continue to work with partners to promote the four Ts: thirst, tired, toilet and thinner. We've already included it as part of the referral pathway for healthcare professionals. However, in terms of creating awareness in early years and education settings, we have to be mindful that there isn't always the evidence to support that being an effective campaign for the early identification of conditions like type 1 diabetes. A recent study from New Zealand has shown no effect following a two-year public information campaign, but we will continue to look for ways to ensure that appropriate staff, including those who work directly with children and young people, like health visitors and school nurses, are aware of key resources issued by Diabetes UK Cymru and others, and, of course, of the relevant NICE recommendations.

I want to finish, again, by recognising that we're here today because of a very personal tragedy, but more than that, the determination of Peter Baldwin's family to make a difference, and they have already made a considerable difference. We will continue to listen to the evidence and to learn from what we are already committed to do, and I look forward to further scrutiny on what we and our NHS are doing and will do and, crucially, to see what difference we have made and what more we can still do.

16:00

Thank you. Can I now call on the Chair of the Petitions Committee, David Rowlands, to reply to the debate?

16:05

First of all, can I thank all the Members for their contributions? I must say that there is one theme that ran throughout each of your contributions and that's the availability of the equipment in order to be able to test for type 1 diabetes. 

Dai Lloyd brought his considerable experience, obviously, as a GP, to the debate and spoke of the necessity to test every child who presents with some or all of the symptoms. But it is true, and we must remember this, that any GP, throughout his lifetime, may only see a handful of type 1 diabetes patients present to him, although, of course, over the coming years, that's likely to increase. So, I must say that we have to not allow this debate to die or for any of the recommendations to slowly melt away. This must be an ongoing debate and an ongoing business of education with all GPs and front-line practice nurses as well.

Lynne Neagle, obviously, again, spoke about testing equipment and being there for primary care providers and also, of course, as all the contributors did, paid tribute to the Baldwin family. Again, Mike Hedges did that as well and also made the point of us making sure that the equipment and the knowledge are made available in our schools and colleges in particular. Janet Finch-Saunders was glad that the Cabinet Secretary had accepted and adopted many of our recommendations, but she said that many things are still not as good as they should be and that matters are not particularly improving at this moment. Julie Morgan, of course, who knows the family well, again spoke about their courage in bringing this matter forward and the work that they continue to do in order to raise awareness of this appalling infliction. Jayne Bryant again thanked the family for their strength and courage, and she spoke about children who already have been saved by the work, and I think the Baldwin family ought to take congratulations for the fact that what they're doing is already saving lives.

I'd like, now, to just speak about what the Cabinet Secretary has said on these matters, but I'd like to ask him: are further actions to ensure symptoms are asked about in primary care ongoing at this moment in time? And, were the NICE guidelines in place when this tragedy actually happened, because you seem to have placed a great deal of emphasis on NICE guidelines? And, whether he expects training to be provided to GPs alongside the new diabetes referral pathway. What places are in progress in order to diagnose the delivery—the progress on diagnosis in the diabetes delivery plan?

Llywydd, I very much hope that this debate and the petitions process as a whole have been a positive experience for Beth, Stuart, Lia and the rest of Peter’s family and friends. I hope that we, as an Assembly, have been able to help to support their drive to improve awareness of the symptoms of type 1 diabetes and its diagnosis. I want to wish the family all the best in their continuing fundraising and awareness-raising efforts on this issue and to thank them for truly honouring Peter’s memory in this way. Diolch yn fawr.

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

Motion agreed in accordance with Standing Order 12.36.

7. Member Debate under Standing Order 11.21(iv): Baby Loss

Item 7 on our agenda this afternoon is the Member debate under Standing Order 11.21(iv) on baby loss, and I call on Lynne Neagle to move the motion—Lynne.

16:10

Motion NDM6801 Lynne Neagle, David Rees, Adam Price

Supported by Angela Burns, Dai Lloyd, Helen Mary Jones, Jayne Bryant

To propose that the National Assembly for Wales:

1. Recognises that, in 2016, 263 infants died or were stillborn in Wales and that families who are affected by baby loss often cannot access appropriate services or support.

2. Welcomes Baby Loss Awareness week, which is organised by a collation of more than 60 charities throughout the UK and will take place from 9 to 15 October 2018 providing an opportunity to raise awareness about the importance of excellent bereavement care for all parents after pregnancy loss or the death of a baby.

3. Recognises that Baby Loss Awareness Week also provides an important opportunity for bereaved parents, and their families and friends, to unite and commemorate their babies’ lives.

4. Recognises that all bereaved parents should receive the same high standard of care when a baby dies, and that while good care cannot remove parents’ pain and grief, it can help parents through this devastating time.

5. Calls on the Welsh Government to take action to improve the care that parents receive after pregnancy or baby loss by:

a) committing to improve and deliver better bereavement care which can be accessed by all parents after pregnancy or baby loss;

b) adopting the core set of standards for bereavement care which have been used to underpin the National Bereavement Care Pathway in other areas of the UK;

c) working with NHS Wales to ensure all staff who come into contact with bereaved parents receive bereavement care training.

Motion moved.

Thank you, Deputy Presiding Officer. I'm grateful for the opportunity to open this individual Member debate on pregnancy and baby loss. Sadly, pregnancy loss and the death of a baby are not rare events. One in four pregnancies end in miscarriage, and, across the UK, 15 babies die every day either before, during or shortly after birth, meaning thousands of parents go through the tragedy of their baby dying.

Most childhood deaths in the UK occur within the first year of life. Neonatal deaths—the death of a baby within the first four weeks of life—account for between 70 per cent and 80 per cent of all infant deaths across the UK. And, in Wales, in 2016, the families of 263 infants went through the devastation of their baby dying or being born stillborn. This means that the vast majority of parents who will need support for the death of a child are parents of very young babies aged 28 days or younger. The quality of care that bereaved families receive after pregnancy loss or the death of a baby is key to their recovery. Good care cannot remove the pain and grief of parents, but it can help them through the tragedy. In contrast, poor care can significantly add to their distress. That is why today's motion is calling on the Welsh Government to take action to improve the care that parents receive after pregnancy or baby loss, to ensure families can access appropriate services or support.

The difficulties families face in accessing bereavement services following a miscarriage or stillbirth is not a new issue for us in Wales. Only last week, Welsh Government was presented with a report calling for better access to specialists and more compassionate care for women who suffer miscarriages. The report, making the case for better miscarriage care in Wales, outlines perspectives from women about the care they had received after having a miscarriage. Among its recommendations, it calls for greater levels of psychological and emotional support, and the creation of two dedicated recurrent pregnancy loss clinics in Wales.

The committee I chair, the Children, Young People and Education Committee, heard about the lack of psychological support for neonatal and bereaved parents in its recent inquiry into perinatal mental health. Public Health Wales told us that the effects the loss of a baby has on maternal mental health were well recognised, and highlighted the Royal College of Midwives's call for specialist bereavement midwives to support families. The Royal College of Obstetricians and Gynaecologists told us that its UK-wide survey of women who had experienced perinatal mental health problems found that some respondents who had experienced miscarriages and stillbirths did not feel there'd been enough support following these events or in subsequent pregnancies. And the Royal College of GPs told us that bereavement by miscarriage, stillbirth or neonatal death is more likely to lead to mental health problems in both parents.

And yet, we heard that on occasions where women were offered support, often, their partners were denied it, with many women reporting feeling that there was an assumption that these events did not affect men in the same way they do women. We also heard that some women reported not being offered any bereavement support, despite asking for it, or receiving it too long after the event. This is clearly not acceptable.

The Children, Young People and Education Committee's report into perinatal mental health was published in October last year. Among our recommendations was a call for Welsh Government to outline how it expects the lack of psychological support for neonatal and bereaved parents to be addressed, and standards to be met, and what steps it will take if compliance with the standards is not achieved. The third edition of the all-Wales neonatal standards was published in May—longer than we had hoped it would take in committee. There is a reference in the standards, which all health boards should be working to achieve, to psychological support for parents. The standards state that timely access to psychological support is vital to prevent any impact on a parent's mental health, and that each neonatal unit should ensure there are enough psychologists, counsellors and other mental health workers available, so that parents, siblings and staff have access to support.

In a briefing from Bliss, the charity for babies born premature or sick, they state that, despite these clear requirements in the standards, they have found that parents in more than half of neonatal units have had no access to psychological support and none of the three neonatal intensive care units has a dedicated mental health worker. This is clearly not good enough, and an issue I will be taking up with the Welsh Government now that the new standards have been published, as part of the follow-up work that the committee is doing on our inquiry into perinatal mental health. That is why I'm glad to have this opportunity to raise the issue again today. I'm grateful too to my co-submitters—David Rees and new father and new leader of Plaid Cymru, Adam Price—in supporting this motion, and also all the Members who have indicated their support for it.

Next week is Baby Loss Awareness Week across the UK. It will run from 9 to 15 October. It is organised by an alliance of more than 60 charities, working to raise awareness of the importance of excellent bereavement care for all parents after pregnancy loss or the death of a baby. Throughout the week, bereaved parents, their families and friends unite with each other and others to commemorate the lives of babies who died during pregnancy, at or soon after birth, and in infancy. A light-a-candle event is being sponsored by my colleague Mark Drakeford in the main hall of the Pierhead on Wednesday 10 October, from 12:15 to 12:45, as part of Baby Loss Awareness Week, and I hope that lots of Members will join that event.

The organisations behind Baby Loss Awareness Week and behind the motion I'm moving today are calling on healthcare professionals, policy makers and parliamentarians to make sure that parents who experience pregnancy or baby loss get the best possible support, wherever they live, when they need it. The quality of care for bereaved parents should not be a lottery. The parents of Wales deserve better. That is why this motion calls on the Welsh Government and NHS Wales to take definitive action to improve the care that parents receive after baby loss.

I understand that England and Scotland have made significant progress in the past 18 months to develop and deliver a national bereavement care pathway designed to improve the quality of care experienced by parents and families at all stages of pregnancy and baby loss. The pathway includes resources, toolkits and training for professionals. It must not be beyond us in Wales to ensure that our parents also receive good-quality care after pregnancy or baby loss. That is why this motion today calls on Welsh Government and NHS Wales to adopt a core set of minimum standards of bereavement care for those parents who have experienced baby loss.

While much more needs to be done to support families whose babies have died, there are some fantastic initiatives in Wales. One such scheme is the neonatal bereavement support provided by the neonatal outreach team at Hywel Dda Local Health Board. Surely, it is incumbent on us to insist on quality support for all parents after pregnancy or baby loss. It's time to stop talking and do something, and I hope that all Members will support this motion today.  

16:15

Well, there are some powerful presentations this afternoon—in the previous debate and this one. I'm grateful to Lynne Neagle for opening this important debate because it is with pride and honour that I speak in this debate, in support of the motion and in celebration of all of the work done in this difficult field. But, so much more needs to be done to provide extra resources for all the nurses, doctors, midwives, bereavement counsellors, neonatal units and all the charities. Services are so stretched and, really, I have to say, I am in awe of all of you providing services out there.

On 9 November 1985, our first-born baby son, Huw, died, 40 minutes after he was born, in my wife's arms. We had one rushed Polaroid picture of him. A postmortem followed, and then, a few days afterwards, the funeral. It's all a bit of a blur now, really, because after the funeral, I had to go straight back to do a surgery in Fforestfach. Huw lies buried in an unmarked grave in Morriston cemetery today, like so many other little babies. 

