National Assembly for Wales

Good afternoon, everybody. I call the Assembly to order, please. 

The first item on our agenda this afternoon is item 1, which is questions to the First Minister, and question 1 is Llyr Gruffydd.

Thank you. May I begin by thanking those volunteers who’ve worked so hard during the very inclement weather, and especially those who have helped to transport health service staff to their places of work, and those who have worked so hard to ensure that there is less pressure on the NHS, local government and, of course, the emergency services? 

We are providing full funding of £27 million to local authorities to enable them to meet the care and support needs of those who currently receive payments from the Welsh independent living grant.

People with disabilities who are in receipt of this grant tell me that their greatest concern is losing that element of independence that the grant provides them on a personal level. They appreciate the independence more than anything else. So, what assurance can you give that they will continue to enjoy the same independence when that grant is brought to an end by your Government?

We’ve been monitoring what the local authorities have been doing, and that monitoring will continue in the current situation, namely the transition period. From the beginning of that period in April of last year to the end of that period, we will be monitoring the actions of local government. We know, of course, that individuals have been assessed during that same period. I know that the Minister is aware of the need to monitor the experience of individuals as regards the process at present, and the Minister is considering the way forward in order to ensure that there is assurance for those in receipt of the grant.

Thanks for that partial clarification. The independent living fund, pre-devolution, was about giving individuals choice and control over how they spent their money, their fund, to live independently. Initially, the Welsh independent living grant worked that way, but, unlike Scotland and Northern Ireland that have developed their models in partnership with the third sector, you're requiring local authorities to meet with people receiving the grant to agree the support they need to do this. The Save the Welsh Independent Living Grant campaign says that independent living is a rights issue and closing the Welsh independent living grant is a betrayal of disabled people, their families, friends, staff and community because it takes their voice, choice, control and independence away from them. I know that the leader of the campaign met Huw Irranca-Davies in January, and the leader of that campaign subsequently said that this was probably the most important meeting of his life. That's how important this is. Will you, at this final point, please listen to this community and recognise that independence means giving them choice and control, and not having to agree how they should spend their money with well-meaning experts in county hall when they are the real experts in their own lives?

In terms of how we got to where we are, there was an advisory group, as the Member will know, which recommended providing future support through local authorities' social services. Now, the principle behind that was to ensure that all disabled people in Wales were supported to live in the same way, and to ensure that the finite funding—let's remember that transferred from the UK Government—is used directly for that purpose and not on the operating costs of separate arrangements for only some disabled people. We've made sure in Wales that every penny of that money has gone to recipients. That has not been the case elsewhere in the UK. 

First Minister, I've been contacted by a number of constituents who are also concerned about the future working of the grant. My constituents are not concerned as to where this funding comes from, whether it's Welsh Government or local authorities. All that concerns them is that they will be given the same level of support. So, what can the Welsh Government do to monitor this new system to ensure that local authorities continue to provide that level of support?

Well, that monitoring is continuing. We know that local authorities had reviewed, or were in the process of reviewing, the future support needs of just over 350 of the former ILF recipients in Wales. Out of these, just over 30 had already agreed and were receiving their future support either direct from the authority or by receiving direct payments in order to obtain their support themselves. Now, there is a need, of course, to continue with the monitoring arrangements, as I mentioned earlier on. We want to monitor recipients' experience of the process, and that is what the Minister is considering at the moment in terms of how that might be taken forward.

First Minister, many local authorities appear to be struggling to meet their obligations under the Social Services and Well-being Act (Wales) 2014. For example, many carers across the country have not received carer assessments. The end of the independent living grant places additional pressures on local authority social services. First Minister, can you guarantee that those in receipt of the independent living grant will receive support that is equal to or better than the support they currently receive once local authorities have to provide that support?

Well, the money has been transferred to local authorities. We want to make sure that the level of care remains at least as good as it has been in the past. And I remind the Member, of course, that the amount we spend on social services per head in Wales is significantly higher than in England.

Well, we consulted on lowering the voting age for local government elections recently. That change will be implemented for the next elections, given effect through the local government Bill in the autumn. And I know the Llywydd is consulting separately in respect of elections to the Assembly.

I thank the First Minister for that reply. There are strong arguments for reducing the voting age to 16, but would the First Minister agree with me that consistency is also an important element in the law, and if somebody is adult enough to be able to participate in choosing the Government of the country at the age of 16, they should be able to drive a car lawfully, to decide for themselves whether to get their bodies tattooed or pierced, they should be able to buy alcohol lawfully, they shouldn't be subject to any rules on film censorship, and so on and so forth? If we are not to have any consistency across the whole range of the law, what possible justification could there be?

Well, there's no consistency in that case now. I believe that 16-year-olds are well able to vote. They're able, for example, to give their consent for medical procedures. Why then should they not be able to form their own minds, make up their own minds, in terms of who to vote for? They can't drive until they're 17, they can't consume alcohol until they're 18, they can't be a competent driver until they're 21, they can't ride any motorcycle of any engine size until they're 24. There are inconsistencies, of course, but, nevertheless, to my mind, 16 is an appropriate age, and the Scots showed this in their referendum, for young people to be able to vote at.

First Minister, perhaps you've noted that, in Scotland, in the referendum on Scottish independence, the number of 16 and 17-year-olds who voted was 75 per cent. That compares to 54 per cent for the age group just after that—18 to 24—and a very similar differential was present in the 2017 Scottish local elections. Do you agree with me that engraining a habit to vote early offers great benefit to society and allows us to focus on the responsibilities of citizenship, but also our ability to influence what goes on around us in the world in which we live?

Absolutely. In Northern Ireland, in many years gone by, the slogan was, 'Vote early, vote often'. The second bit of it, I suspect, we need to leave out. But the figures speak for themselves. The fact that 16 to 18-year-olds turned out at a far higher rate than those in the immediate age group beyond shows how enthusiastic they are, how engaged they are with the political process, and how important it is that that sense of engagement continues as they get older.

Plaid Cymru supports extending the franchise to young people at 16 and 17-years-old, certainly, but we want to encourage people of all ages to vote in higher numbers, and, to do that, we need to give them good reasons to vote, and you can’t just expect people to vote because you’ve given them the right to do so. So, in your proposals for reforming local authority elections, where are you putting the priority? Is it by ensuring that all votes count via a proportional system, by changing the voting system, elections on different days, electronic voting, voting using different methods? Where do you think you will not only get young people to have the right to vote, but how you will encourage them to vote, too?

Well, there is scope to consider the methods that people use to vote. For example, there’s no reason why every election has to be on a Thursday. Why can’t we have elections on the weekend?  That happens in a number of other countries. Historically, Sunday would be difficult in Wales, but voting happens on the weekend in a number of countries, where more people can go out to vote. In time, I’m sure we will see people being able to vote electronically. Of course, there are issues regarding the security of doing that, but I’m sure they will be resolved. What is crucial is that we ensure that people want to vote, that they understand how the system works, that they have a desire to vote, and then, of course, consider how we could facilitate that further.

First Minister, the proposals announced by the Welsh Government in January to lower the voting age to 16 in local council elections achieved wide cross-party support, and, as the Cabinet Secretary for Local Government and Public Services has stated,

'Local democracy is all about participation.' 

First Minister, it is our duty to ensure the political rights that we bestow on all our children are allied with commensurate political activity and literacy. What actions, therefore, can the Welsh Government take to ensure that every Welsh child, wherever they are born and educated in Wales, has access to comprehensive and universal civic education at the heart of their education to ensure that they are politically literate on the governance of Wales and the United Kingdom?    

Well, we are developing a new curriculum for Wales and one of the four purposes of the new curriculum is that young people leave education as ethical, informed citizens who are able to understand and exercise their human and democratic responsibilities and rights. Of course, making sure that happens in practice will be an important part of the curriculum, because we know that education is about qualifications, yes, but it's also about developing the whole person and the whole person's knowledge of society around them. 

We'll now turn to the party leaders to question the First Minister, and the first up today is the leader of Plaid Cymru, Leanne Wood. 

Diolch yn fawr iawn. First Minister, the media has reported today that at least 271 highly vulnerable mental health patients have died over the last six years after failings in NHS care, and that 136 NHS bodies have been given legal warnings by coroners. As is often the case, the report refers to patients in England and Wales. Can you tell us whether any Welsh NHS body has been subject to a legal warning by coroners regarding the death of a mental health patient? 

I'm not aware of one, but I will write to the leader of Plaid Cymru with more information on that. 

Okay, thank you for that.

There have been many calls for an inquiry into these deaths, including calls from your own party. Now, we know that there have been failings in mental health care in Wales. We can all remember the Tawel Fan scandal. So, I don't think there's any room for complacency on this question. Suicide rates are higher in Wales than they are in Scotland and England, yet we also know that a minority of people who lose their lives have had contact with mental health services in the year prior to their death. This suggests that the mental health needs of all, but possibly young people in particular, are not being met. Can our public services be more proactive in identifying and supporting people who are experiencing mental health crises to get help earlier, and do you have an access problem with your mental health services? 

I think there are issues with certain sections of the population not accessing services, not wanting to or not recognising where they may have symptoms that imply a negative state of mental health. Of course, through the schools, we have a support system now that helps young people, and we would encourage GPs, as they talk to people who come to see them perhaps with physical ailments, to actually try to identify whether there is something deeper that is affecting a person's overall state of health. 

I think you can do much more than that, First Minister. We know that children and young people with mental health difficulties go an average of 10 years between first becoming unwell and getting any help. And many of us here in this room, I'm sure, will have casework of patients who have had to fight to get any support at all.

Now, I've got reason to believe that the number of people detained by the police under section 136 for their own safety, which is due to be published soon, will have gone up dramatically. I've also been informed that because some patients are not deemed to be at immediate risk, despite having been sectioned, they can be waiting days for transfer. Service capacity is clearly inadequate to deal with crisis, and reducing the usage of section 136 has to now be a priority for your Government.