At the time, nobody could talk to us about this tragedy. Our families clammed up. My staff in the surgery were specifically instructed by my GP partners not to talk about Huw. But, what a fantastic bereavement counsellor we had. It does make you think, 'Why us? Why Huw?', and you can subside into self-pity, or you can say to yourself, 'This tragedy is not going to define my whole life.' Huw's short life certainly made me think about life, its meaning, what you can accomplish in 40 minutes, what you can contribute to humanity in warmth, compassion and kindness that other people, like Huw, never have the chance to make any contribution—only to kick-start me to also contribute on his behalf.

He is not forgotten. Our actions as his parents are in tribute to him; his life that could not contribute, but sparked others. I became a better doctor after this tragedy. My counselling now had the depth of lived experience rather than just being lifted from the educated text. Because people do not know what to say in tragedy when they were facing me and my wife. I say now to people—they don't know what to say, and I say, 'Just say, "I am so sorry." Don't walk away. Don't turn your back. "I am so sorry." There are no words', I counsel, 'And "I will listen when you want to talk."' Never turn your back on somebody who has faced tragedy.

Huw challenged, in his 40 minutes, me to do his bit, and not stay a victim but live as a tribute to him. Three wonderful children followed and on 9 November last year, our first grandson, Dyfan, was born.

In conclusion, as Plaid AMs we often say that we stand on the shoulders of the giants of Welsh history here in the Senedd, keeping the flame of Wales alive. We also stand on the shoulders of those who would dearly have loved to make a contribution but could not. Diolch yn fawr.

16:20

I'm pleased to have the opportunity to speak on this motion ahead of Baby Loss Awareness Week. No-one can underestimate the impact of pregnancy loss or the death of a baby. Feeling able or allowed to grieve can be incredibly difficult, particularly in the months and years after. One mother told me that special remembrance services bring such comfort because it's when families can allow their emotions to come out and commemorate the baby's life. Services will be taking place across Wales next week helping to bring together families who have experienced similar losses.

As today's motion sets out, it's crucial that families who are affected by pregnancy or baby loss can access appropriate services and support, and we've already heard that there's a disparity in access to services across Wales. In Newport we have some excellent support groups, and one of those is the Beresford pregnancy counselling centre. Staff at the centre provide free help, information and support to families across south Wales. As well as extreme distress, losing a baby or pregnancy can cause feelings of anger, resentment, anxiety, panic and sleeplessness. These feelings are all a normal part of grieving, and sessions allow parents to let off steam. The centre is a safe space for mothers and fathers that they so desperately need.

Immediate access to care and support will never ease parents' grief, but it can help them cope at a devastating time. I recently spoke to a mother who told me how she's incredibly grateful to staff at the Royal Gwent Hospital for how they looked after both her and her husband when they lost their baby. The sensitivity and genuine compassion shown to both parents will stay with them forever. Another mother told me that she didn't know how she'd have carried on if she hadn't already had a child.

The depth of feeling does not diminish over time. Not long ago I spoke with a couple who've just marked the fiftieth anniversary of their baby who was stillborn. While their baby will never be forgotten, they were only recently able to have a memorial made. The parents, who went on to have other children, have never forgotten their daughter who died. At the time, they were told to just get on with it and get over it, but they now feel more able to speak of their grief all these years later. I pay tribute to my colleague Dai Lloyd for his personal contribution today, which was so powerful.

It wasn't long ago that people didn't speak about pregnancy or baby loss. There are families and parents across Wales who have been silently grieving for decades. Raising awareness now should hopefully bring some comfort to families, although nothing will ever be able to take away that pain. It's important for mothers and fathers to have time to grieve and not feel they just have to carry on. Access to an excellent level of bereavement care for all parents after pregnancy loss or the death of a baby is crucial. 

The stillbirth and neonatal death charity, Sands, is there to help parents grieve and to support them through their darkest times. The Newport Sands group is run by bereaved parents who aim to help others going through similar tragedies that they have experienced themselves. Support packs and memory boxes are handed out at the monthly meetings, which, like those at the Beresford centre, are a safe space for bereaved parents. The bereavement suite at the Royal Gwent Hospital was funded by Sands, and this facility has been able to support many families. Sands are an incredibly dedicated group of volunteers who provide an invaluable service.

Whilst there's more support available to bereaved families now than previously, there's certainly more to do. In England and Scotland, health professionals and a group of baby loss charities have developed a new approach to improving bereavement services using a set of minimum standards. I hope that these can be adopted here in Wales. Improving the consistency and continuity of care for parents is crucial and I agree with the motion to adopt the national bereavement care pathway. This underlines the need for all NHS staff who come into contact with bereaved parents to receive bereavement care training and I hope this is something that NHS Wales will look to facilitate.

I urge Welsh Government to accept the proposals put forward in the motion today. They'll make a big difference to parents who have already been bereaved and also those who, sadly, will experience pregnancy and baby loss in the future. I hope to see many Members standing by bereaved parents, lighting a candle with Sands in the Pierhead next week. It's vital that those who need support always have access to the best possible care that can be offered.

16:25

I would like to thank Lynne, Adam and David for bringing forward this very important debate. Next week is Baby Loss Awareness Week and what better way to mark it than to debate the support Wales gives to those families affected by baby loss?

It is a sad fact that pregnancy loss and the death of a baby are not rare. A quarter of pregnancies end in miscarriage and every day in the UK 15 babies die before, during or shortly after birth. This is devastating for the parents and, sadly, they often don't get the help and support they need, but we give thanks to all of those who give their time and help, and succeed in making things better. We can do so much more for the hundreds of Welsh families that suffer from baby loss. Unfortunately, Wales has no specialist miscarriage clinic and Welsh patients find it difficult to get a referral to the Tommy's clinic in Coventry.

Campaigners recently presented the Welsh Government with a 24-page report, detailing actions that could be taken to improve services for families suffering from recurrent miscarriage. The 'Making the Case for Better Miscarriage Care in Wales' report makes 11 recommendations, which include the creation of dedicated recurrent pregnancy loss clinics in Wales.

We are providing care for those suffering from pregnancy loss, but it has to improve, and sometimes pregnant mothers are given a leaflet and sent home following a miscarriage and there is no bereavement support for the mother or the father and no follow-up. Some families suffer this multiple times and if they are lucky, they may get a referral to a gynaecologist. One couple were told, after their fifth miscarriage, that some people are just incompatible and they should consider adoption. So there needs to be more understanding of how to treat bereaved families. Even though we are succeeding in many areas and many people get the support that they need, there are those slipping through the net.

Sadly, less than half the local health boards provide mandatory bereavement care training for staff and those that do offer training provide less than one hour of training each year. I am pleased that the Welsh Government accept that compassionate bereavement care and support is a key part of maternity services provision. However, this is not happening on the ground. There are very long waits for bereavement counselling in Wales and, as a rule, these services are not offered to families suffering from miscarriage.

I do hope the Cabinet Secretary, in responding to this debate, will indicate support for the 'Making the Case for Better Miscarriage Care in Wales' report’s recommendations. We have to do better for families in Wales suffering from baby loss. Although we are doing an awful lot, there's more that we can do. So, let’s mark Baby Loss Awareness Week by improving services for Welsh families by working together. I pay thanks to those who are already succeeding and helping people in Wales to move on and have the support that they need. So, I urge members to support this motion. Thank you very much.

16:30

Thank you. Can I now call the Cabinet Secretary for Health and Social Services? Vaughan Gething.

Thank you, Deputy Presiding Officer. I'd like to start by thanking Members who both tabled the debate on this again important and emotionally charged issue, but in particular to those who have contributed.

Stillbirth, pregnancy loss and the death of a baby are often events that we don't consider happening to us. They're things we hear about with other people. But they do happen to lots of people in our country and they will happen again in the future. I am committed to doing what we can and what we should do to reduce these distressing events.

When families suffer the loss of a baby, NHS Wales must ensure that bereavement services are available to provide support and the appropriate environment for families to spend time with their baby. The Welsh Government is already working with the maternity and neonatal networks in collaboration with health boards to ensure improved and standardised practice. 

In Wales, our response to stillbirth was strengthened following the National Assembly one-day inquiry into stillbirth held in 2013, and like a number of other Members I was on the committee during the course of that inquiry. The maternity network was set up as a recommendation from that. It focused on raising awareness of stillbirth, implementing measures to detect babies at risk and improving the health of mothers, which is a key risk factor. In addition, it included the implementation of a growth assessment programme right across Wales, with multiprofessional training and emergency drills and guidance for reduced foetal movements, and a perinatal mortality review process and learning to come from that. 

But stillbirths and pregnancy loss are often subjects that are not discussed. We've heard from Jayne Bryant about her recollection of that, but in particular Dai Lloyd's own experience. There are times you hear from Members in this Chamber things you did not know and would not have expected. It may have happened some decades ago, and for all the medical experience and life experience, I think it's still a remarkably brave thing to share in the Chamber about the real impact, and it brings home that that story is played out in other families each day within the country and it highlights why we need to improve what we can do. 

The safer pregnancy initiative led by the maternity network listened to families who wanted midwives and obstetricians to break the silence. With increasing complexity in pregnancy, including obesity, smoking and maternal health factors like diabetes, stillbirth has a risk of increasing prevalence not reducing. That's why the safer pregnancy initiative was so important, with the posters, the information wallets to carry hand-held notes, and to raise issues such as foetal movements, smoking, eating well, and seeing your midwife early to take advantage of the excellent midwife care that is available. A recent evaluation of that initiative has shown that women and healthcare workers welcomed the approach, and the network is already looking at ways to extend the message with a consistent approach. 

The Wales neonatal network was established in autumn 2010 and it aims to ensure the best possible outcomes for babies and mothers with more standardised care. It brings together NHS health professionals and partners from other organisations to oversee neonatal care against all-Wales neonatal standards. Those standards stipulate that each unit should ensure that timely access to psychological support is available to parents, and as we've heard in the opening, we still have some way to go before we get there on a consistent basis. Earlier this year, the neonatal and maternity networks commenced their plans to merge and become a joint network during next year, with revised governance and leadership arrangements. That merger will bring us opportunities to foster closer links across that broader pathway for mother and baby, and to provide new areas for joint working and improvement. 

The birth of a baby on the threshold of survival is uncertain in outcome, and Welsh Government has worked with our NHS and with families to develop guidance for professionals, to ensure that all babies receive individualised assessment. Where the birth of a baby on the threshold of survival is anticipated or occurs, maternity and neonatal teams should ensure that clinical assessments and individualised decisions are made about the ongoing management and support provided. And the use of that clinical judgment must take place in a sensitive partnership with families, who should be treated with respect and dignity.  

The death of a baby is a devastating experience for all those involved. Women and families deserve personal support and information following stillbirth and the death of a baby. There has been collaborative work already with third sector agencies such as the stillbirth and neonatal death charity, Sands, and 2 Wish Upon A Star, to help provide training, information for families and to develop improved environments, and to give opportunities to build future memories.

The positive point that we should take is that there is already excellence within our services here in Wales. Members may remember Laura Wyatt, who is a midwife in Cardiff and Vale. She is a recent UK midwife of the year in the Royal College of Midwives Awards, and that award came on the back of her nomination by bereaved parents, and it was the support that she gave to them and her support afterwards, as they had become parents, that was the point of the nomination—to recognise the difference that her work made. She is part of the bereavement sub-group of the maternity network, helping to develop those improved standards and helping to develop better environments for parents. 

Within maternity services now, all health boards have an identified bereavement lead to support families and enable them to spend time with their babies. So, I welcome the launch next week of the UK standards for bereavement care. The maternity network has linked with Sands throughout the development and pilot of the care pathway and standards. The maternity network has adopted these within the new all-Wales bereavement standards, so all maternity services have a bereavement pathway in place, and will review these following the UK pilot evaluation. 