I will come back to this issue when those figures are published, but wouldn't you agree with me now that it's a good time to have a wider inquiry into our emergency mental health system to identify these failings? Isn't it time to stop pretending that everything is fine, when clearly these figures demonstrate that it's not?

I think it's important to wait to see what those figures actually show, and then, on the basis of what we find, to see what action needs to be taken. In terms of mental health in Wales, we've seen the provision for children and young people improve substantially with the extra money—£8 million, if I remember—that went into those services, and, of course, what is being done in schools to assist young people as well. She mentions figures that are yet to come out. I think it's important to wait until those figures are out and then make an assessment of what more needs to be done in order to bring the figure down—those who are subject to section 136 orders and, of course, those who, tragically, take their own lives. 

The leader of the opposition, Andrew R.T. Davies.

Thank you, Deputy Presiding Officer. First Minister, I join you in your comments earlier, when you answered question 1, on the heroic efforts of the emergency services and everyone over the winter weather that we had back last Thursday. There have been some heroic stories, but also some heart-warming ones as well. Equally, it boils down to the fact that what local authorities, health boards and other public bodies are facing once the clean-up operation is complete is a rather large financial bill that will land in treasurers' departments the length and breadth of local authorities across Wales. What discussions, if any, at this very early stage, has the Welsh Government had with public sector bodies—health boards and local authorities—in helping them meet this financial bill, which they weren't expecting this late in the winter?

There have been discussions with local authorities. At this moment in time, we have asked local authorities to quantify what the extra pressures might be in order for us to better understand the situation.

I take it from that that there will be Welsh Government support coming forward for local authorities, First Minister, in particular some of the ones here in the south, which seem to have had the biggest quantity of snow dropped on them.

But I would like to ask you a question about the National Procurement Service, which the Public Accounts Committee looked at yesterday and which the auditor general has highlighted as being particularly poor value for money for the Welsh pound. When it was first brought forward, the then finance Secretary to the Welsh Government said that this was going to be a collaborative model to actually deliver savings in public procurement—£4 billion of public procurement goes on here in Wales. The initial sum allocated was to try to save money—around £1 billion of public procurement on electricity costs and other costs that are met. It was deemed a

'very Welsh way to meet Welsh business needs but also value for money for the Welsh pound'.

Well, virtually on all counts it seems to have missed its goals. What are you doing, First Minister, as a Government, to either make this system work better or actually reform it totally so we can get better value for the Welsh pound?

First of all, it has to be said that the NPS hasn't lost money. It's not yet at the point where it can pay for itself from levy subscriptions, but the service is on target to secure the public purchasing services envisaged, and that's about £40 million so far. The NPS actually belongs to its 73 members across the public service. It is governed by an independently chaired board, comprised of representatives of the membership. We have hosted the service and we have supported it financially, but we don't actually own the NPS alone.

I can say that uptake of NPS frameworks has increased steadily since it became fully operational in 2015, and it's still increasing. An indicative figure for spend for 2016 was £234 million, an increase of over 50 per cent on the previous year, and that means indicative savings of £14.8 million. So, we know that the service is growing. It wouldn't be the case to say that it has lost money, but it's not yet in a position where its levy subscriptions are covering its costs.

First Minister, it's unable to pay the initial capital that you made available to it of £6 million, or its annual running costs of £2.5 million. In its first year, it was only able to attract £330,000 of levy money, as you put it. It has missed virtually every target that was set in its first year—it's now in year 3. By any measure, what could have been an exciting National Procurement Service, actually delivering real value back to the taxpayer, has failed to achieve its goals. If you look at Welsh Government procurement, only 32 per cent of its own procurement is localised here in Wales. With your document 'Prosperity for All', you talk about delivering greater payback to communities across the length and breadth of Wales. Well, using the procurement service, you've failed in its first three years. How are you going to actually meet the policy initiative that is in your 'Prosperity for All' document with, obviously, delivering that Welsh pound back to businesses?

We're confident that the NPS is on target. What the NPS needs to consider is whether to increase the subscription in order to provide more revenue for itself to cover those costs in the future. But we're confident that it's on course to meet its target and, as I say, the public purchasing savings that are envisaged as part of that target we believe we will meet. What we do know is that around £40 million has been saved so far through the procurement service.  

The leader of the UKIP group, Neil Hamilton. 

Thank you, Deputy Presiding Officer. All Members, I'm sure, are pleased, albeit in varying degrees, to see the return safely of the First Minister from the United States of America. I read the written statement that was published this morning by the Welsh Government of what he did on his trip there, and I was quite surprised to see that there was no mention of any meetings with members of the United States Government administration. And on the very day President Trump announced that he was intending to see tariffs introduced on steel from all parts of the world, the First Minister was meeting the person who lost to President Trump in the presidential election, Hillary Clinton. Shouldn't the First Minister be more interested in playing power politics than the politics of impotence? 

I'm not sure whether the leader of UKIP thinks I should have broken down the door of the White House in order to demand a meeting with the President of the US. It doesn't work that way, I can assure him. But, of course, the issue of steel tariffs puts a very big hole in his view of the world, a post-Brexit world, because we were told by him and by others that the way was now open for us to do a deal, a free trade agreement, with the US, and yet one of the first things the US has done is impose tariffs on steel that we actually export to the US. It's not a very friendly action, is it? 

The First Minister knows that the United States' concern about steel exports to the United States is not with Britain, because actually there's been an 11 per cent reduction in the volume and value of steel that is exported from the UK to the US in the last two years. The quarrel is with countries like China, which produces half the world's steel and where there's massive excess capacity equivalent to the entire consumption of steel in the United States over one year, and countries like Vietnam and Canada, which export to the United States 10 times as much steel as we do. The President is concerned about the effect of the North American free trade agreement with Canada and Mexico. We happen to be caught up in the slipstream of all this. The response of the European Union to the President's announcement is likely to be disastrous whilst we are within the customs union, because the European Commission now says it wants to retaliate by introducing tariffs on cars, perhaps, and other manufactured goods, which could have massive impacts upon British workers' jobs and Welsh workers' jobs over many parts of the country. If we had an independent trade policy outside the customs union of the EU, we would perhaps be able to strike our own deals with other countries, in particular the United States, which is our biggest single trading partner apart from the 27 countries of the EU.     

Let me try and educate him. First of all, US businesses want to see free trade. That much is true. The US Government does not. It does not. These steel tariffs are being imposed on all countries. He may be right in saying that China and other countries are the main target, but this is a blunt instrument that's being used against all. No-one has said in the US administration that the UK will be exempt in some way, or the EU will be exempt in some way. This is a tariff against all. He then criticises the European Union for suggesting that there may be retaliation. What does he expect? Is he saying that if the UK was not in the EU, there would be no action by the UK Government? Because if he wants a definition of impotence, he's just given it. 

The question is whether we should attempt to solve these problems by diplomacy and sensible talking to other parties, or engage in the kind of megaphone bellicosity that has come out of Brussels in the last few days. There are very serious issues at stake her. Other countries like Germany and Spain export far more steel to the United States than Britain does. So, Britain is not the cause of the current problems and concerns in the United States. Whilst it's true the announcement that's been made so far is on the basis of this tariff applying universally throughout the world, the details of what's proposed are not yet published, of course, and those are up for negotiation. The US commerce secretary has said as much.

So, I revert to the first question I asked the First Minister: does he not think it would have been sensible to open some channels of communication, even if it wasn't at the level of the President of the United States himself, who is very pro-British—it's obvious from the things that he's said in the time that he's been in office—[Interruption.] Well, Members can laugh, but the United States is globally a vastly important influence upon the economy and in particular on jobs and the livelihoods of people in this country. We should surely want to get on as well as we could with the leader of the free world and with one of our most important trading partners. 

Well, he talks about megaphone bellicosity without any sense of irony and blames Brussels for it. I have to say, the reality is that the current US Government—I don't believe this is a view shared by US businesses at all, nor those who invest in Wales—wants to impose 24 per cent tariffs on steel from the UK. I agree with him; the UK is not the main target for these tariffs, but is caught up in it anyway. Now, the Prime Minister herself has spoken to the President, to no effect at all, in terms of these tariffs being lifted. Now, is he really saying that if the US imposes tariffs on goods coming into the US, that the UK and the EU should do nothing at all in response? I'm afraid that's not the way the world works.

I'd prefer to see a situation where the US has freer trade with the EU and, by definition, the UK, but it may have escaped his attention that the US has the most protectionist Government it has had for many, many decades. It is not interested in free trade deals that are not wholly of benefit to the US. When I was in the US, one of the themes that emerged was that the NAFTA negotiations are based on the US demanding everything for itself and no flexibility as far as Canada and Mexico are both concerned. You cannot be a protectionist Government on the one hand and then say you want to have free trade on the other. I very much regret the announcement that was made by the US President in terms of steel tariffs. It may have an effect on the Welsh steel industry, but to sit back and do nothing is the most impotent response imaginable.  

Thank you. We now move back to questions on the order paper. Question 3, Mark Reckless. 

Yes. I refer the Member to my written statement, which was issued earlier today.

The First Minister went to the United States promoting a free trade deal between the UK and the United States. He came back saying we have to leave it to the EU. Isn't the truth that his policy of a new customs union with the EU is the worst of all worlds, in that we would have no independent trade policy yet we would have no say and no vote over the EU's trade policy? As with Turkey, the EU would set our trade policy and we would have no say. The US or Russia could specifically target UK exports and we would have no power to respond. How on earth would that be in our interests? 

Well, size and mass are important. The UK is just 60 million. The EU is far, far bigger. The US is far, far bigger. We are surely in a better position when we work with other countries in order to develop a common goal. That seems to me to be perfect common sense. But I have to say to him—. He mentions the customs union. Once again I say in this Chamber: offer a better alternative to the customs union—none has been offered—and secondly, solve Ireland. How many times have I said it? I was saying it three years ago in this Chamber, that Ireland was at the heart of the problem when it came to a deal between the UK and the EU. Nobody has come forward with any suggestion that involves the possibility of an open border between the north and south in Ireland and yet still have the UK out of the customs union and the republic inside the customs union. That would create a situation where smuggling would be rife, there's no question about that. That is the question that was never answered in the referendum, hasn't been answered now and still has no solution, apart from the obvious solution which is to stay in the customs union. 

During your meetings with representatives of the Government of Quebec last week, did you have an opportunity to discuss the veto that they have in Quebec over international trade deals? You, in your comments to date, have said that you want Wales to have an influence, but not the kind of veto that territories of Canada, for example, and, truth be told, European regions such as Flanders and Wallonie have. Have you changed your view given your visit?

Well, it wasn't raised during the discussions. Of course, the Quebec Government is one that believes in the unity of Canada, but they don't view it as any kind of a problem. But, of course, one of the things I did discuss with them was the system of shared sovereignty that exists in Canada. And that is a system that, in my view, should be considered in the United Kingdom.

First Minister, the leader of the UKIP group has already raised the issue that President Trump tweeted about the trade tariffs on steel. Unlike him, I and my constituents—many are steelworkers—have deep concerns about the content of that tweet and the implications it has for the steel industry. Will you raise as a Government with the UK Government as much as possible the actions to be taken within the UK to protect the steel industry because the cost to the UK steel industry is unacceptable? It might be 10 per cent going out to the United States because of Tata, but that 10 per cent has major financial implications for steel and implications for Port Talbot. Will you therefore protect the steel industry as much as you can and make sure the UK Government does so and works with the EU this time, rather than hinders it, in actually addressing this issue?

Absolutely. I know that a letter has gone from UK Steel to the UK Government emphasising this point, saying the obvious point that whatever is not able to be exported will seek to find a market within the EU, and that will inevitably mean a depression in the price of steel, and that will have an effect on all European steelmakers, including, of course, those in Wales.

I very much regret the blunt imposition of tariffs that has been imposed by the US Government. Look, I have argued for tariffs in the past against steel from China. I've said it in this Chamber. But the whole point is that you look to be selective in order to make sure that you protect your industries against those products that carry the greatest risk. Welsh steel is not a risk to US steel. It's not a risk to American security, it's not a risk to the US steel industry because we produce products that, by and large, are not manufactured in the US, and yet here we have the US Government trying to use the blunt instrument of a tariff against all goods coming into the US, and that is a point that we have made to the UK Government, that this is something that's not acceptable. In fairness, the UK Government has accepted that point. We know that the Prime Minister has spoken to the President of the US expressing her grave concern at what's being proposed.

We expect the Welsh ambulance service to work with partners to deliver sufficient emergency ambulance cover to ensure all patients who require an emergency response receive that in a time commensurate to their clinical need.

Well, I thank the First Minister for that answer, but does he feel that it is unacceptable that one of my elderly constituents, after suffering a fall, had to wait over 10 hours for an ambulance to arrive? This was before the recent inclement weather. During this time, she was advised by response staff not to move in case she exacerbated her injuries. Dutifully, she lay on the bathroom floor until the ambulance arrived. I would like to state here that the care she received from the ambulance crew once they attended was excellent in all respects. Nevertheless, does the First Minister not agree with me that it is totally unacceptable that, in twenty-first century Wales, a patient has to wait 10 hours for an ambulance response?

It's very difficult to offer an answer to the scenario that the Member has posed because I'm not familiar with all the facts. However, I'd be more than happy to investigate this for him, if you were to write to me with further details, to see what happened in this—. I've got no reason to doubt what he's saying, of course, but in order for me to give him a full answer and his constituent a full answer, if he were to write to me, I will provide that answer.

A specific question on waiting times during the bad weather that we've just experienced—we are aware of the particular pressures put on the ambulance service because of the snow. I've heard one particularly concerning report about the impact of waiting a very long time on a specific patient. Heavy snow isn't something that happens on a weekly basis, but neither is it something that's entirely exceptional. Can the First Minister refer us to information that will provide us with assurances that the ambulance service does plan as much as possible in order to cope when we do experience circumstances of extreme weather as we had last week?

I will give you some of the background and then go on to say what actually happened during the bad weather. First, there was an increase in the number of calls, as Members would expect. There were 103 red alert calls on the Sunday, which was 20 per cent higher than the previous week, so there was an increase in calls, as people would expect. What, then, did the ambulance service do? They worked very closely with the health boards and their emergency service partners, through the gold command, because that is how it is resolved and co-ordinated, in order to ensure that every resource is used to support them. What does that mean practically? Well, a 4x4 vehicle and also, of course, the air ambulance helicopter to ensure that they could reach people who needed emergency treatment during the last week.

So, what happens is that the response is co-ordinated through gold command to ensure that all the emergency services work together to help each other and, of course, to help the public.

Thank you. Sorry, I was just listening to the end of the translation, which was slightly behind you. Question 5, Mike Hedges.

Through their teaching and research activities, Welsh universities are contributing to the wider prosperity and well-being of Wales, raising the country’s profile internationally and attracting investment. And, of course, they have an important role to play in delivering our economic action plan.

Can I thank the First Minister for that response? Across Europe, North America and parts of England, universities act as major drivers of economic development and not just as major employers. For example, Mannheim has the Mannheim Center for Entrepreneurship and Innovation and provides a founder and incubator platform for students, young entrepreneurs and investors. Aarhus has, like Cambridge, a research park fostering innovation and employment. Does the Welsh Government have any proposals to emulate those two successful European cities within the two city regions of Wales?

Well, I would argue, of course, that they are already in place, to a great extent, and are being developed. If we look, for example, at the Menai science park development around Bangor University, it's one example of collaboration between Government, industry and Bangor University itself. Other examples? Well, Swansea University's second innovation campus, of course—one of the largest knowledge economy developments in the UK, which, I know, before the Member for Aberavon points out to me, is in his constituency, but nevertheless, of course, it's an important driver for both neighbouring constituencies and beyond.

We have the Trinity Saint David SA1 innovation quarter and that is estimated to contribute more than £3 billion to the regional economy over the next 10 years. We have SPECIFIC, based, of course, at Swansea University, collaborating with Tata Steel, with NSG Pilkington and AkzoNobel, and that focuses on the generation storage and release of energy related to buildings, and, of course, more widely, a compound semiconductor cluster infrastructure between Cardiff University and IQE and Aberystwyth's innovation and enterprise campus. So, we are seeing now the development in a number of universities of innovation and—the example I've given in Bangor—science parks in order to turn intellectual property and research into jobs.

The approach to strengthening local government is under consideration at present. Proposals will be set out in due course.

Thank you. Here, last week, your Cabinet Secretary for local government confirmed that he will not proceed with the earlier proposals made to regionalise on a mandatory basis, and therefore, to all intents and purposes, his predecessor’s proposals are going to be binned, as far as I can see. Is there an agreement within your Cabinet on this fundamental change of direction?

Well, the situation hasn’t changed with regard to the way forward. What everybody accepts, I’m sure, is that we must consider the way in which local government works. Nobody’s arguing that the current system is one that works well, and, of course, we want to work with other parties to ensure that the structure is more sustainable ultimately.

Yes. This is one of the areas the Minister for Housing and Regeneration will be looking at as part of a wider review of leasehold and service charge issues.  

I'd like to take the opportunity to commend the Minister for Housing and Regeneration on the work done to minimise the leasehold contract. There is one area where leaseholders actually have more rights than freeholders and that is where leaseholders can challenge what they see as unreasonable service charges by estate management companies. Freeholders' rights in this regard are much more limited. Indeed, when a freeholder constituent in my constituency e-mailed an estate management company to complain, they had an e-mail back from the company director of the estate management company telling them to get a life.

I'm introducing a Member's legislative proposal in this Chamber next week to enhance the regulation of estate management companies and to strengthen freeholder rights. I don't expect the First Minister to commit the Welsh Government to support it now, but would the First Minister be willing to meet with me and the Minister for Housing and Regeneration to discuss this in advance of next week?

Yes, the issue he raises is an important one, because, increasingly, what I'm seeing is that new housing estates are built and instead of the local authority adopting not just the roads but the environment, a service charge is imposed on all residents, even though they own their house as a freehold, which they have to pay. Now, it's not clear, of course, what arbitration mechanisms are in place in order to make sure that the amount paid is reasonable. Some developers will insert in the contract of sale that there will be a particular increase in the level specified every few years or so, but that's not universal practice. So, I think the Member has identified an important point here. Usually, we assume that freeholders have greater rights than leaseholders, but this is one area where that doesn't happen. If we are to see a situation in the future where more and more housing developers develop houses on the basis that they say to local authorities, 'Look, there's no cost to you', then the issue becomes more acute, and I'd be more than happy, of course, for discussions to take place with him in order to see how this can be taken forward.

We are moving forward with our ambitious vision to reshape public transport infrastructure and services across Wales, including local bus services, following their devolution, rail services through the next Wales and borders franchise, and, of course, the south-east and north Wales metro projects.

Thank you. First Minister, in the past 12 months, the A55 has now been closed 55 times. That, of course, brings about huge delays for our bus services, our commuters and, generally, really affects business, our tourism industry and everything. Can you provide an update on the works to follow the A55 resilience study and confirm how many of the quick wins that have been identified will be carried out by your Government?

First of all, the A55 was built to a standard below the standard that would be build to now. But it's there, and we have to deal with it as it is. What can we do, then, to improve the flow of traffic along the A55? Well, there are two specific projects that I'd refer the Member to: firstly, the removal of the roundabouts in Llanfairfechan and Penmaenmawr. That work is ongoing, in terms of the design stage. That will help to move traffic more quickly. And, of course, the work that's being done to look at a third Menai crossing that would turn the A55 into a proper dual carriageway, rather than having one section where it's reduced to one lane either way.

We set forward a coherent approach in the context of the Wales Bill, but the UK Government didn't accept those arguments. It's why I have established the Commission on Justice in Wales to provide an expert, independent, long-term view.