Baby Loss Awareness Week gives us the opportunity to remember those babies who have died, and should help us to break the silence and start conversations about this important issue to make sure that Dai Lloyd's recollection of people deliberately avoiding having a conversation is not the way in which we will work and behave in the future. Providing safe and effective maternity and neonatal services for women and families will help to support every child and every family to have the best possible start. I'm committed to ensuring that families who suffer the loss of a baby have the best possible care and support from our health service here in Wales, and I'm also happy to commit to providing a future update to Members on the progress that we make following the passing of this motion.  

16:35

Thank you, Dirprwy Lywydd. I'll respond to this debate on behalf of my colleague Adam Price, who's one of the persons named in tabling it. I'd like to begin, of course, by thanking all Members for taking part in what has been, I think, a very moving debate. It is not always appropriate for politicians to bring our personal experiences to bear on our politics, but sometimes it very much is, and that was very much the case today. Before I respond to anything that other Members have said, I'd like to thank Dai Lloyd for his contribution. It was very moving, and I also think inspiring. I'm very grateful to you, Dai, for that.

Lynne set out a very powerful case for improvement in services, and set out the inconsistency that families too often have to bear. But Members across the Chamber who've participated have also highlighted that there is some very good practice, and the important thing, I think, is to learn from that. Jayne Bryant's comments about some of the excellent services provided by the third sector, some of the services that are led by the parents—they're very valuable and very important.

Lynne talked about the silence that often surrounds these issues, and other Members have mentioned that. It can be very difficult. Often a miscarriage, for example, is treated as if it isn't a real loss, as if it isn't really a bereavement. But of course, to those parents, that is a real child, of course it is. I think Members have also highlighted—Lynne particularly—the need to provide services for fathers as well as for mothers. Too often, still, no bereavement support is offered, but when it is, too often it is only offered to the mother as if the father has not suffered a loss, and it's very important that we ensure that the loss for both parents and indeed family members and, as others have mentioned, siblings too who can be affected by the loss of a baby—that that is all acknowledged.

I'm grateful to Caroline for making the points about the need for specialist services for women suffering from recurrent miscarriages. The idea that you can simply say to a couple, 'Well, there's some sort of incompatibility here, and you will never be parents and you just have to accept it' is something that I think, in Wales in the twenty-first century, none of us would want to tolerate. I also think the points about further and better training for staff are very well made.

I'm grateful to the Cabinet Secretary for his response and appreciate what he set out in terms of the work that is being done, but I think the evidence that has been presented today, the evidence from the charities that have formed part of the alliance for Baby Loss Awareness Week—and I would briefly wish to thank those organisations for coming together so effectively to help raise these very important and very difficult issues, and I'm certainly looking forward to participating in some of those commemorations with families that Jayne and Lynne and others have mentioned that will take place next week—. 

But I'm sure that the Cabinet Secretary would agree that there is no room for complacency here. I'm very glad to hear him tell us that, through the maternity networks, all services will now have an identified bereavement pathway. I wasn't quite clear from his remarks how long those pathways have been in place. If it's very new, then I think we can look forward, as he said, to hearing an update on how well those services are being delivered. But we do know that there can be a gap between national policy and delivery on the ground, and I'm sure that none of us in this Chamber will tolerate such a gap around such a sensitive issue.

No mother, no father losing a child in Wales should be left alone to deal with that. And we know that that still happens now. Many of us in this Chamber will have family experience. I think we tend to think sometimes of the loss of a baby as something rare. As Lynne and others have pointed out, in fact, that is not the case, and those early days are the most dangerous time for any child in Wales.

So, in conclusion, Deputy Presiding Officer, to repeat my thanks to everybody who's contributed, to thank all those who have spoken out, particularly parents and families who've shared with us the challenges that they faced, to say a huge thank you to all the wonderful people who do provide excellent services, but to say that I look forward to the update from the Cabinet Secretary about the actual delivery of proper psychological counselling services for families everywhere in Wales who experience this, if this is what they want. If one family is left alone in this experience in our health services in Wales, that is one family too many, and that we cannot tolerate. Diolch yn fawr. 

16:40

Thank you. The proposal is to agree the motion. Does any Member object? No. The motion is therefore agreed in accordance with Standing Order 12.36. 

Motion agreed in accordance with Standing Order 12.36.

8. Plaid Cymru Debate: People's Vote

The following amendments have been selected: amendment 1 in the name of Darren Millar, amendment 2 in the name of Gareth Bennett, and amendment 3 in the name of Julie James. If amendment 1 is agreed, amendments 2 and 3 will be deselected. If amendment 2 is agreed, amendment 3 will be deselected.

We now move to the Plaid Cymru debate on the people's vote, and I call on Adam Price to move the motion—Adam.

Motion NDM6816 Rhun ap Iorwerth

To propose that the National Assembly for Wales:

Believes that a people’s vote should be held through a UK-wide referendum on the final terms of the UK’s exit from the European Union.

Motion moved.

Diolch, Dirprwy Lywydd. Plaid Cymru put forward this motion today on a people's vote because it's our considered and heartfelt belief that it's our solemn duty to do everything in our power to avoid a self-inflicted calamity to our country. Democracy is indeed a powerful thing; it can form and topple Governments, it can create new democracies and nation states, but at its essence, of course, it provides regular opportunities for the people themselves to change their minds.

On 23 June 2016, people from all four nations of the UK took part in one of the single biggest exercises of democracy the UK has ever seen. Promises were made by both sides of the referendum campaign, 'leave' and 'remain', and, quite often, by individuals and politicians who were not in a position to deliver them. Let's look at some of the promises that were made, some of the facts, and the options in terms of what we should do now. 'Let's give our NHS the £350 million the EU takes every week' was the most widely recognised promise of all, of course: rowed back on the day after the vote. Of course, the reality is that Brexit is actually costing the UK economy £500 million a week now, according to the latest projections from the Centre for European Reform. That's £26 billion a year, which, as it happens, is the difference between continuing and ending austerity—ironic, since austerity was one of the key driving factors behind the vote.

Members may have heard my warning this morning that we're heading towards an economic iceberg and need to change course. There are some who are advocating an alternative strategy, which is best described as, 'Let the iceberg move'. They dismiss all the warnings and insist that we're about to enter calm waters and that the EU will eventually buckle to our demands.

We were promised shiny new trade deals with EU and non-EU countries, the former being the 'easiest trade deal ever negotiated', it was claimed. Well, now, while they're right that leaving the single market and customs union would allow the UK to begin the work of negotiating new trade deals with other countries, there are deep and troubling questions regarding the content and timescale of such deals. The average time for negotiating a free trade agreement, according to the Peterson Institute for International Economics, is 18 months, with a further three and a half years to get to the implementation stage. These figures are the average for bilateral trade deals between two partners. If Brexit happens, the UK will need to agree a trade deal with the EU and separate ones with its trading partners, of which there are over 50. No country on the planet has been in a position where it's had to negotiate over 50 free trade agreements at the same time under these circumstances. The current Government has spent two years negotiating a deal with the EU and has failed to make any process. The idea that negotiating 50 such deals at the same time will be a walk in the park is complete fantasy.

There has already been a massive opportunity cost since the referendum—Government time all taken up by one issue and thousands upon thousands of civil servants working solely on plans driven solely, it seems, by dogma and ideology, with one result: the undermining of the Welsh and UK economy.

Even though the macro outlook is alarming, things get even worse when you drill down and look at some of the detail about what leaving the EU customs union and single market means in practice. This would mean leaving, for example, Euratom, which is the legal contract by which the UK is able to import radioactive substances widely used in the field of medicine for treatment of cancer. Leaving the EU means leaving Euratom unless the UK applies for associate membership, which it doesn't intend to do. Are we really saying that our radioactive independence—whatever that means—is more important than the welfare of cancer patients?

Of great concern as well is what the proposed FTAs would entail and their wider implications. Eurosceptic Tories recently released a report calling for a trade deal between the UK and the US to allow American companies to compete for health contracts in the NHS: a far cry from boosting the health budget using the Brexit dividend that was promised.

Among the other backwards measures advocated by these right-wing zealots is holding a bonfire of consumer and environmental regulations: hormone-treated beef, chlorine-washed chicken—the well-being of people and animals sacrificed on the altar of an imperial nightmare. It's a sad—

16:45

I don't think I'm a right-wing zealot, but it's for others to describe me. The problem is that I remember, in the referendum campaign, making many of these points. I was an enthusiastic remainer. I've not changed my judgement on the strategic advantages to the UK of remaining in the EU, but a decision was made. What assessment have you made of the damage you will cause to our democratic culture if you seek to overturn that referendum result?

Well, look, I think the point at the heart of everything that I have said is that these sunlit uplands, this land flowing with milk and honey that was promised, has been shown to be a complete and utter lie. The people were lied to and, actually, many of those who voted on the basis of this false prospectus are angry about a political class that has acted as charlatans, and, in those circumstances, actually, in order to save our democracy, we need to revisit this question by providing the people with the full facts that they were deprived of last time.

It's a sad reflection of the current climate that we have now members of the ruling party also openly saying that risking peace in the north of Ireland is a price worth paying to realise their distorted aims. They've talked a lot about freedom as their justification, but what about the freedom to live in peace, as was guaranteed under the Good Friday agreement? They claim to want freedom from European tyranny, but what tyranny are they referring to? The tyranny of grams and kilometres? The tyranny of peace on a continent that has spent 100 years of its history at war? The tyranny of the European Court of Justice, which guarantees our human rights? The tyranny of being free to live and work in friendly neighbouring countries?

Plaid Cymru does not propose holding a referendum to revisit a constitutional decision lightly, but it's abundantly clear by now that we're heading, head first, towards a national emergency based on a false dream that was sold to voters. Many Members on the benches here campaigned with me to secure devolution for Wales in 1997. We had a proper implementation plan and a White Paper; we explained to voters in great detail what we intended to do. People knew what they were voting for, and, when we secured a 'yes' vote, we kept our word and delivered on what we had promised. The same was the case in Scotland in 2014; the Government had produced a White Paper setting out exactly what independence meant—it was 670 pages long and was absolutely comprehensive. They were in a position to make promises and deliver on them. That was not the case for the 2016 referendum. The 'leave' campaign was in no position to make or honour the promises it made to voters.

Now, Members on the Tory and UKIP benches may disagree with me now. I say, 'Fine. Let's put it to a vote—a people's vote—and let the people decide whether they did, in fact, vote for a "no deal", a disaster deal, a self-destructive deal, or were they, in fact, sold a lie by shady charlatans and they now want to rectify the decision in the light of the new evidence they have.'

16:50

The Llywydd took the Chair.

I have selected the three amendments to the motion. If amendment 1 is agreed, amendments 2 and 3 will be deselected. If amendment 2 is agreed, amendment 3 will be deselected. I call on Paul Davies to move amendment 1, tabled in the name of Paul Davies.

Amendment 1—Darren Millar

Delete all and replace with:

1. Believes that the outcome of the UK-wide referendum on the UK’s membership of the European Union must be respected.

2. Notes that the people of Wales voted to leave the European Union.

3. Calls upon the Welsh Government to support the UK Government in protecting the integrity of the United Kingdom as we leave the EU.

Amendment 1 moved.

Diolch, Llywydd. I welcome the opportunity to take part in this debate and I move the amendment tabled in the name of Darren Millar. The next six months will shape the way Wales and the United Kingdom engage with the rest of the world for generations to come, as we leave the European Union. For trade, investment, security, immigration, it is vital that we secure the best possible deal for Wales. 

Today's debate should be about exploring how we can secure the best possible deal for the people of Wales. Instead, today's motion has focused on shifting the debate from this discussion on to overturning the outcome of the referendum and the clear statement sent by the people of Wales.