Thank you for that answer. As you say, the criminal justice system is more than just one piece; it's made up of various elements, and one of those elements actually is the prison service and that's something that I believe should be devolved to Wales.

The conclusion from the research into the size of prisons is that smaller prisons have better outcomes than larger ones, both for prisoners and communities. Small prisons are very often more effectively run, have lower levels of violence, better staff-prisoner relationships, greater focus on resettlement and better facilitate contact between prisoners and their families. In other words, they're totally better than the larger prisons. And that's supported by the experiences we are seeing in HMP Berwyn at the moment, which opened last year, as you know, in Wrexham. It's faced substantial problems, despite currently holding fewer than half the prisoners it should hold: 15 fires, 46 cells have ended up out of use due to damage, and three call-outs to the national tactical response group. Clearly, superprisons do not work. Therefore, do you agree with me that superprisons have no future in Wales and that the proposals by the Ministry of Justice for the one in Baglan should be withdrawn and the land used for real economic growth, just as the covenant on it says?

Well, the Member has been extremely strong in his view on this, and it is a matter that's not devolved, but I will seek to answer some of the questions that he poses. When the Parc prison was opened in Bridgend, in the council ward that I represented, it did not work well. It did not work well for its first few years. There were a number of serious incidents within the prison. It went through prison governors at the rate of knots. One prisoner escaped by hanging onto the underside of a lorry and was never found, and staff from Swansea and Cardiff had to be brought in to deal with unrest within the prison. That is something, clearly, that nobody wants to see. But he raises an important point, and it's this: if we get to the point where we are looking to devolve criminal justice, then we need to develop a Welsh penal policy. I've always argued that you can devolve the police separately, but if you take the courts, then you have the probation service, you have the prison service, you have sentencing policy, the Crown Prosecution Service—it all hangs together; it's all part of the justice system. It is time, I think, as he rightly points out, for us to start the debate on what a Welsh penal policy might look like if criminal justice is devolved. He makes the case for smaller prisons. I've got no reason to doubt what he is putting forward, but I think it's hugely important that he has started a debate on what Welsh policy would look like in the event of criminal justice being devolved.

Thank you very much, First Minister. Thank you. Diolch.

Item 2 on our agenda this afternoon is the business statement and announcement, and I call on the leader of the house, Julie James.

Thank you, Deputy Presiding Officer. There are no changes to this week's business. Business for the next three weeks is shown on the business statement and announcement found amongst the meeting papers, which are available to Members electronically.

I call for a single Welsh Government statement, hopefully from the health Secretary, on multiparametric—or mp—MRI scans for suspected prostate cancer patients from NHS Wales. When I wrote to the health Secretary regarding this, he wrote back to me last week saying that the current guideline from the National Institute for Health and Care Excellence—or NICE—doesn't recommend pre-biopsy mpMRI, and there's no clinical consensus on the optimum design of a prostate cancer pathway including this.

When the community health council for north Wales wrote to him, welcoming his commitment to expect health boards to revise their diagnostic pathways to incorporate these scans, if recommended by NICE in revised guidelines after April 2019, they also expressed concern that this would be too late, that patients in north Wales will continue to be left behind, and their discussions with neurologists in north Wales suggest that we need to be developing the service now in preparation for NICE accreditation. The reply on this occasion was,

'Once the clinical benefits have been assessed, and if the guidance is updated, I would expect health boards to revise their diagnostic pathways.'

However, the current guidance says that the key priorities for implementation in the prostate cancer diagnosis and management, from NICE, includes:

'Consider multiparametric MRI...for men with a negative transrectal ultrasound 10–12 core biopsy to determine whether another biopsy is needed.'

Well, last Friday, I met constituents—patients—who have had to spend large sums of money after that guidance was followed by a consultant in Wrexham, but the NHS in north Wales would not fund the essential scans that they ultimately received across the border in England. One told me he'd spent £1,020. He also told me that these scans were more than twice as accurate as those currently available. That gentleman was from Flintshire. Another one told me—a gentleman from Llangollen—that the buck stops with the Welsh Government because they put the the health board into special measures, and that he is amongst nine men from north Wales who have now had to pay for this despite it being available in England and south Wales. They want to meet the Minister. They say that they want him to accept that the same should be happening in north Wales, and they ask why people like him aren't being refunded when they've had to pay for this potentially life-saving procedure themselves.

Waiting for 2019 is not good enough, Cabinet Secretary. These men's lives are at risk. It's available in parts of Wales. You say you believe in a single NHS Wales. Well, please deliver on that now.

Well, I'm not entirely certain what I was being asked, but the Cabinet Secretary was here to listen to the Member's constituency case load, and he's obviously in correspondence with the Cabinet Secretary, which, I imagine, will continue.

Can I just say this to the business manager? I note from the business statement that the Government has still not stated when it will make a statement and publish the report on producer responsibility as regards packaging and recycling, which was promised by the First Minister in February. So, can the business manager confirm when this will be?

Yesterday I visited Natural Weigh in Crickhowell along with Kirsty Williams, which is the first zero-waste shop in Wales, and a very welcome private initiative. But the odds are stacked against shops like Natural Weigh because the supermarkets at the moment can package what they sell us in whatever they want and it's the taxpayer that picks up the tab for paying for it to be recycled, hopefully, but in many cases, of course, not recycled but disposed of in general waste. So, the key report on producer responsibility unlocks some of the ability for shops like Natural Weigh in Crickhowell now to make their way and be successful, and of course I wish them all the best.

Secondly, can I request a timely debate on the serious problems experienced with the north-south rail service last week? The very bad weather, which I admit would have led to service cancellations anyway, did obscure what, in fact, I think, was the most serious maintenance failure on the Wales and borders franchise that I can certainly recall. Last Tuesday a fault was found in a train wheel, which led by the end of the day to the withdrawal of 27 train units and the suspension of the south Wales to Manchester service, which is a vital link for those travelling from north and mid Wales, and vice versa, of course. It took until Monday this week—six full days later—for this to be resolved. It seems a fault at the track at Maindee, Newport was damaging train wheels.

Now, when you think about it, this is actually an absolute disgrace. Can you imagine what would have been the reaction had the east coast main line in England been out of action for six days? I don't know who's responsible, though as it was a track fault, Network Rail have some serious explaining to do. I do know, however, that it's shameful that we have to put up with such a sub-standard service in a modern economy.

This is the price we pay for an atrocious under-investment in our rail infrastructure, running at at least £1 billion. It's what you get with 5 per cent of the rail infrastructure but 1.5 per cent of the investment. And as we see huge investments in England in Crossrail and high-speed rail, we're left with track that actually damages trains and no service for a week. It's an appalling state of affairs, so can we have an opportunity very soon to debate these issues? I appreciate there have been written statements from the Cabinet Secretary, but if we debate these issues, we can also explore the possible ramifications for the new franchise, the financial investment profile of which I still think has yet to be made publicly available. We may also seek answers as to what compensation may also be available.

Finally, Deputy Presiding Officer, on a very different topic, can I say I was moved to host a meeting of Kurds living in Wales last week, focusing on the attack by Turkey in and around Afrin in northern Syria? They had moving and very powerful stories to tell and, as citizens of Wales, it is right that their stories and experiences are heard in our Parliament. So, would the First Minister please convey their concerns as Welsh citizens directly to the UK authorities and make a statement on that to the Assembly? To see a NATO ally attacking our allies against Isis, and those working for a secular democracy in Syria and Iraq, which is a very fragile flower indeed, is an abomination. It would serve the Welsh Government well to speak out for our Welsh citizens from Kurdistan.

The Member raises three very important and very diverse points. On the producer responsibilities, the Minister is indicating to me that she's in negotiation with producer organisations in Wales and will be bringing a statement forward once those negotiations are complete. I would like to just say that I do share the Member's frustration at some of the producer packaging that we have, and in some ways our modern, digital way of living has made that worse, because when we order things over the internet they do come rather ludicrously packaged. If you'll forgive me, Presiding Officer, just for one moment, I ordered a small lead for my phone—I won't mention the make of my phone—and it came in a box this big, and it had quite a lot of completely unrecyclable packaging inside it that, if it had contained a fragile piece of china, might have been understandable, but it was a piece of plastic lead. I've actually written to the company in question, complaining, and with lots of photographs to say, 'What on earth was the purpose of this?' So, I share his frustration, and I know the Minister shares his frustration as well, so I'm sure she will be bringing forward that statement once those discussions are complete.

My Cabinet Secretary colleague for economy and transport is indicating that he'd be more than happy to have a Government debate on the subject of the service failure, and in fact the franchise in its entirety and our aspirations, if you like, for what sort of control we should have, and indeed some calls for further devolution of some parts of the network. I think the service in question is one of the areas in which it's not entirely certain whose responsibility it is. I share some frustrations of that as I'm from Swansea and we have the Great Western issue as well. So, I think we are saying that a debate in Government time would be a very good way of exploring some of those issues and seeing what level of consensus there is across the Chamber on that. 

And in terms of our Welsh citizens who have Kurdish links, I also share his sorrow and regret at some of the things that are going on. I'm more than happy to pass on his concerns and the concerns of this Chamber to the First Minister, who I'm sure will act accordingly.

I had two points I wanted to bring up with the leader of the house. I'm very pleased we're having an individual debate tomorrow on prisons and I'm hoping to use that opportunity to talk about women prisoners, but I wanted to draw to the attention of the leader of the house the activities of the Koestler Trust, which is a prison arts charity. This week, I'm expecting a painting to go up in my office that has been painted by a woman prisoner, and is there to mark International Women's Day week. So, I thought this initiative has got such worth that I wondered if it would be possible at some point to have a statement about initiatives like this in Wales, which as well as the intrinsic merit of the paintings themselves, are a form of rehabilitation. So, I wondered if there was something we could look at there.