As representatives of the Welsh electorate, we have a duty to deliver on the result given to us by the people of Wales in June 2016. The UK Government is working to deliver the best possible deal for Britain and Wales post Brexit, and I hope that the Welsh Government is constructively working with its Westminster counterparts to get that best possible deal. Let me remind Members that almost every local authority voted to leave the European Union. That is something that we cannot ignore.

There are, of course, significant opportunities for Wales post Brexit, and the Welsh Government should now get on with promoting Wales as a place to do business. As I understand it, Welsh exports are worth £14.6 billion each year, with 61 per cent of Welsh exports and just under half of our imports going to and from the EU. And so it's absolutely essential that the Welsh Government works with businesses and public services to plan and prepare for Brexit.

Now, I appreciate that progress has been made in some areas. For example, I'm pleased that the Welsh Government has launched the Business Wales Brexit portal—a website specifically designed to help businesses as they prepare for the changes and challenges arising from the decision to leave the European Union. It's that sort of activity that is crucial as we move ever closer to leaving the EU. Similarly, for Welsh farmers, leaving the EU also presents opportunities to put in place bespoke Welsh policies that can better reflect the changing nature of the industry and help support Welsh farmers for the future. However—

16:55

In a minute. However, instead of exploring those themes and discussing ways in which we can work closer with businesses and industries to prepare for Britain's withdrawal from the EU, this afternoon we're discussing whether or not another vote should be held or not. And I give way to the Member for the Rhondda.

Do you honestly believe that Wales and people in Wales will be better off after Brexit?

The Welsh people, the British people, have made their decision to leave the European Union, and we must now deliver Brexit; we must respect their wishes. And you should respect—[Interruption.] You should—[Interruption.] You should respect their wishes as well, because I would remind the Member that her constituency also voted to leave the European Union.

Now, the UK—[Interruption.] Now, the UK Government has made it abundantly clear that it will not overturn the result of the referendum and that it will continue to move forward in its negotiations as it navigates its way out of the European Union. Clearly—

Mick Antoniw rose—
 

Not at the moment. Not at the moment. I would like to make some more progress, thanks.

Clearly, I accept there are still a number of outstanding issues between the UK and the EU in its current negotiations—not least of all around the nature of the border between the UK and the Republic of Ireland. However, I'm confident that those matters will be resolved during the course of the negotiations, particularly as both the UK Government and the EU have made it absolutely clear that they wish to avoid a hard border between Ireland and north Ireland.

Naturally, as the UK leaves the European Union, there are several constitutional questions that will arise for each of the devolved administrations. Indeed, the First Minister was quite right when he said, last year, that Brexit provides an opportunity to reinvent and strengthen the United Kingdom, and I agree with him that there are significant opportunities to readdress the relationships between the devolved administrations, and I look forward to addressing those constitutional questions as we move forward.

Llywydd, we on this side of the Chamber have been very clear: we will work with colleagues across this Chamber and beyond to see Wales prosper once we leave the European Union. Welsh communities, Welsh industries and the Welsh people all rely on its Governments at all levels to do everything possible to make this happen. Anything else, including implementing a second vote, will only serve as a distraction at a time when we need to focus all our efforts into seeing Wales flourish for the future. We will not support calls to frustrate the will of the people by supporting a second vote on Britain's withdrawal from the European Union. We have a finite amount of time before we leave the EU; let's make the most of it by working together in the interests of our constituents, and I therefore urge Members to support our amendment.

I call on Neil Hamilton to move amendment 2, tabled in the name of Gareth Bennett.

Amendment 2—Gareth Bennett

Delete all and replace with:

To propose that the National Assembly for Wales:

1.  Recognises that it is the decided will of the people that the United Kingdom leaves the European Union, which was expressed in a referendum held less than 27 months ago.

2. Calls upon politicians opposed to the United Kingdom leaving the EU to respect the recently expressed wishes of Welsh and British voters and stop trying to undermine the Brexit process.

3. Calls upon the Welsh Government to work with the UK Government to secure the best deal for Wales and the UK, outside the EU, the single market and the customs union.

Amendment 2 moved.

Diolch yn fawr, Llywydd. I move our amendment to this motion. I was disappointed by the speech of the new leader of Plaid Cymru, who I welcome to his position, for its pessimism, its faintheartedness, its gloom, its utter lack of confidence in the people of Wales and the people of the United Kingdom to make a success of the great opportunities that becoming once again a sovereign, independent nation—which I should have thought would have been at the very heart of Plaid Cymru—gives us the opportunity to do. He made a speech like a kind of inverted Mr Micawber, just waiting for something to turn down. This is from people, of course, who never wanted a people's vote in the first place on whether we should join what was then the European Economic Community, which became the European Community, and which has evolved further into the European Union.

We've been promised referenda by Governments both of the Conservatives and of the Labour Party on the individual treaties that have extended the reach of European Governments in the periods since 1973, and those promises have been comprehensively broken. David Cameron didn't want the referendum on whether we should leave the EU now. He was forced into it because UKIP was breathing down the necks of Tory MPs, as Mark Reckless will be able to remind us, because he lived through it. And now, of course, the parties that don't like the result of that referendum want to reverse it. Although I must say that Adam Price's speech was directed not to his motion, which doesn't actually call for a second referendum on EU membership, but merely a referendum on the terms of our exit. So, if Plaid Cymru had the courage of its convictions, it should have put down a motion saying, 'We should have a referendum in the hope that we can reverse the decision of the last one.' I think David Melding had a most important contribution in his—

17:00

Can I finish this point? It was a most important contribution in his intervention, where he asked what damage this would do to the fabric of democracy of this country if this decision were now to be reversed. I give way to Mick Antoniw.

Thank you for giving way. Is it your view, then, that if Theresa May's deal is a bad deal, Parliament should vote it down? 

Oh, certainly it is, yes. I never had any great confidence that the EU would negotiate a deal with us in the first place because—[Interruption.] The EU is a political project first and foremost, and we are talking here in terms of an economic relationship with the EU in the years to come. I would much rather leave, as Theresa May used to say, with no deal than a bad deal. I believe that the Chequers proposals don't actually mean leaving the EU at all. It's BRINO—Brexit in name only—because they would preserve us, in effect, as members of the customs union, and how that would play out beyond there is anyone's guess. We would become rule-takers from the EU. We would pledge to accept for an indefinite time the rules that they make, which would entangle our own businesses, and we wouldn't be able to even influence the terms of them, let alone disentangle them afterwards.

But, let's get back to the main point of Adam Price's speech here, which was that British people are far too stupid to have been able to make a decision on the basis of enlightenment. It's only people like us who can do that. Extravagant claims were made on both sides, as they are in every single election campaign, whether it's a general election or the Welsh Assembly election. Should we have an election every year on that basis, or every week on that basis? Clearly, this is an absurd proposition.

I'm not against having a referendum in the future on whether we should go back into the EU if that's what a substantial number of British people want, and they can get a majority of Members of Parliament to support that. If there were a second referendum now, I'm personally confident of the outcome. I think it would actually confirm the decision of the first referendum. But, that would introduce a further period of uncertainty, which is, of course, the continuing mantra of remainers now. So, this isn't going to solve our problems.

In the referendum campaign itself, the Government—the UK Government—at our expense, spent £9 million producing this document. The idea that the British people had no idea of what the consequences of leaving the EU might be on the worst possible scenario—. Just read this document because, on one page, it says that the economic shock:

'would put pressure on the value of the pound, which would risk higher prices of some household goods and damage living standards. Losing our full access to the EU’s Single Market would make exporting to Europe harder and increase costs.'

Then, on the following page, it says:

'Some argue that we could strike a good deal quickly with the EU because they want to keep access to our market. But the Government’s judgement is that it would be much harder than that…No other country has managed to secure significant access—' [Interruption.]

Yes, and in spite of all that, the people still voted to leave the EU. The people knew what they were doing. All that the remainers—the unrepentant, unrelenting remainers—want is to try to reverse the decisions of the British people that were made two years ago.

I just want to make one more point as I am out of time already. Let's keep the economic case in perspective—[Interruption.] I just want to make one point. The World Trade Organisation's weighted average of EU tariffs is just 2.7 per cent, which translates to £3.9 billion in tariff receipts. The EU's average weighted tariffs for UK imports into the EU is only between 4 per cent and 7 per cent—an aggregate of £5.5 billion to £10 billion. These are trivial figures in the context of the economies that we are talking about. Whatever the outcome of the current negotiations, even if there is no deal, then we can easily cope with disruptions of that kind.   

I call on the First Minister to move formally amendment 3, tabled in the name of Julie James.

Amendment 3—Julie James

Delete all after 'believes that' and replace with:

the option of a people’s vote must be kept on the table and in particular if the Prime Minister is unable to secure agreement on the final terms of the UK’s exit from the European Union and there is no subsequent general election, then the people must decide on the way forward.

Amendment 3 moved.

Formally, Presiding Officer.

Diolch, Llywydd. As one of the original signatories to the people's vote, there is no doubt in my mind of the dangers that people in Wales face from crashing out of the EU without a deal or with an extreme Tory Brexit. 

It's our concern for our struggling economy, for jobs, for wages that drives Plaid Cymru on this question, and that's what drove us to co-author the White Paper with the Government, which said that Wales's interests would be best served by us remaining in the single market. This option has not only been rejected by the Prime Minister, but has also been rejected by the leader of the official opposition. So, in truth, the party in Westminster fighting for what both of our parties have agreed is what's in Wales's best interests is Plaid Cymru. Labour in Westminster are not advocating for the principles outlined in that White Paper, and that is a matter that can't be easily resolved with a general election. We had one of those just last year and it solved nothing. A Labour UK Government wouldn't take us closer to that agreed position either. We all know that. Different coloured ties at the negotiations at this late stage will solve nothing.

So what options do we have to get out of this mess? What options do we have to avoid this economic nightmare that could make austerity look like a walk in the park? A people's vote on the final deal will give people a further opportunity to give a view when more detailed information has become available. As someone who has described herself as a Welsh European, I want us to keep our links with the European Union, but we do have to keep our eyes wide open here as well. There are no easy options or perfect outcomes. If Brexit goes ahead, especially if it goes ahead without a deal, it will be a disaster for our economy. I'm absolutely convinced of that.

But there are concerns for our democracy, too. If people perceive that a pro-remain establishment is simply overturning the original vote because of some sort of paternalistic, 'They don't know what they're doing' attitude, then there are dangers facing our democracy. How will people have faith in democratic processes if they can be simply overturned? So we need to be very careful of not being open to accusations that politicians, experts, academics are only interested in overturning the original result.

I support a vote on the final deal, to ratify or otherwise, but simply re-running the original question or overturning the result will not resolve the issue. Many people who voted 'leave' did so because they had nothing to lose. People in my area, right across the former coalfield, especially the older generation, they can remember a time when our communities were not relying on handouts that often seem to be spent on projects with no tangible benefits to their lives. They understand that our communities were built by people doing things for themselves. There were no widespread public services when the villages of the Rhondda were being thrown up around the pits. Those were created by collective action, pooling pennies earned in the mining industry, and since that industry was deliberately demolished in the 1980s, our people have had no choice other than to be dependent on benefits, on handouts from Westminster or Brussels or the lottery or Communities First-type initiatives. After a decade of austerity and even longer of not being listened to, many people living in these communities decided to send a big and powerful message to the establishment. They used what little power they had to stick their two fingers up to dependence, to poverty, to hand-wringing, to paternalism and to the Tories. I can't tell you how many people I know who wanted to give David Cameron and George Osborne a bloody nose, and simply could not understand how I was on the same side as those two conmen.

Whatever happens, the concerns of working people, of those on zero-hours contracts, dependent on benefits and food banks, as well as those older people who yearn for a different time, must be addressed. If we have a people's vote on the final deal, then we need to learn the lessons of the 2016 referendum and address the underlying causes that led to the Brexit vote: poverty, disillusionment with our political system, and the despair felt by many of our communities. A people's vote needs to be an exercise in further democracy, not seen as an attempt to overturn a democratic decision, and as a Welsh European, I will continue to campaign for Wales's best interests on that basis.

17:10

Llywydd, in politics, there is often an easy path and a hard path. If the easy path was always the right way to go, then the job we do here would be simple. In fact, we'd hardly be needed at all. But the reality is that, more often than not, the hard path is also the right way. In an age where a lie can be retweeted 30,000 times before truth has booted up her laptop, that is more true than ever. So, there are some hard things we need to be aware of in this Chamber.

Firstly, Wales voted to leave the European Union. I accept that and I respect that. Secondly, the offer that was made to people at the time of the 2016 referendum is never going to be delivered on. Instead of leaving being 'cost free' and 'the easiest thing ever', it is going to cost the UK a minimum of a £50 billion divorce bill that we will still be paying in 2064. And that is before we even consider the cost now in higher prices and low growth, even before we've left—a cost that the Centre for European Reform estimates at £500 million a week.

The third fact we have to accept is that there is no majority in the House of Commons for any sort of Brexit—not for Theresa May's Brexit, not for Jacob Rees-Mogg's Brexit, and not for any sort of blindfold Brexit either. But the weakness of the Prime Minister and the aggressiveness of the Breximists on the ERG—the political cousins of the UKIP Members in this Chamber—means that unless we find a way out of this mess, we will have the worst kind of Brexit at all: a 'no deal' Brexit that would destroy our manufacturing in Wales and devastate our health service; a 'no deal' Brexit that will decimate our automotive, aerospace and agricultural sectors; a 'no deal' Brexit that will destroy jobs at companies like ArvinMeritor in Cwmbran who depend on just-in-time manufacturing. It's their jobs, their mortgages, their kids' futures at stake.

So, the fourth fact is that we need a way out of this mess, and that means that parties will have to co-operate. My party's amendment says the way out is a general election. I will vote for it, but I will do so knowing that the fifth fact is that there is little to no chance of it happening. And that leads me to my sixth and final fact, that a people's vote is the one way we have to unite to get us out. It's time we dropped the party political bombast and showed leadership, even if it's hard and recognise that fact. 

A people's vote will not be a repeat of the 2016 referendum, but a vote on the actual deal. The advocates of Brexit got the right in 2016 to negotiate for us to leave, but we should have the right to tell them that what they're offering is not good enough compared to what we have today. I'm not afraid of that debate, but it seems the advocates of Brexit are.

My turn to speak, sorry. I stand today with deep concerns about this motion.

In 2016 we had a national debate, we had a democratic vote and the people voted to leave the European Union. It is our job as elected representatives to implement the will of the people. We must always remember that Government is the servant of the people not the master.

No, I won't—this is short.

This debate, it seems to me, is about much more than the prospect of leaving the European Union. We are, in effect, asking the people of Wales to think again. That's wrong. [Interruption.] Yes, and they voted leave.

Asking Wales to think again, this could start a dangerous precedent, and you lot know it. Let’s look back at the 1997 referendum on devolution. Then, the people of Wales gave a much less clear mandate for devolution than they did when they voted to leave the EU in 2016. But that was the right answer, clearly.

Then, in 2015, a majority Conservative Government was elected with a clear manifesto pledge to provide the people with an in/out referendum. Two questions: in or out. In 2016, the people duly voted in that referendum to leave the EU, and finally—and you can take the smiles off your faces, Labour Government—in 2017, both major political parties committed to leaving the European Union in both of their manifestos. So, there have been several people's votes on leaving the EU, whether you lot like it or not. You committed to it.

Today’s debate is certainly not about the people, it’s about politicians saying, 'We know best', ignoring the instructions given to us by the people. [Interruption.] You've had your instructions: it was 'leave'. Where does this end? [Interruption.] You know what, I can stand here all day and wait for my third paper if you want me to, I don't care. Yes? I'm disappointed to be standing here today. The new leader of Plaid Cymru—although, Adam, I really do like you—quite rightly, in my view—[Interruption.] The new leader in Plaid—[Interruption.]

17:15

Thank you, Llywydd. [Interruption.] I wouldn't. The new leader of Plaid Cymru, quite rightly, in my view, spoke after his election about the significant number of challenges Wales faces, and yet he’s decided that his first valuable Assembly time debate will be to insult the people of Wales because they don’t share his view on the EU. This time could be much better spent discussing health, education and the additional powers set to arrive in this place after Brexit. Those things could easily start to improve people's lives here after Brexit.

I will close now by simply asking Members to respect the vote that people have already had. I fear for our democracy if we do not respect those votes. Diolch yn fawr.

Llywydd, I have to admit that I have form on resisting the results of referendums when I feel that the people have made a mistake. I joined Plaid Cymru in 1979 after the devolution referendum was lost. It took us 20 years to overturn the result of that referendum. I don't think there are many people—. [Interruption.] It did take 20 years, I'll give David Rowlands that. It took 20 years, but we can't wait 20 years to look again at the result of this referendum. Wales is about to be dragged over a cliff into a 'no deal' Brexit abyss and the risks faced by the rural communities that I represent in mid and west Wales are well known. Those of us who know that this would be a disaster have an absolute duty to resist that and to put the reality to the people of Wales of what we will actually face, if and when we leave, and what the deal will actually be. 

The original referendum was deeply flawed. People were invited to vote for more control. What we have seen instead is a power grab by a Tory Government dragging powers away from Wales back to Westminster while the Labour Government here stands by wringing their hands. And people were invited to vote for billions of extra pounds for the NHS, among other things. There were all sorts of things we were going to spend this money on—the farmers, we were going to spend it on the health service. Goodness me, it was the magic money tree, really, wasn't it? Instead, as has already been pointed out by Adam Price and Lynne Neagle and others, this Brexit is already costing us millions of pounds a week and we will have billions of pounds in the divorce Bill, and the potential impact on the Welsh economy, long term, is dire. 

Each Welsh voter who supported Brexit will have had their own reasons, and I have a lot of sympathy with what Leanne Wood said about what some of those reasons would be—a resistance to an establishment that people felt was ignoring them. I remember campaigning with Lee Waters in Llanelli and two young men saying to me, 'I can't get into this at all. This is posh English blokes shouting at each other. This doesn't feel as if it's anything to do with me.' That may very well be true, but I am convinced that none of those voters who voted for Brexit voted for drug shortages, unemployment, a hard border in Northern Ireland, visa requirements to visit our nearest neighbours and threats to environmental protection and our human rights. And all of those are real risks of a hard 'no deal' Brexit. 

I want to refer today, Llywydd, to those people who in that referendum could not vote—71,500 young people, approximately, have reached the voting age in Wales since we voted to leave. That is not far short of the national majority in Wales for Brexit. Now, I do not mean to imply for a moment that all young people would have voted to remain, but we do know that young people were much less likely to support Brexit, and it's obvious that the impact of Wales leaving the European Union, especially if we do so without a deal, will have a much more profound effect on the lives of those young people than it will have on the lives of those of us who have already benefited from decades of EU membership, and may now be coming to the end, some of us, of our working lives.

There is evidence of much anger amongst young people about Brexit. I saw this when I was leading a national youth work charity. These young people have a right to be angry. Our generation is taking an ill-informed gamble with their futures, and we owe them the right to have a voice in determining that future, and to take part in a people's vote on the deal that is actually being offered.

I want to refer very briefly to the Government amendment, which invites us to look at the general election as a way of resolving this. Well, as Lynne Neagle has already said, I'm at a loss to see how that would work. There's no need to rehearse the division and chaos that is the Conservative Party's position on Brexit, but I'm afraid that Labour in Westminster is not much better. I follow politics pretty closely, and I have no idea what a Labour Westminster Government would do about Brexit. Would they renegotiate? Would they put on a referendum without the option to remain? Would they place a referendum with a potential option to remain if the deal was rejected? I suspect I don't know because they don't either, and I suspect that that depends on whether you believe Jeremy Corbyn, Keir Starmer or any of the other people who may be speaking. A general election cannot, sadly—and I wish this were not the case—get us out of this mess, as Lynne Neagle has said, and I suspect many other Members on the Labour benches know this. 

We need a people's vote once the deal is known, and every single one of us in this Chamber and beyond who believe that the future for Wales is as a member of the European family need to be campaigning now for that people's vote, so that people can vote on what's really on offer and not on the pie in the sky that they were fed in 2016.   

17:20

I absolutely acknowledge that people voted to leave the European Union in 2016. [Interruption.] I'm not ignoring them at all, but I don't think they voted to lose their jobs, and that is one of the consequences of crashing out of the European Union. I think that it was a very, very complicated issue, being put—. [Interruption.] No. It was a very complicated issue. Trying to put it to a referendum was—. You only have to remember how difficult it was on the doorstep to have a conversation that did not need to go on for half an hour, because it's such a complicated issue. The original disaster occurred when David Cameron decided to put this issue to a referendum as an alternative to having to put up with the split in the Conservative Party. But we are where we are, so we have to get on with the situation that we have.

There have been some benefits to the Brexit vote, and one of them is that it's lowered the value of the pound that has helped to secure our steel industry, so that is something we should all be grateful for. But that doesn't mean to say that crashing out of the European Union isn't something that nearly everybody in this Chamber would be appalled by, including, I hope, Paul Davies. So, I think that of course we need to secure the very best deal that we possibly can, and that's why we should support our Cabinet Secretary for Finance and the excellent work he's doing in the Joint Ministerial Committee to try and navigate some sort of rational behaviour by the UK Government in the way it's going to affect the devolution settlement. But I really think that we are deluding ourselves if we think that, as Members of this Chamber, we have any influence over what the UK Government is getting up to. They have far too big a problem themselves.

I feel some sympathy for Mrs May, who's had to spend two years trying to think of a way of squaring the circle in her own party, which means that, unfortunately, she hasn't had enough time to listen to what the EU-27 members have been saying really carefully. So, I do not understand—I cannot see how the UK parliamentary Conservative Party will unite behind whatever agreement Mrs May manages to achieve by way of agreement that doesn't contradict the commitments laid down in the Good Friday peace agreement. So, the only way she can avoid crashing out of the EU, which I'm sure she doesn't want to do, would be to rely on the parliamentary Labour Party and its six conditions for support. Now, I think Labour's demand for a general election is for the birds, because the Conservative Party is never going to vote for a general election before 2022, and therefore this people's vote, plebiscite, alternative referendum is actually the only way out of absolute political deadlock, which we have never seen in our lifetime, even though it may have occurred perhaps in the 1920s, 1930s.

So, we have to prepare for the possibility of some sort of referendum in order to have some resolution to the problem that is about to occur at the end of March next year—[Interruption.] It is not without risk. There is the possibility of civil unrest because passions are so high on this issue. So, those of us who are concerned about this need to do all we can between now and then to reach out to all those people who voted differently to the way that we wanted them to to ensure that—[Interruption.]—no—to ensure that we are able to have a civilised discourse on this matter on the issues that face us. I find it really difficult to understand how Welsh farmers voted to forgo 80 per cent of their income, which they got from the common agricultural policy, but it is a fact they did, so we all are to blame for not communicating clearly enough the consequences of the way we voted. People thought that this was just something we'd be able to reverse next time, just like with general elections, but we cannot—. This is a really, really serious issue. We cannot underestimate the possibility of conflict if we cannot resolve it by another means, and it seems to me that, in the absence of a general election, which I don't think will happen, some sort of plebiscite is the only way of resolving it.

17:25

The Deputy Presiding Officer took the Chair.