Secondly, a week ago, hordes of women descended on the Whitchurch rugby club in my consistency. The roads were blocked and they weren't able to get into the room that had been set aside. This was for a meeting organised by our MP, Anna McMorrin, addressed by Carolyn Harris MP and myself, and this was all to do with the absolute fury about what's happened to their pensions—the so-called WASPI women. It did seem to be such a matter of such huge concern to so many women, and I know so many women throughout Wales, that I was wondering whether there was anything at all that we could do through our business here in the Assembly to look at this issue and to look at the huge implications it's having for women in the planning of their lives, such as whether they give up a job or not, affecting their roles as carers—all things that do impinge on our devolved responsibilities, although of course the issue itself is non-devolved.

Indeed. Well, two very important points indeed. In terms of the art project, I'm delighted to hear that there's a painting going up in her office; I look forward to having a look at it. Of course, it isn't devolved to us, but it impinges on a lot of devolved Government services: employability, social services, caring, and so on. So, what I'll do is I'll have a conversation with various Cabinet colleagues to see what we can do in terms of a cross-Government response to that, and I'd be more than happy to come and look at the painting and have a further discussion with her about what can be done. It seems like a very good project indeed. I'm sure we can do something with it. 

In terms of the WASPI women, as they're called, I must declare an interest at this point, Presiding Officer, to say that I'm actually one of the WASPI women. I'm in the age group of the women who've had their pensions moved. Mine's been moved by seven years. And that's fine if you're actually still in employment, but not if you're not still in employment, or your whole family responsibility was predicated on your being able to retire at a particular point in time. The issue isn't that we don't have pension parity, which is what we're often asked. That's not the issue. The issue is the amount of time with which you have to prepare and plan for the amount of income that you'll have. So, it's not the move to parity across the genders; the issue is how long you had to plan for that and how much you would have had to save in order to make sure that your plans stayed in place. I think it's really important to make that point, because the issue here is that was not long enough for people who are not fortunate enough to stay in employment past their sixtieth birthday to be able to put those plans into preparation. And as a result of that, a very large number of people are actually suffering severe hardship as a result of not getting their pension for those years. So, it isn't a devolved matter, but it does impact on our services very, very much. I know that my colleague the Cabinet Secretary for Economy and Transport has made our views on the impact on the Welsh economy overall well known. I'm more than happy, as the equalities Minister, to make that point again forcibly to the UK Government.

Leader of the house, I would like to ask for a statement from the Cabinet Secretary for Economy and Transport on support for businesses affected by the proposed M4 relief road. I have been contacted by a manufacturing company in Newport that would suffer considerable and irrecoverable loss of business, as well as incurring relocation costs, due to the forced closure of their existing site in Newport. Although this company has been in contact with the Welsh Government since 2016, they are deeply frustrated about the lack of clarity with regard to the level of practical and financial support they can expect to receive to enable them to continue to operate in Wales. Leader of the house, could I ask you for a statement by the Cabinet Secretary on this matter as soon as possible? Thank you. 

Yes. The Cabinet Secretary has already said that there will be a debate on the floor of the house about the M4 and all of its ramifications as soon as the outcome of the public inquiry is known. So, I'm sure that that is an aspect—businesses displaced by the proposals, whatever they might be as a result of the public inquiry, I'm sure will form part of that debate. 

I'd like to ask the leader of the house for a Government statement from the Cabinet Secretary for local government if possible, and, indeed, for further guidance on the obligations on local authorities under the Well-being of Future Generations (Wales) Act 2015. I'm sure the Cabinet Secretary will be aware that in our community the leisure centre at Pontllanfraith is under threat of closure. It's had a last-minute reprieve temporarily because of the hard work of local people campaigning to save that asset. It does enhance people's well-being. It's had record numbers of users in the last financial year, but the local authority, like every other, is caught in this position, due to the fiscal policies of the British state, of desperately trying to raise money, and they would like to sell off the land for the leisure centre in order to sell to developers to make money to pay for services. And Caerphilly council is now having an overall leisure and well-being review, and I think, as part of that review, having greater clarity on their obligation under the well-being Act would enhance that review, and would make it very clear to them their obligations, and, hopefully, will lead to an outcome where citizens can continue to enjoy the outstanding facilities at Pontllanfraith and elsewhere for the future. 

The Member makes a very important point. It's one of the very desperate effects of the austerity agenda overall, and although councils in Wales have been protected by this Government in a way that hasn't been possible for councils in England, nevertheless the austerity agenda bites hard. And it bites hardest on some of our hard-fought-for and much-loved community facilities. And that's happening right across Wales, and lots of councils are indeed struggling with that. And it's a real dilemma between supporting statutory services that councils must maintain and the so-called discretionary, but nevertheless absolutely essential, services that the Member points out. 

It's not for us to second-guess the individual decisions of different councils and so on, but I know that my Cabinet Secretary colleague is in constant dialogue with the Welsh Local Government Association and with individual councils about their well-being duties, and I'm sure that he'd be more than happy to write out again to them expressing the overarching strategic nature of their duties under the Act, although I would emphasise that individual decisions are very much a matter for the local democratic institution. 

May I thank the leader of the house for her statement and pursue an issue that is important these days? Air pollution continues to be a problem facing many people in my region, as you will know, coming from Swansea yourself. In Hafod in Swansea, in Morriston and in Port Talbot, air pollution causes ill health and unnecessary deaths. Now, when ClientEarth took this Government to court, it was admitted that the Government’s lack of action on air pollution was unlawful. We are now waiting for the clean air plan for Wales and the clean air zones to be launched. Can I ask you, therefore, for a debate and an update as soon as possible on this plan, and ask when this Assembly can expect further information on the clean air zones? Thank you.

The Minister's listening to your remarks, which I'm sure she concurs with, and she will be bringing forward a statement for the house to consider shortly. I would like also to say, though, that there's very much an equalities issue here as well. One of the interesting things, if Members have access to university studies about clean air, is that, in Swansea for example, much of the pollution generated by the cars on the seafront in Swansea, from the very wealthy parts of the city, actually flows up the hill in a perfect storm to the poorer part of the cities at the top. So, the pollution generated by the wealthy parts of the city actually impacts heaviest on the poorer parts of the city. So, I'm not sure that everybody is entirely aware of quite how air flows work in that way, and the complexity of actually managing variable traffic speeds, for example, in order to reduce the way that air flow actually happens, given particular climatic conditions. We didn't suffer from the snow in Swansea particularly over the weekend, but we had severe wind, and that caused some very serious pollution issues in the city in pockets, as it pocketed in particular aspects of the city. And Swansea University has been very proactive in its pursuit of that as an issue. And I know the Minister is very well aware of these issues, and she will be taking those into account when she brings her statement forward.

Thank you, leader of the house.

The next item, therefore, is the statement by the Cabinet Secretary for Health and Social Services on valuing the NHS workforce. And I call on the Cabinet Secretary, Vaughan Gething, to make his statement. Vaughan Gething.

Thank you, Llywydd.

A statement on the NHS workforce is, of course, timely, particularly given the extraordinary weather experience over the last week. I am grateful for the opportunity to join the First Minister in placing on record my gratitude and appreciation for the response of public service workers across local government, the national health service, emergency services, the third sector, and, of course, the wider public. The extraordinary commitment shown by NHS staff that we have all seen in the past few days is just another example of why they are held in such high regard by this Government and, of course, the people of Wales.

I want to highlight the work already under way to support, develop and expand the workforce, both now and in the future. We regularly discuss the recruitment challenges facing the national health services. The challenges are real, and, of course, I expect scrutiny. However, it is an undeniable fact that, despite eight years of austerity at the hands of the UK Government, tough financial choices made by this Welsh Government have seen the NHS workforce grow to record levels. Official statistics show that we have a record number of total staff working in NHS Wales. We have record numbers of qualified nurses and midwives, hospital consultants, and ambulance staff.

And this Government continues to take positive action, through our 'Train. Work. Live.' initiative, to support NHS organisations to train and recruit the workforce that they and we need. Already our return on investment has been significant, particularly in terms of the number of doctors choosing Wales to undertake their GP training. This May, I will be in Belfast for the launch of year two of the nurse 'Train. Work. Live.' campaign. And, later in the summer, 'Train. Work. Live.' will expand to include allied health professionals, with a focus on increasing the mix of healthcare professionals in primary care.

As well as recruitment initiatives, the continued investment that this Government has chosen to make in the education and training of the current and future NHS workforce is critical. Members will know that the budget for non-medical healthcare professionals has grown year on year. In December last year, I announced a £107 million package of support for 2018-19, and that is a £12 million increase on the year before.

And this continued investment during the past five years means that there has been a sustained increase in training places in Wales. This includes, over that time, 68 per cent more nurses in training, health visitor training places have more than doubled, an increase of 42 per cent in midwifery training places, 51 per cent extra occupational therapy training places, and an increase of 53 per cent in physiotherapy training places. We have invested and will continue to invest in training for healthcare scientists, dental hygienists and therapists, and in key emerging areas like training in genetics.

The role of the paramedic is changing, and will continue to evolve within a wide variety of care settings. There will continue to be a greater emphasis on critical decision making, treatment and management, rather than the historic focus on transporting patients to accident and emergency. And we are supporting those changes in the paramedics' role, and, since 2014, the number of paramedic training places available in Wales has increased by 139 per cent.

Unlike some other parts of the UK, this Welsh Government recognises how important it is to support our healthcare students during their study. That's why we have kept the NHS bursary. Last year, I announced that we would consult on future plans for the longer term financial support for healthcare students. That consultation will begin in the coming weeks, and I look forward to receiving a wide range of views from organisations and individuals to help inform future arrangements on a long-term basis.

As Members will of course be aware, there has been significant interest in the level of medical student places available in Wales. And in north Wales the debate around a new medical school has, of course, continued. And I have made the Government’s position clear. Our view is that Bangor University, working with Cardiff and Swansea medical schools, can and will deliver increased opportunities for medical education and training in north Wales. I know there has been a significant amount of work already undertaken to inform proposals for the future. 

I hope to be in a position to say more about those proposals in the coming weeks. But I want to make sure that we have a plan that is both deliverable and sustainable, and a plan that delivers the ability for students to undertake and complete their medical degree programmes in north Wales. While much of the focus has been on north Wales, many of the challenges we face in the north are also present in other parts of the country, particularly in west Wales, and I want to ensure that we also address those as part of a coherent plan for Wales. 

Despite the record staff figures, we know that demand continues to grow. That is part of the reason for our need to reform health and care services. We need more staff in certain professions and specialties, but we know that is only part of the answer. The fact that the challenges we currently face are taking place within the context of record numbers of staff demonstrates this. We owe it not only to the citizens of Wales, but to our NHS workforce too, to do this. We need to create a system that allows them to succeed in delivering the best possible care. That is why, when discussing our workforce, we cannot separate it from real and meaningful reform, including, of course, the need for new models of care that were highlighted in the parliamentary review. 

Part of the system reform we're committed to, of course, specifically in relation to the workforce, is the establishment of Health Education and Improvement Wales. This is a major and significant change. It demonstrates this Government’s commitment to a new, multidisciplinary approach to our health services. HEIW is not simply a structural change. It is a new, strategic approach to the long-term future of the health workforce. I was pleased that the recent parliamentary review recognised, in a number of significant ways, how the creation of HEIW could be harnessed to deliver the vision of seamless health and care in Wales. The review also identified the opportunity for HEIW and Social Care Wales to lead the way for partnership across the health and social care system. I expect those two bodies to be working as one across many of the challenges that will face our care workforce in the years ahead.

Like all of the public sector workforce, staff in NHS Wales have suffered at the hands of UK Government austerity. That is why we have repeatedly called on the UK Government to end the cap on public sector pay and give workers across the UK a much deserved pay rise, and it remains our view that that pay rise must be fully funded by the UK Government. One of the strengths in Wales is our commitment to social partnership and collaboration between the Welsh Government, the NHS and trade unions. This strength is something we will build on in moving forward once we have received the pay review body's recommendations in May to agree on a fair and affordable pay award.

Our NHS looks forward to its seventieth birthday this year. It remains a truly great achievement of political will and community values to create and sustain our national health service. The NHS that we celebrate is, of course, the story of our staff: people drawn from all communities and all corners of the globe. I am tremendously proud of the people who make up our national health service and I look forward to continuing to serve them as we redesign the future for health here in Wales.

Thank you very, very much for your statement, Cabinet Secretary. Apologies that I'm not Angela Burns for you today. Can I just associate myself with your remarks thanking the NHS staff for their work, particularly during this last week? I think we've all been surprised and delighted in some ways by the pictures of people stumbling through the snow in order to fulfil what they think are their duties to the population of Wales. 

I think one obvious way perhaps to recognise that commitment would be to fast track the staff in the NHS when they need the services of the NHS, not least so that they can get the quickest treatment or attention that they need for themselves, but because of the potential effect of that in making them able to come back into the workforce as soon as possible in order to offer their services, perhaps, in so doing, reducing the strain and stress on health boards when they're having to consider taking on agency staff. We know that 330,000 days were lost to stress-related conditions only last year, 2016-17, and, if those could have been acted on a little bit sooner, perhaps it would have been quicker or easier for those members of staff to come back into the workforce and continue offering the exemplary care to the people of Wales. I think agency staff cost £178.8 million last year. That's quite a big saving, if you can get people back into work as quickly as they would like. And, if you're worried at all that this sounds like preferential treatment, I'd ask you to consider the effect of behaving in this particular way, because it means that those NHS staff are back in work sooner and offering their services to the people who need them. 

We also talked about—. I appreciate that this is a statement on the NHS workforce here, but, following the parliamentary review, I think it's become a little bit less meaningful, if I can put it like that, to talk about the NHS workforce in isolation from the social care workforce. I certainly welcome the investment in the training places for the prevention and rehabilitation professions, and for those training in medical care, but if you're looking at a seamless service—you mentioned it in your statement—I think these kinds of statements need to start talking also now about the impact and career paths of those in non-medical care. So, I was wondering whether we might have a similar statement fairly soon on the social care workforce, not just the NHS workforce.

I'm very, very pleased to hear about the growth in the NHS workforce, but could you give us an indication of where that growth has been concentrated geographically? Where are the staff in certain disciplines, and has reconfiguration and some of the noises off that we've heard fairly recently, not least with Hywel Dda, already been seen to have an effect on where people are interested in working, particularly in the hospital setting but not specifically?

Yes, we certainly do need more staff in certain professions and specialities. The role of the deanery has come up several times in arguments on this in the past, and I'm wondering whether you can give us some indication of whether there's a specific issue—I'll call it that, as there's not necessarily a problem—with the deanery promoting those specialisms that we need at the moment.

Just two more, if you'll bear with me, please, Llywydd. Obviously, I'm very pleased to see that more people are doing their GP training in Wales. Can you tell us how many of those people are actually from Wales and what we're doing to keep them once they've been trained here?

Then, finally, paramedic training—I was very pleased to see that. Can you confirm whether the pay rise that paramedics have recently been proffered, if you like, is conditional in any way on the particular training that you've referred to? Is it a generic pay rise or is it specifically allied to this new training that you mentioned in your statement? Thank you.

Thank you for that series of questions. Again, I think the commitment of staff that we've all seen—stories of people walking miles and miles through the snow to get in—and the tremendous support of the public, with people giving lifts and going up and down roads to give staff lifts as they've seen them coming in, really is tremendously heart-warming, which, again, reinforces the public value that is placed on the service.

I'm going to deal with the range of points. On your point about whether we could fast-track treatment for NHS staff, there's a piece of work already looking at this following previous comments made in the Chamber. I do think that we need to add a note of caution about this, because if we decide to advantage groups of staff, wherever they're from—whether it's the NHS, or whether it's the emergency services, carers or whoever it may be—and if we say that it won't be their clinical need but who they work for that will see them advantaged in the system, I think we need to think very carefully about what that means.

So, I certainly wouldn't stand up in the Chamber today and say that the NHS workforce will get prioritised over and above other people, but there are challenges about the NHS as an employer in any event. Any employer should support their employees with good occupational health support either to keep them in work or to help them return to work if they're out of work, and to understand the reasons for that as well. That's a different point to, potentially, seeing them leapfrog other citizens of the country for treatment.

On the social care workforce, actually, Rebecca Evans, in her previous role, made a number of statements about promoting the social care workforce and a career path for them. You'll hear more from Huw Irranca-Davies on those points in the coming months as well. Also, that will be linked into the commitments that the Government has made in 'Prosperity for All', about the social care sector being a priority sector as part of the foundational economy. So, you will hear more about the social care workforce individually as well as together, as I've indicated in my statement about the development of skills for and with that workforce that is, understandably, integrated, and will be more so, with the national health service.

On the geographical growth in numbers of staff, some of our areas have actually done particularly well with this. In nurse recruitment, for example, Hywel Dda have done particularly well on actually recruiting more nurses in the last year or two. Part of the challenge in different grades of staff is that it can be difficult recruiting in different parts of the country—that's why 'Train. Work. Live' was designed, because you can actually have a great life living in the western parts of Wales, whether north, mid or south, and it's about how you make those opportunities available and then understand what that means for those healthcare staff and their families to move there and to make a positive choice to live in or near that part of the country.

Some of that also, though, goes back to the points that I made in my statement about the models of care that are provided, because there's something about understanding and taking on board the challenges the parliamentary review set out for all of us that if we want to try and run our current models of care, then they won't work—they won't work for the staff or the public. So, our current way of running the whole service isn't fit for the future, and changing that really does matter. And I've given previous indications in the past of models of care that have changed that have made recruitment easier. Stroke care in Gwent is a good example of where change in the way care is delivered has made it easier to recruit the right staff to deliver that improved quality of care. 

I can't tell you what the percentage of Welsh-domiciled GP trainees is, but I'll investigate to see if I can give a meaningful figure and write back to Members on that. And on band 6 and paramedics, you'll have seen that England announced a band 6 paramedic status some time ago. They've yet to agree how to get there, though, so that isn't in place there. We went through that, and, again, in social partnership we had a conversation with employers, with trade unions as well, and we not only agreed a road map for band 6—so, what that should mean—but, actually, how to get there too, because it is about new skills and those skills being consistently applied to have the band 6 pay that goes with it. Not every paramedic will want to do that. There will still be a role for band 5 paramedics within the service. So, we're in a good place, and that is money for reform and improvement. It's good for the workforce to do a job they will find interesting and the skills we will all benefit from in the public at large. We made a difficult choice to invest money in doing so, and that means there is money that we've invested there that isn't available in other parts of our workforce, but that is a choice we have made, again, for the future of the NHS and the people that it serves.

I think the stories that we've heard from across the NHS in the recent extreme weather conditions show the extreme dedication of staff to provide care for their patients, and I hope that they hear our gratitude for their commitment to their work and the service they provide. 

Thank you, to all the NHS staff, for your commitment.

I have a number of questions to ask. One could insist that everything was fine in terms of staffing levels in the NHS in listening to this statement, but I do have a number of issues that I think are important to emphasise and to highlight here. This claim that there’s a record number of staff working in the NHS. We still have fewer GPs working in the NHS in Wales than we had in 2013. StatsWales hasn’t published figures for corresponding numbers of full-time posts for three years, whilst they are looking at the quality of the data. We have fewer hospital doctors than we had in 2014 once you remove that 'general practice doctors in training' category from the figures—something that was added from somewhere to the figures in 2015.

It’s true to say that official figures do show that there are more people working in nursing, midwifery and health visitor roles. It isn’t clear, however, from your statement this afternoon, how many qualified nurses are working—that is to say, fully qualified nurses—within our national health service. And we know from a freedom of information request from the Daily Post recently that 750 fewer nurses are fully qualified in the Betsi Cadwaladr health board than we had five years ago.