Well, I find myself disagreeing with most of my Labour colleagues and Plaid Cymru colleagues and sadly find myself almost agreeing with the Conservatives and with UKIP, because I think it was a relatively simple matter, and I think most people were completely clear about what they did vote for. Those who voted to leave the European Union clearly voted because they were assured that we would not leave the single market. Daniel Hannan, the Tory MEP, often described as the Brexit of—

Neil Hamilton rose—

I will take an intervention when I've actually made a few more points, okay? So, don't jump in; hold your horses. 

What he said was:

'Absolutely nobody is talking about threatening our place in the single market.'

And Owen Paterson, Tory MP, prominent campaigner for Vote Leave, also said,

'Only a madman would actually leave the market.'

So, people were clear on that. They also said—we had the bit of racism that UKIP and the Tories introduced into this—'Turkey is going to join the EU and millions of people will flock to the UK.' Where are we? All negotiations with Turkey are suspended on human rights grounds and there is absolutely no prospect of that happening. That actually was probably the most disgraceful part of the whole campaign, because it introduced a racist element built on a lie, and it was a disgrace.

The other thing that people have voted for, quite simply, was because they knew that a free trade deal with the EU, as they were assured by Liam Fox, would be the easiest thing in human history. This is what Liam Fox said, that the free trade agreement that we will have to do with the European Union should be

'one of the easiest in human history'.

And they were also assured, it was very clear, that we would be saving for the NHS £350 million a week. It sounds like a very, very good offer. They also said that we would protect workers' rights, there'd be no problem with workers' rights. Well, we now have a Brexit Secretary, Dominic Raab, who has described workers' rights as 'obstacles to British business' and UK workers as the 'worst idlers in the world'. Last week, at Tory party conference, he said absolutely nothing about the protection of workers' rights. And we were also assured that Wales would not lose a penny, we'd be better off, in fact—we'd not only not lose a penny, we'd probably have a few more pennies—and yet Theresa May has refused at every stage to give that guarantee. It would be so easy—[Interruption.] Yes, I'll take an intervention. 

17:30

I campaigned hard for us to remain in the EU, and I will join the campaign to get us back in the day after Brexit becomes a reality, because that's when a democratic response is possible. Public opinion has not shifted at all in the time since the vote, and all these arguments have been rehearsed repeatedly. People still stick to the judgment they made in that referendum.

Well, I think you've actually made the point for a people's vote, because the only way of testing that comment—which I disagree with—would be by actually putting it to the people. Because I think what you actually have is that people did know what they were voting for, but what is clearly happening now is that is unravelling and it is completely clear that every promise that enabled people to vote to actually leave the EU is now unravelling, and that is why we get to a situation where there has to be a vote in Parliament, first of all, on Theresa May's deal. And the reason I asked the question earlier is because of this: if Theresa May cannot honour the promises that were made in the deal, then that deal has to be voted down and there has to be then a decision, ultimately, by the people. Now, I think the people's vote is actually a badge, and it is showing—. It is a badge that is reflecting people's attitudes to the fact that they were sold a pup. They were defrauded during the referendum.

The reason why I think it's going to be a general election, and the reason why Keir Starmer's and Jeremy Corbyn's position is right, is because the most likely outcome is going to be a general election, because we cannot, probably, have a people's vote before we actually come out of the EU, because, in order to introduce legislation, the time for that legislation to go through—. If Theresa May were to have to introduce legislation for a referendum now, that would be, effectively, a vote of no confidence and we would have a general election. And I think the position that has been adopted by Keir Starmer, and I think the position adopted by Jeremy Corbyn, is absolutely right. It has given the Tories the right to negotiate. They have failed in those negotiations, that is quite clear, and, ultimately, there is a need to have a new mandate. As Jeremy Corbyn said at the Labour Party conference:

'We will vote against any reduction in rights, standards or protections and oppose a deregulatory race-to-the-bottom.'

So, let me say to the country: Labour will vote against the Chequers plan—as, apparently, I think, half the Tory party conference is going to vote against it anyway—and whatever is left of it, and oppose leaving the EU with no deal. It is inconceivable that we should crash out of Europe with no deal. That would be a national disaster. That is why, if Parliament votes down a Tory deal, or the Government fails to reach any deal at all, we would press for a general election. Failing that, all options are on the table. The likely outcome is a general election. The likely outcome of that general election is that Labour will win, that Labour will either negotiate on the six principles—and, failing that, there will be a referendum for people to actually decide whether they want to stay in the EU or whether they want to leave the EU again.

Can I now call[Interruption.] Thank you. Can I now call on the First Minister, Carwyn Jones?

Thank you, Dirprwy Lywydd. Many of the arguments that have been rehearsed on the floor this afternoon have been rehearsed before and, indeed, were rehearsed two years ago. It's right to say that there was a referendum two years ago and people voted in a particular way, and I've always been very cautious in giving, or appearing to give, the impression that that referendum should be overturned at the drop of a hat, because that's exactly what the Conservatives did in 1997. That was their argument. They said, 'Well, I'm sorry, there was an Assembly referendum in 1997', and for eight years they kept a policy of calling for a second referendum. It seems to me that the Conservatives only accept the results of referendums that they agree with. So, I don't think that is a point that is well made by the Conservative benches.

I don't think there can be, personally, a referendum on the very same question and the very same circumstances, but that's not the case here. As I've said many times in this Chamber, people were asked two years ago to vote for an idea—not a plan, an idea. When we had our referendums here in 1997 and 2011, people could, if they wanted to, look at a document that would tell them exactly what would happen if they voted 'yes'. That wasn't available to them in 2016. Surely, then, people have the right, having taken a decision, to be able to shape that decision. Otherwise, it is the most arrogant and elitist argument to say to people, 'You've taken a decision; now it's all out of your hands.' That's not democracy.

Now, we've heard many times in this Chamber the claims that have been made. We know that there's no £350 million a week for health—that was nonsense; it's been accepted that way. We know that there are no trade deals—none have been negotiated—we know the ports aren't ready, we know the German car manufacturers haven't stepped in to force a deal, and we know that the EU has not fallen apart as a result of Brexit. Now, I don't want to dwell too much on rehearsing those arguments apart from to say this: the argument that is now put forward by Brexiteers is— where they are challenged on facts, where businesses say, 'This is bad for us; "no deal" is bad for us', the response is, 'You don't have confidence in this country.' People deserve evidence; they don't deserve guff.

Secondly, we can see an emerging theme from the Brexiteers that says this: 'Well, if Brexit doesn't work out, it's the fault of the remainers and not our fault.' A stab-in-the-back theory, actually, I think, is beginning to develop here—you know, 'We threw the brick through the window; you're trying to put it back together, but we disagree with the way you're trying to do it.' That is the Brexiteers' argument, as I see it. I don't accept what is said by Neil Hamilton, that people consciously decided to take a view about the customs union and the single market, and why? Because you can be in both without being in the EU. You can be in the customs union without being in the EU; you can play a full part in the single market without being in the EU—[Interruption.] Of course.

17:35

In the course of my speech, I read out from the document that the Government sent to every single household in the country, and it explicitly states in here, in effect, that we would be leaving the single market:

'Losing our full access to the EU's Single Market would make exporting to Europe harder and increase costs.'

There were arguments on both sides. We've heard a load of them today, rehearsed once again. Ultimately, in the jangling of campaign, people make up their minds how to vote, as they do in a general election. We can't re-run a general election every year—well, we could do, but that would not be sensible—why should we do it on this?

The point is this, isn't it? On the Brexiteers' side, repeated claims were made that everything would be fine, there would be a free trade deal and there wouldn't be a 'no deal'. Well, that was just wrong, wasn't it? We all see that. Nobody said two years ago—no-one in UKIP; Nigel Farrage didn't say it; the Brexiteers on the Conservative side didn't say it; the Brexiteers on my own side didn't say it, in my own party—no-one said, 'Well, if we crash out, there'll be a "no deal" and it doesn't matter.' It was always about a free trade agreement, and Norway was the example that was given. There are people in this Chamber, actually, who said that Norway was the example that the UK should follow. I think there's merit in that, although the model isn't exactly right as far as we are concerned. The reality is that the EU is a political project, but then so is the UK. Every nation state, every sovereign state, is a political project and we have to bear that in mind.

But I want to turn, if I could, my attention to an issue that I first raised in this Chamber years ago—one that is trying to be dismissed, but is, in fact, at the very heart of Brexit and the Brexit negotiations, and that's the situation in Ireland. In 1995, the end of the Troubles was being seen by people there. When the Good Friday agreement was signed in 1998, it brought to an end not 25 years of trouble, not 100 years of trouble, but 300 years of on and off war. That's what it brought to an end. People were told, 'You will be able, now, to share an identity; the border will be porous and it won't make a difference anymore, because we're all part of the EU.' That, now, is in grave danger. And yet the response of Brexiteers is to say—Jacob Rees-Mogg has said it; Boris Johnson has said it—that it doesn't matter; that, somehow, it is the tail wagging the dog. Well, in reality, it is absolutely crucial. Because, let me tell Members—and I'll tell Neil Hamilton this—more than 3,000 people died between 1969 and 1994. People on both sides were killed because of their religion. You could not walk the streets in certain parts of the city without putting your life in danger. A helicopter was in the air all day. When you crossed the border, you went through a security point. There were roadblocks all around the city of Belfast. The situation in Northern Ireland was dire: people were killed who were driving taxis because they drove for the wrong firm; people were killed when bombs were placed, as we know, at Enniskillen; people were killed in pubs because they happened to be the wrong religion in the wrong pub. And here we have people saying, 'It doesn't matter; it doesn't matter.' Say that to my wife's family. And you say that to the people of Northern Ireland who went through all that mayhem for many, many years, and say to them, 'It doesn't matter about Northern Ireland'.

Because, remember, the UK is not even 100 years old—not even 100 years old. The UK only came into existence when the Irish Free State was set up under its current borders. I say to Members in this Chamber now: I have seen what conflict looks like in Northern Ireland, and I have seen what peace brings. I saw the prosperity that peace brought. I saw the barriers coming down. I saw people being able to walk the streets without fear of being kidnapped or murdered. We play around with that peace agreement at our peril; it is not something that you play games with, and it is not something that can be dismissed as a result of the Brexit negotiations. Brexit has to take into account that there exists on the island of Ireland a border that's been fought over, where people have died, and a border that in 1998 was an issue that was settled with a peaceful outcome. That is now under threat.

So, yes, there are arguments in this Chamber that have been rehearsed many times before. I'm not seeking to rehearse them and I'm not seeking to say, 'Well, you know, the result was wrong two years ago', because those arguments have already been made, but we do not play with people's lives, and we do not ignore the fact that peace was brought to the island of Ireland because—true—of the efforts of the UK and Irish Governments, but because of the efforts of the EU as well.

With the stakes being so high, I can't see what objection anybody would surely have that, if the political process fails, if Parliament can't agree, if there's an election and there's an inconclusive result, the people are then asked the question, 'What do you now think? You know what the circumstances are, you know what the stakes are—what do you want to do?' And that's democracy.

17:40

Diolch, Dirprwy Lywydd. I'm grateful to those Members that have taken part in this debate, and I'd like just to respond, first of all, to the First Minister, who spoke very, very powerfully, drawing on his own family experience, of course, in terms of the history of Northern Ireland. You know, actually, the contribution of the EU in terms of peace, right throughout this continent, has been right at the core of its history, of course. I was in Germany on the night the Berlin wall came down, there as a student—as an Erasmus student, as it happens. I thought I was on the wrong border that night, because I was on the Franco-German border; I was in Saarbrücken. Cardiff University sent its students to Saarland, which was a bit of a busman's holiday—a coal and steel region of Germany. But, actually, that was the right border to be on, that night, because I witnessed French and German students at that university hugging each other in tears, and I couldn't help myself thinking, actually, it wasn't so long ago on that border that young men from those two countries would have been fighting each other. And, you know, if there is a people's vote, that's the kind of passion, I think, that we can put at the core of this question. 