And add to that concerns about Brexit, and we haven’t felt the impact of that as of yet, although there is anecdotal evidence about the negative impact it will have. But would you admit that the picture that you painted in your statement is incomplete? Would you also admit that we must give consideration to the full picture, including those negative elements—the problems in terms of workforce planning—rather than just looking at the positives that there undoubtedly are, or we can’t truly get to grips and resolve some of those problems?

In terms of training places, once again you refer to paramedics, nurses and other health professionals in relation to training places. I celebrate any increase in training places, but we can't avoid the difficult question on GP and doctor training specifically. I am very eager to see this Government bringing us a figure as to how many doctors you hope to see trained in Wales in ensuing years, wherever they may be. What is our output to be in terms of the number of doctors trained here?

And that brings us on to plans for a medical centre in Bangor. You’re entirely right in saying that the west is also very important in terms of increasing the numbers trained, but, in terms of Bangor, I’m very pleased now that talk of medical training in Bangor is a central part of any statement on NHS workforce planning. Siân Gwenllian and I are certainly pleased to see that we are gaining ground here, and I’m very confident, having had discussions with Bangor University, that we are moving in the right direction. But, as I always do, I will ask you for a little less ambiguity. You talk about training opportunities; tell us once again that full training will be available in Bangor from year 1 to year 5, because that’s the direction we need to travel in—and I’m confident that we are going in that direction. Also, a bird in the hand may be worth two in the bush, and perhaps I should not just focus on doctors, because I can tell you that there is  pressure already to include dental training in the new centre in Bangor. Again, last week, I was asked about introducing an element of pharmaceutical training in Bangor. So, it’s not just doctors that we’re talking about here, but the whole range of professionals across the health service.

And just very briefly in terms of nursing, can you comment on continuing professional development for nurses specifically? I know it’s something that the RCN is concerned about, namely the lack of time and attention given to CPD. Also, there was no reference in the statement to provisions for the safe staffing levels Bill. Is there a statement on where we are with that?

Thank you for that series of questions. I'll try and take them in a sensible order. I want to start at the outset by saying that I don't think my statement does avoid the reality of some of the challenges we face. I'm very explicit about those challenges in this statement as well. It's certainly not any desire on my part not to paint the full picture. If you wanted a complete, detailed picture, I'd still be on my feet for some time, which I might be happy to be but other Members may not be so. But, it is an undeniable fact, not a claim—it is an undeniable fact—that we do have record numbers of NHS staff. That is an undeniable fact. But, within that, we recognise there are challenges within different staff groups and also how we get our staff groups to work in a different way now and in the future. That's so much of what we have to spend our time upon.

I'll try and deal with your questions about doctor recruitment at this point as well, and training. I don't think we have really been ambiguous about our expectation for north Wales. I've been clear that I wanted to see as much medical training and education as possible taking place within north Wales. I've deliberately not committed to saying absolutely what that would be because I don't have a plan in front of me to do so, and I need to understand the evidence of what is possible, the discussions that I've indicated in my statement that are taking place, and then there will be a signed-off plan. At that point, there'll be more detail.

Not only that though, but hearing the Cabinet Secretary for Education intervene, there's a serious point about the work that we have to do together—that we have to continue to do together—on funding, because there are pressures in the budget, as everyone in this room will know. So, it's not just about having a plan that looks and sounds great, but actually we have to fund it. If we're going to fund a plan to do that, about who we expect to take up those places, and really then see a benefit for us as a whole and actually see more doctors from Wales being able to train, work and live within Wales, but also more doctors then staying in Wales, wherever they come from, at the end of their period of study, we can't avoid these very real and practical discussions that we need to have and it can't simply be that I announce a great policy position and I then say to the Cabinet Secretary for Education, 'You now need to pay for it.' It's not as simple as that and nor should it be.

On the broader point about the future of the workforce, that's why I made reference to Health Education and Improvement Wales, and actually what will come from that and the long-term plan for health and care in Wales. We'll need to understand, for that future workforce, the models of care we want to have and the staff we'll need to be able to deliver that too. I just want to make this point about—. You mentioned GP challenges; well, that's why the first phase of ‘Train. Work. Live.’ with GPs has been so successful and such good news for us that we overfilled our places as a country. But it's also worth pointing out when we talk about GP numbers that the great majority of GPs are not employed by the national health service. They contract with the national health service to provide services, and part of our challenge in delivering a future NHS workforce is having models of employment that allow us to do that.

I'll deal with your questions about nurse recruitment as well. We do have a record number of qualified nurses right across the national health service. Some of that varies from one health board to another. I recognise that you were making points about north Wales, but I'm really clear that this is about qualified nurses, and this goes back to the point about the Nurse Staffing Levels (Wales) Act 2016, which will be commenced in April. Commencement is not being delayed, and I expect to report in the future to this place on the early stages of doing that to see the impact of that and to see whether we are seeing improvements in the quality of care as a result, because that was the point of the Act. It is to make sure that we see improvements in the quality of care delivered. But there's something about saying that those will be qualified nurses, so we're not moving down the track with the NHS workforce that they've been taking in England where they're introducing nurse associates. The Nursing and Midwifery Council have agreed to regulate them, but I am genuinely concerned, as are indeed the chief nursing officers of Wales, Scotland and Northern Ireland, about whether this is really about role substitution and really about the financial saving rather than having appropriately qualified staff to do the right jobs and deliver the right quality of care.

I'll make one final point, because you mentioned Brexit. We have real challenges in nurse recruitment in Wales and across the UK and across the wider western world. We know that we'll need more nurses. It's part of the reason why we continue to invest more money in nurse training—because we know we need to grow lots more of our own. But also, to keep the service running, we need to continue to recruit staff from other parts of the world. That's also why I made it explicitly clear that the national health service has always relied on staff from every community but also from every country around the world as well. It's part of our success story that the national health service has actually made the country more cosmopolitan and multicultural. If you look at the people who exist within Wales now in different communities, they're here because of the national health service.

That's why I really do hope at some point for an outbreak of common sense on Brexit and the position we will take on actually having equivalence in both standards, whether it's pharmaceutical issues or about qualifications, and our ability to recruit staff from within the European Union and also much further afield than this. I don't often say pleasant things about Jeremy Hunt in public, but I actually think that, on the challenge of recruiting staff from outside the European Union and the wider world, I think Jeremy Hunt wants to be able to do that in a way that's sensible. The challenge is that, within the UK Government, the Home Office continue to stand in the way of doing that. That is a challenge for all of us. I really do hope there'll be an outbreak of common sense within the UK Government for the Home Office to get out of the way of recruiting the right sort of healthcare staff for every part of the national health service in all four nations of the UK.

Thank you for your statement, Cabinet Secretary. The past weekend highlighted just what amazing people we have working in our NHS and the wider health and social care sector: doctors and nurses doing double shifts, GPs sleeping in their surgeries, staff walking miles in blizzard conditions, all to ensure that patients continued to receive world-class care, despite sub-zero temperatures and snowdrifts. Therefore, I wish to place on record my thanks to all our NHS staff for the amazing job they do, day in, day out, whatever the conditions and the pressures they are put under. I may disagree with you from time to time on policy, but I will always stand shoulder to shoulder with you in defending our NHS staff.

The only problem with our NHS workforce is that there aren't enough of them. Cabinet Secretary, I welcome the additional investment your Government has made in non-medical healthcare professionals and the increase in training places in Wales. However, there are increasing shortages in some areas of our NHS. As our NHS evolves, the staff requirements will change. Therefore, Cabinet Secretary, how will the LHBs and Health Education and Improvement Wales work together to take a more strategic approach to workforce planning in our NHS? Planning is essential to embrace the changes ahead. Will HEIW be undertaking an audit of staff within each speciality in order to address any shortfalls? When we look at diagnostic staff, Cancer Research UK tell us that there is no data on vacancy levels within endoscopy. If we are to maximise the effect of the faecal immunochemical test on bowel cancer, we must ensure that there are sufficient numbers of staff able to conduct colonoscopies. Cabinet Secretary, do you or HEIW have any plans to create a non-medical endoscopist training programme within NHS Wales?

Of course, the majority of patient interaction within the NHS comes at the GP surgery, despite the fact that general practice receives just over 7 per cent of the NHS budget. Cabinet Secretary, do you support the Royal College of General Practitioners's call to increase the spending on general practice to at least 11 per cent? The royal college have also stated that GP training places need to be around 200 per year. You have made progress in increasing the number of training places in recent years, but do you have any plans to increase this further?

Finally, Cabinet Secretary, NHS England have announced a state-backed indemnity scheme for GPs over the border. Therefore, do you have any plans to introduce a similar scheme for Welsh GPs? As we celebrate the NHS’s seventieth birthday, it is important to highlight that it wouldn’t exist without our excellent staff, and we must do all we can to show our NHS staff how much we value them, both in monetary terms and also in terms of increasing staff. 

Thank you for the comments and questions. I'll start with your first point about, 'We don't have enough staff'. Well, we have record numbers of staff. We will always need to be thinking about how we have those staff organised in the best way to deliver the best possible care, regardless of the financial picture or otherwise. We always have a responsibility to do that, but we are eight years into austerity, and the choices that we are making to put more money into the national health service come at a real cost to every other part of public services and public spending in Wales. If the Cabinet Secretary for Education were on her feet, she would tell me about real pressures, and if the local government Secretary were on his feet, he would tell you about pressures in those sectors as well and beyond. So, let's not pretend that this is simply a matter of political will; this is a matter of our budget being reduced deliberately. You know, people voted for a Government that promised to impose austerity in three successive general elections, and I wish they had not, but that is the choice that people made and I really do think that people who have stood up and campaigned for a Government to do that over three successive general elections need to take some responsibility in those parts of the country in Wales where they are now faced with having to make choices that are as a direct consequence of United Kingdom Government austerity.