I am, like Leanne Wood, a passionate Welsh European. Gwyn Alf Williams actually famously said if the European Community as was didn't exist, then we Welsh would have to invent it. It's actually right at the core of our history, from the very beginning. In terms of the time that we find ourselves in now, I pay tribute to the passionate speeches that we've heard, particularly on the Labour backbenches. But here's another difficult truth: we, of course, between our parties, negotiated the White Paper, which set out a sensible way forward in delivering the Brexit mandate, limiting the damage in terms of people's lives and livelihoods. Unfortunately, we live in a time when the British political establishment has no sense. It's incapable of delivering anything. I mean, the truth of it is, if people talk about the moral mandate of the 'leave' campaign, that these people lied. They broke the law. And then they left the scene of their political crime, leaving the consequences to others. That isn't good enough. And, if you talk about the damage to democracy, think about what will happen next. Think about what will happen next if this disaster of a 'no deal' Brexit is allowed to happen in front of our very eyes. 

We've been witnessing, haven't we, a car crash in slow motion? Well, it's speeding up now, right, and the responsible thing is that we—. The first imperative in a democracy is to be honest with the people, and that is—. We have a mandate in this Parliament, we're a people's Parliament, and we have to be honest with the people of Wales. They were lied to, and they deserve the opportunity—now that they have the truth unveiled, they deserve the opportunity to actually decide what they want to happen next. [Interruption.] I give way.

17:45

Thank you. You have been honest, very honest, in saying that you wish to campaign to reverse Brexit. Will you be also honest in admitting that, if we were to announce that there was going to be a second referendum, that would give a green light to EU negotiators to deliver a bad deal or no deal in the expectation that people would then vote to remain?

Well, look, it's not us on this side who have undermined the Prime Minister's negotiations. I mean, look at what even her former Foreign Secretary is saying about the way that she's handled the negotiations. That's one bit where it seems there's wide agreement. It's been shambolic; it's been absolutely pathetic. The problem is, of course, that it's the people who will pay the price for the lack of political leadership there. We are in a position of gridlock, a political gridlock, and we have to find a way forward. There is no easy path forward, and it's under these circumstances that it's right and proper in a democracy that we give the people their choice to revisit this question, because they were lied to; they were never furnished with the full facts upon which they could make a decision.

I would say to Members in the Labour Party that this is an opportunity, yes, I think—this is bigger than party. This is actually about the future of our nation. It will affect us—as Helen Mary has said, particularly the young people, who are demanding a people's vote in greater and ever greater numbers. They will have to live with the consequences of this. The tragedy, of course, is that this collapse of political leadership at the centre of the British state doesn't just affect the Conservative Party; I have to say that it affects the Labour Party as well. We in this Parliament have been able to form agreement in terms of the White Paper, but I'm confused as to what the position is of the Labour Party at the British level. In terms of the six tests that were referred to, well, the policy is to be outside the single market, so how can you meet the test of delivering the exact same benefits? That's kind of Theresa-May-parallel-reality world. We, I think, deserve better than that. I think, actually, Labour Party members and supporters deserve better than that. And I would just appeal to you, even at this late stage—and I'm looking at the business manager: don't join UKIP and the Tories tonight. Vote with us for a people's vote. 

The proposal is to agree the motion without amendment. Does any Member object? [Objection.] Thank you. We will now defer that voting until voting time. 

Voting deferred until voting time.

We are approaching voting time, so unless three Members wish for the bell to be rung, I will go straight to the vote. No, okay, thank you.

9. Voting Time

I call for a vote on the motion, tabled in the name of Rhun ap Iorwerth. If the proposal is not agreed, we vote on the amendments tabled to the motion. Open the vote. Close the vote. For the motion seven, no abstentions, 40 against. Therefore, the motion is not agreed. 

NDM6816 - Motion without amendment: For: 7, Against: 40, Abstain: 0

Motion has been rejected

We now move to vote on the amendments. If amendment 1 is agreed, amendments 2 and 3 will be deselected. So, I call for a vote on amendment 1, tabled in the name of Darren Millar. Open the vote. Close the vote. For the amendment 10, no abstentions, 36 against. Therefore, amendment 1 is not agreed.

NDM6816 - Amendment 1: For: 10, Against: 36, Abstain: 0

Amendment has been rejected

We now move to vote on amendment 2. If amendment 2 is agreed, amendment 3 will be deselected. I call for vote on amendment 2, tabled in the name of Gareth Bennett. Open the vote. Close the vote. For the motion two, 10 abstentions, 35 against. Therefore, amendment 2 is not agreed.

NDM6816 - Amendment 2: For: 2, Against: 35, Abstain: 10

Amendment has been rejected

We now call for a vote on amendment 3, tabled in the name of Julie James. Open the vote. Close the vote. For the amendment 27, no abstentions, 19 against. Therefore, amendment 3 is agreed.

17:50

NDM6816 - Amendment 3: For: 27, Against: 19, Abstain: 0

Amendment has been agreed

Motion NDM6816 as amended:

To propose that the National Assembly for Wales:

believes that the option of a people’s vote must be kept on the table and in particular if the Prime Minister is unable to secure agreement on the final terms of the UK’s exit from the European Union and there is no subsequent general election, then the people must decide on the way forward.

Open the vote. Close the vote. For the amended motion 28, no abstentions, 18 against. Therefore, the motion as amended is agreed.

NDM6816 - Motion as amended: For: 28, Against: 18, Abstain: 0

Motion has been agreed

10. Short Debate: See differently—Living with sight loss in Wales today

We now move to the short debate.  If Members are leaving the Chamber, could they do so quickly and quietly, please? If you're leaving the Chamber, please do so quickly and quietly, because I'm moving to the short debate and I call on Nick Ramsay to speak on the topic he has chosen. Nick Ramsay.

An audio-visual presentation was shown. The transcription in quotation marks below is a transcription of the oral contributions in the presentation. The presentation can be accessed by following this link:

Audio-visual presentation.

'Sight loss is not black and white.'

'Ninety three per cent of us who are registered blind or partially sighted can see something.'

'My eye condition is glaucoma, and, if you imagine in my left eye, I've no perception of light at all, so it's completely black, and in my right eye, it's almost like I'm looking through a really murky kind of watery fog machine, if you like.'

'I have Usher syndrome type 2. That's a combination of hearing impairment and retinitis pigmentosa. The most common misconception about my sight loss in particular is that I don't "look blind".'

'I have macular degeneration. I can't see your face now, there's just a big round blob there and I have double vision as well. The first couple of years were horrendous, it was like a bereavement really. I was so afraid. I might cry. People are absolutely brilliant, but without the white cane, I would not be as confident.'

'In the UK, more than 2 million people are living with sight loss. Being registered blind doesn't mean you can't see anything. There's a whole spectrum of sight loss out there and that's what people need to know about.'

'RNIB Cymru. Golwg gwahanol. See differently.'

Diolch, Dirprwy Llywydd. I've agreed to give Dai Lloyd a minute of my time during this debate. This video that you've just seen, produced by the Royal National Institute of Blind People, is from the How I See campaign and raises a number of issues that I wish to put before you today. 

Sight is often cited as the sense that people would be most afraid of losing, and it can be tough. From difficulty accessing treatment and services to a lack of emotional and practical support, blind and partially sighted people each face their own set of challenges every day.

Feelings of isolation are unacceptably high, and only one in four blind or partially sighted people of working age has a job. And we know the numbers will increase dramatically. An estimated 107,000 people in Wales live with sight loss and this is expected to double over the next 20 years. That means there will be approximately 218,000 people in Wales living with sight loss by 2050. 

Sight loss affects people of all ages, but, as we get older, we are increasingly likely to experience it. People with sight loss are more likely to have a fall and are more likely to live in poverty. They're more likely to have depression, to be unemployed and have problems with everyday life, such as going out, cooking and reading. Today, I want to touch on just some of the barriers that blind and partially sighted people face and to challenge us to see and do things differently.

As most sight loss conditions are degenerative, but also treatable, it's crucial that people have timely access to eye care and ongoing treatment. Ophthalmology is one of the highest volume hospital outpatient services, and many eye patients have an ongoing need for timely follow-up to preserve their sight. As a member of the cross-party group on vision, I've heard from patients on hospital eye clinic waiting lists that their appointments are being cancelled at exceptionally short notice. I know we've got other members of the group here today, too. Delays to treatment can put people at risk of irreversible sight loss. That said, I would like to welcome Welsh Government's recent announcement of investment to support implementation of the new ophthalmic outcome focused measures—the first nation in the UK to have specific measures for eye care. This is something I've championed for several years and raised the need for in my last debate on this subject.

These new measures will provide clinically approved targets and prioritise patients according to their risk of irreversible sight loss. No-one should lose their sight in Wales because of a treatable eye condition. I look forward to hearing that health boards have implemented these new measures and to receiving the first progress reports in April 2019. It's high time we had transparency from health boards as to the number of patients at risk of losing their sight. This is a long overdue system change for eye care in Wales, and let us not forget the patients in all of this. We need to make sure that they're kept fully informed about the changes, and understand what it means for their care and treatment.

For people living with sight loss, it can impact on every aspect of life—physical and mental health, the ability to live independently, to find or keep a job, their family and social life. Timely access to support from social services is critical to help mitigate the impact of sight loss. Rehabilitation is a specialist service that helps a person with sight loss to adapt to the world around them. The service supports people to relearn skills they need to live an independent life. It could include emotional support, help with mobility, aids and adaptation, or help to assist with activities of daily living such as laundry, cooking and cleaning.

Now, every year in Wales half of those over 80 will have a fall in their home. Almost half of all falls experienced by blind and partially sighted people have been attributed to their sight loss. What's more, falls have been estimated to directly cost the NHS £67 million per year. The cost of falls in Wales related to vision alone is estimated to be £25 million annually. It's a no-brainer in my view that rehabilitation should be a universal offer to all blind and partially sighted people. The economic value alone of vision rehabilitation per referral is estimated at £4,487.

However, it's unacceptable that when it comes to accessing rehabilitation, too often we see a postcode lottery in Wales. In some areas of the country, some people are having to wait over 12 months to see a specialist rehabilitation officer, during which time their sight condition may be deteriorating and they risk becoming quickly isolated. Forty-three per cent of people who lose their sight will suffer significant and debilitating depression. The problem is further exacerbated by the fact that not enough people are being trained to replace retiring rehabilitation officers. Charities in the sight loss sector are increasingly concerned about the provision of rehabilitation for visually impaired people. In some areas, waiting times are unacceptably long, and in others people are getting screened out of rehabilitation assessments completely, or they're being assessed by unqualified staff. Local authorities and health boards need to develop clear referral routes into rehabilitation and early intervention and preventative services where this is not already happening. It's unacceptable that this profession is not being futureproofed. We need to establish plans for future workforce development and encourage people into the role. Ultimately, we need to make sure that people have timely access to rehabilitation services no matter where they live, to enable them to live as full and independent a life as possible.

Turning to the ability to access information and advice, the majority of people who lose their sight also lose their ability to communicate via standard print. This is vital for anyone to maintain their well-being and have voice, choice and control over their life.

In 2013, the accessible healthcare standards for people with sensory loss in Wales were launched. Wales became the first country in the UK to lay out how NHS services will be delivered accessibly to people who are deaf, hard of hearing, blind, partially sighted or have dual sensory loss. Accessible information might mean receiving information in Braille, in large print, in audio or e-mail—whatever is right for that patient to support them to participate fully in their healthcare, as fully as possible. But it is now five years since we launched those standards. The stark reality is that these have had a limited effect, and people are still facing major barriers to healthcare. Patients are still leaving hospital every day unsure of how much medication they are meant to take, or unsure of what advice they have been given. Yes, there has been tentative progress in some areas, but, overall, charities such as RNIB and Action on Hearing Loss tell us that there has been little demonstrable change for people with sensory loss in Wales. Moreover, we were proud, and rightly, that Wales was the first nation in the UK to implement the standards. Why then are we still in many ways no better than across the border in England? Surely, it's high time that the standards, like the Welsh language standards and others, became mandatory. Why isn't Welsh Government setting annual targets from each health board to monitor the improvements? This is a patient safety issue. Patients need to be able to engage in and fully understand their consultations with healthcare professionals.

The built environment is another area where we can minimise barriers for blind and partially sighted people. RNIB Cymru's Visibly Better programme supports organisations to develop environments that more people feel confident in getting in and around. The design principles help prevent falls and promote confidence by establishing appropriate lighting levels, colour and tonal contrast, and fixtures and fittings that aid way finding. Visibly Better design has been used in the newly refurbished radiology department at the University Hospital of Wales. The whole area is now much easier for patients to navigate confidently and safely. We need to futureproof our environments for our ageing population, and we need a commitment to these principles being applied to other public spaces in the future.

If I can just touch on shared space, the concept of shared space is, on the face of it, a most appealing one. Spaces are deregulated to ensure that no-one has a sense of priority. The space is jointly shared by vehicles, pedestrians and cyclists. It all sounds great, but it relies on the ability to make eye contact and that is not easy if you can't see. That means that that space becomes unsafe and avoided. This situation can be worsened by the removing of any crossings and differentiation between pavement and road. The Active Travel (Wales) Act 2013 was introduced with the primary aim of promoting the increased benefit of walking and cycling. However, blind and partially sighted people risk not feeling these benefits when poor planning of shared space puts them at risk of collision with cyclists, so something that starts off as a good idea can end up with a different consequence. A survey carried out by Guide Dogs showed that 97 per cent of people with sight loss have collided with street clutter such as A-boards. 

Finally, Dirprwy Lywydd, I just want to address the issue of transport. Many blind and partially sighted people are reliant on public transport for most of their everyday journeys. In rural areas where people may feel more isolated and public services are further away, blind and partially sighted people rely on public transport that is often old, with bus stops that have no information. That affects people who are fully sighted as well, so we all appreciate those problems.

Can I end by wishing RNIB a very happy birthday as it marks 150 years of championing the rights of blind and partially sighted people this year? We in Wales need to find new solutions and new ways to build a country where the equal participation of blind and partially sighted people is the norm. These are just some of the barriers that people with sight loss face every day, and I know we can tackle them. We can do things differently, and we can see things differently. Diolch yn fawr.   

18:00

Diolch, Dirprwy Lywydd, and can I commend Nick Ramsay's excellent presentation setting out all the facts and the details? And it's good to highlight the issue of sight loss here in the Assembly, as chair of the cross-party group on vision. As Nick alluded to, earlier in the summer we had figures through that showed that there were 54,000 patients in Wales on follow-up waiting lists in ophthalmology clinics in our hospitals that were at risk of losing their sight. These are people that had been seen by specialists, were due to be seen again in three or six months—they had glaucoma, or whatever—but those appointments were always being put back for a variety of reasons, and sometimes they would not got seen for months, sometimes years. They're at risk: 90 per cent of sight loss was happening in those follow-up waiting list situations. It is a situation that needs to be tackled, because these people have been diagnosed and they've been lost to follow-up because of delays. There are initiatives, as Nick was saying, and we look to Government to bring those figures down. Diolch yn fawr. 

Thank you. Can I now call on the leader of the house to reply to the debate? Julie James.

Thank you, Deputy Presiding Officer, and I very much thank Nick Ramsay for raising this very important issue, and I'm pleased to be able to talk about the actions this Government has been taking to help remove the barriers for people who are blind or partially sighted, or to see differently as Nick Ramsay has put it. 

Last month, the Cabinet Secretary for Health and Social Services announced a £4 million investment as part of measures to transform eye care services across Wales, to ensure patients are diagnosed and treated more quickly. We've requested advice from an independent panel on how to allocate the £4 million, and we are working to involve everyone in designing the best way to implement changes or standardise and simplify what is already being done. We will make sure patients are kept fully informed about any changes and understand what it means for their current treatment. We do accept entirely what Nick Ramsay has said about people being involved and engaged in the care that they receive.

The service changes will support the introduction of a new performance measure to be introduced later this month and it will be based on the patients' clinical needs. Wales will be the first UK nation to introduce a measure of this kind for eye care patients alongside the existing referral-for-treatment target. The challenges facing ophthalmic services are well known. Nick Ramsay pointed out a number of them.

The number of people with sight problems is set to increase dramatically, and as such obviously the burden on current services will also increase. As the video is very dramatically showing us, and quite rightly so, currently nearly 107,000 people in Wales are living with sight loss, and this is predicted to double by 2050. Improving access and speeding up diagnosis are vital to ensure eye care services are fit for the future. We absolutely recognise that some waiting times are too long and there is a much needed system change for eye care—that is why the Cabinet Secretary for health is announcing these. We do need to find new ways of working alongside the community. 

The Cabinet Secretary for Health and Social Services has also emphasised that we expect all patients to be seen as quickly as possible and in order of clinical need. As Nick Ramsay says, we are rightly proud of the fact that we're the first Government in the world to have an eye care delivery plan and are now the first in the UK to introduce a performance measure of this kind for eye care. These changes are in line with our long-term vision for the NHS in Wales to transform the way services are delivered and provide quality care closer to people's homes.

We are also bringing forward new patient pathways to prevent sight loss and better support people to live independently in the community. Since 2001, the NHS Wales eye care service has enabled optometrists and ophthalmologists, so primary and secondary care tiers, to work at the top of their licences to reduce the number of patients being referred to hospital eye departments. The service works to firstly preserve sight through the early detection of eye disease and then to provide help to those who have visual impairment for which further treatment is not appropriate. 

Two ophthalmic services are unique to Wales and are providing high-quality services and support to people with eye problems. They are the eye health examination service, which enables people to access services in their local optometry practice instead of their GP surgery or hospital department, and the diabetic eye screening Wales service, which screens all patients with diabetic retinopathy to help prevent them going blind unnecessarily.

As well as improving patient pathways, Nick Ramsay rightly also brought up the issues around essential work that needs to be done to ensure that we support independent living. The Government is incredibly proud to be able to promote the social model of disability. That is to say that we recognise that there are organisational, attitudinal and environmental barriers to equality and inclusion that must be removed to create a level playing field and to ensure any person living with a disability has access to the same opportunities as everyone else. We obviously also take this approach with sight loss.

A third eye care service, also unique to Wales, is the low vision service. This enables people living with sight conditions to make the best use of the sight they have by prescribing low-vision aids and enabling them to live as independently as possible. Working with the low vision services for Wales, we are working to ensure effective referrals to social services and the third sector to offer vision impaired individuals help to establish the support they need and wish to achieve.

We'll shortly publish a new framework, entitled action on disability, the right to independent living, in October of this year—in fact, in this month of this year. The new framework will continue to be rooted in the social model of disability. We've been extensively engaging with disabled people and their representative organisations over the last year to identify areas of inequality that matter most to disabled people of all ages in Wales, together with their potential solutions. 

Our ambition for the low vision service is one of many actions in the framework's action plan tackling some of the key barriers identified by disabled people themselves. These key barriers will be no surprise to Members to hear. Nick Ramsay pointed out many of them. They are: accessible information, access to buildings, access to shared space, including active travel routes and street clutter issues, and access to public transport. I think you highlighted all of those in your contribution, Nick. 

We also introduced the all-Wales standards for accessible communication and information for people with sensory loss in December 2013. The aim of the all-Wales standards is to set out the standards of service delivery that people with sensory loss should expect to receive when they access healthcare in Wales. The key part of the all-Wales standards is the requirement that every patient or service user who requires communication support should have this need met.

As a result of this requirement, the new accessible data information standard has been issued to meet the need to provide communication support. This is a national project, led by the Welsh Government in partnership with the Centre for Equality and Human Rights, health boards, NHS trusts, the NHS Wales Informatics Service, and third sector partners. The standard enables GP surgeries to capture, record, flag and share the communication information needs of patients with sensory loss. It is a tool, or an enabler, to help GP practices and healthcare professionals meet their legal duty under the Equality Act 2010 to make reasonable adjustments for those with a disability. It also enables GP surgeries to do this in a consistent manner across all health boards. And, in addition, a Welsh health circular has now been issued with an implementation plan giving details of this new accessible data standard.

One of the other areas I also want to mention—and, again, Nick Ramsay raised this—is access to employment opportunities for people living with disabilities, including impaired vision and sight loss. Seventy-five thousand disabled people in Wales are either actively seeking work or would very much like to work. Just 45 per cent of working-age disabled people are currently in employment, compared to 80 per cent of those not disabled, which is a really pretty shocking disability employment gap of around 35 per cent.

We've been working very hard in this sector to identify these barriers because they're very often beyond the control of the disabled person. So, organisational systems, attitudinal, physical and environmental barriers. Many of the commitments set out in our employability plan are aimed at tackling this disability employment gap. We work with partners to address the issues, including employer attitudes, job design and working practices.

I was very pleased to speak at an employability inclusion summit in Swansea last Friday, where I had the privilege and pleasure of meeting a large number of disabled people and talking to them about some of the barriers they had encountered, but much more importantly, and optimistically, about some of the available assistance to employers, and there were a large number of employers there who were very able, eager and willing to look at some of the small adjustments that they could make to ensure that they could continue to employ people with disabilities.

We've also established an officials working group on equalities and employment, which includes driving forward actions on disability in employment, to supporting our commitments within our employability plan to increase the number of disabled people into work. In partnership with disabled people, we are working to develop a meaningful target that will reflect their needs and wishes and that will be ambitious and achievable. We hope this will provoke the step change necessary, both within workplaces and society, to break down the barriers faced by disabled people and those with long-term health conditions while seeking employment.

I just want to say, Dirprwy Lywydd, at this point, that we know that in trials where personal characteristics are stripped out of application forms, employers are often shocked then to discover that the person that they previously said wasn't acceptable to them actually has all of the qualifications necessary. We know that this employment gap exists at all levels of skills. So, disabled people with a PhD are less employed than other people with a PhD, and all the way down there's a skills gap. So, it's very much the social model: it's around us accepting that disabled people very often, if not always, have the skills available to them and, actually, what we need to address is the inclusivity of our employment practices, both in the public and private sector in Wales.

Our business skills gateway webpages have now dedicated pages setting out the support available to employers and individuals to assist them to employ disabled people, and we're working with the DWP to help develop an employer pack of information about access to work, which will include further information to help employers seek specialist advice to help with the recruitment of disabled people. Lastly, a new disability action plan for apprenticeships will be published in autumn this year, focusing on practical actions to break down barriers to disabled people accessing apprenticeships.

The question was asked in Nick Ramsay's contribution: how can we remove the barriers to equal participation in society of blind and partially sighted people? And the answer is that we can do that by improving patient pathways; using the social model of disability; listening to the community and taking action on the issues that matter most to them, such as accessible information, employment, and the clinical pathways that Dai Lloyd also emphasised. So, I'm very grateful to the Member for raising this important point and I think that, together, we can continue to make Wales an exemplar in this field. Diolch. 

18:10

Thank you very much. That brings today's proceedings to a close. Thank you.

The meeting ended at 18:14.