On Health Education and Improvement Wales, the purpose of this is to improve strategic planning of the workforce. That's what they will do. As they move into the shadow form for the first six months, I will have more to say specifically about that, so rather than talking off piste now I'll come back, I'm sure, in the future with more to say about them and their way of working.

Just briefly on your point about non-medical endoscopists, we already have some within our system already. I've met a nurse endoscopist within Powys. I think it was actually in Russell George's constituency. So, those people do exist and our challenge is how we have a route for them to continue to do that, as opposed to that person being a one-off.

On your point about the percentage for primary care, I've stood on my feet in this Chamber more than once in the past and talked about the percentage of NHS spend that goes into primary care—it's actually more than 11 per cent. The regular response then back is from the Royal College of GPs, who are actually talking about the general medical services side of it, so a specific part of primary care, not primary care in total. But you will have seen the ambitions that are set out by this Government, but also within the Parliamentary review, to have not just an increasing level of activity within local healthcare, but to actually make sure that resources follow that and we have a plan to deliver more resources in local healthcare where more activity will take place.

On your final point about GPs, I just want to go back to the points that I've made about where our workforce comes from. Many of our GPs, from the implementation of the national health service, have come from other parts of the world. Myself and many other people meet BAPIO, the British Association of Physicians of Indian Origin—a huge part of the history of the national health service and of its future. They too are concerned, as are all GPs, about indemnity. The state-backed scheme that was announced as a preferred option for the UK Government in England is still something we don't have clarity on in terms of what it means and its application. I say again: if there is to be a scheme that is negotiated with the British Medical Association and others to support GPs in England, and the UK Government and the UK Treasury stand behind that, I would expect no less favourable terms to be made available to GPs in every other part of the United Kingdom. But those discussions are not complete. So, I'm not in a position to tell you, because I know that the UK Government Minister is not in a position to tell anybody else whether there's agreement on what that will look like. But there is recognition that indemnity is a real mischief for us to conquer.

Like others, Cabinet Secretary, can I also join you in thanking the health and social services staff, emergency responders, public service workers and volunteers, of course, in the efforts that they've shown over this winter and especially over the last few days?

In my former role—I may have mentioned this once or twice—I was a trade union official, and I did represent NHS staff. It's particularly pleasing, I think, to see the paramedic band 6 coming to fruition. I was there at the outset of those negotiations, and seeing that come to fruition is really quite pleasing, and I'm glad that's now happening. When I was in that role, I was aware on a daily basis of the kind of heroic efforts that we saw NHS staff performing over the last few days. It has perhaps been more in the news, it has been more public over the last few days, but actually, if you're in the service, you see people going a step further than they need to every day of every week. I remember very clearly having to talk to some politicians and political parties about the need to be careful in their criticisms of the NHS, which play out, intentional or not, as criticisms of the staff who deliver our service, and the demoralising impact that that had then and continues to have.

So, I'd certainly echo your views, Cabinet Secretary, that if the Conservatives in particular are so keen on supporting and thanking our NHS workers for the terrific job they do week in and week out, then their move certainly should be to lift the pay cap and make sure that all of our NHS staff get the pay rise they so richly deserve. And I'd certainly also echo your views that just calling for extra staff in a vacuum is not going to take us any further forward when we are, as you've said, eight years into a period of austerity that one particular party in this Chamber seem to continue to advocate.

But my questions to you, Cabinet Secretary, are: despite the undoubted record numbers of staff, the pressures are still huge for all the reasons that you've set out, and given those types of pressures, specifically, that we've just witnessed, would you agree that staff well-being has to be a very high priority and that people will need now some time and space to recover from these recent pressures so that we can sustain the services over the medium to long term? And can I ask you what more you think we can do to help manage those pressures on those hard-working staff, both in health and social care? 

Thank you for the comments and questions. You're right about the band 6 conversation; I remember you in a different role when those conversations started, and I recognise you are in Unison and suffragette purple today as well. I do recognise there's something about the good will and the commitment of staff. It's a regular part of what keeps the service going, because NHS staff do not work to the letter of their job description; they go above and beyond it on a regular basis. If that stopped, then large parts of our service wouldn't take place in the way that they do.

On the point about the negative public and political debate, it does impact on staff. I remember meeting, as the then Deputy Minister for health, paramedics, and they were particularly downcast for the way that they felt they were talked about. They didn't feel it was the Government that was being talked about every month when ambulance response times were published, and it did affect their morale in a real and material way. There's something about the wider public debate and the impact it has on the current workforce, but also, potentially, the workforce of the future, because there are some people who are opting not to pursue a career in medicine or in the health service because of the way the NHS is regularly talked about. They see that on the first few pages of newspapers on a regular basis—and the distance and the speed at which the negative news travels about the national health service. So, that's why I try to take every opportunity to thank and praise NHS staff for what they do.

On your point about the pay cap, I know that matters too, and there's something about the value that people feel placed upon them as well. Having seen teachers having the continuation of a 1 per cent pay cap and having seen other public service workers having that pay cap continue, what next happens with the pay review body's reporting, and the terms on which any pay rise is offered, will matter a great deal to today and tomorrow's workforce as well. I sincerely hope the UK Government recognise their responsibilities and do the right thing in providing a fully-funded, decent pay rise. 

On your point about staff well-being, I recognise this all too well. For those staff who work really hard, you can't keep going at 100 mph every single day, because at some point people end up breaking. So, they need to have time to recover and the space to do so. That's why we have decent terms and conditions for NHS staff, but it's also why it's important to look again at what the parliamentary review said about staff well-being. I think it's really interesting their proposal about the emphasis that we should have on the well-being of our staff and how they're treated and managed, and, actually, how they feel genuinely empowered to make choices about the future of the service because that matters too. So, there's a range of things.

It comes back to my point about the NHS as an employer, employing over 90,000 individuals in the country, and it needs to make sure that it's a good employer and looks critically at itself and the way it treats all of its staff and recognises opportunities for improvement. I've never said the NHS is a perfect employer because it is not, and that is something we will always continually need to look at and that will definitely form part of our response to the parliamentary review.

Can I thank the Cabinet Secretary for his statement on valuing the NHS workforce? Following on from Dawn Bowden about staff well-being, I was going to concentrate on junior hospital doctors and their continuing well-being, and ask specifically of the Cabinet Secretary what he is doing to address the concerns of junior hospital doctors in Wales today and to explore the culture of how their rotas are managed within our hospitals.

Obviously, there's been mention of 70 years of the NHS this year, and some of us have been working in the NHS for more than half that time, now, I shudder to think back. But anyway, back in the day, as junior hospital doctors, we worked in fixed firms—consultant, senior registrar, registrar, senior house officer or SHO and house officer. It was fixed, you had the same team day in, day out, and it was the same team for six months. There was no problem with rotas; we worked very hard—over 100 hours a week. There was no problem getting time off for study or exams and there was no problem getting time off to get married. Even the administrators were there all hours, helping us all out—one big happy family. Fast-forward to today and our juniors feel undervalued and unloved. They no longer work in fixed teams. Modernising medical careers has wrecked that firm and juniors now work with different people every day; they're not in a fixed team. Litigation has risen, they're held to blame, as individual errors, for systemic failures, when the gaps in the rota mean that they have to cover two or three and sometimes four or five wards on call. If something happens, it is automatically their fault and not the fact that there just weren't enough doctors around and they were having to cover multiple wards.

There is a schism between hospital administrators, particularly the ones who arrange the rotas—they're no longer part of the team, so juniors now have to battle to get time off for holidays, time off for study leave, time off to study for the exams that they need to progress in their careers, and even have to battle for time off to get married and have a honeymoon and things. Now, that wasn't the way it was; there's been a subtle change in culture. Juniors feel harassed, bullied and exploited and that's why they're leaving. So, in terms of valuing the NHS workforce, Cabinet Secretary, can I ask what you're doing specifically to address the concerns of junior hospital doctors in Wales today? Diolch yn fawr.

Thank you for the comments and questions. I think it's a reflection of the fact about how much the NHS has progressed in terms of the level of activity that now takes place—the level of demand that comes through the doors of the national health service in local healthcare and in hospital settings and the ability of the national health service to do more. This is part of our challenge. It also goes along, of course, together with the demographic rise and the fact that more of us live longer—a celebration, yes, but also a challenge for the health service. But also the fact that the health of the nation has not improved in every single aspect. Part of the challenges we see coming through our doors are driven by poor population health outcomes.

I agree with you that individual staff, particularly—and this is almost always where it happens— . I go back to my previous life when I, at one point, represented some of Dawn Bowden's members and others in and around healthcare services, in Health and Care Professions Council and Nursing and Midwifery Council hearings and fitness-to-practice hearings, and, actually, you tend to see more junior staff carrying the can for individual system failures and you tend not to see senior registrars being brought for those regulatory hearings. I don't think that's right and we need to think again about the culture we create and the regulatory environment that recognises individual and collective responsibility in doing so.

I also recognise that part of the reason why juniors feel particularly put upon—. I don't think you can really underestimate this, but I'm still struck, even in Wales, by the anger that exists about the junior doctors' dispute and strike. Even though lots of juniors said they felt grateful for the fact they were in Wales and not in England at the time, it really has poisoned the well in terms of how juniors feel about the whole health service and their willingness to not just train here but then to commit to remaining within the UK as well. That contract is part of where we are in our conversation with junior doctors. So, I meet the British Medical Association on a regular basis and they regularly bring the chair of their junior doctors committee to that, partly because it's time we had a conversation about the contract and the dispute, but it's more about what we then do, because rotas—that's all part of the conversation that we have. So, I continue to have an open and constructive conversation with the British Medical Association, and I expect to continue to see representatives from their junior doctors, because we need to particularly understand the particular challenges they face, because, after all, they're part of the future of the service.

Thank you, Cabinet Secretary, for your statement today, and I think it's important that we remind ourselves of the importance of the workforce in the NHS. Can I join you and others across the Chamber—and I'm sure I'm speaking for everybody who might not even speak today about the support we give to the NHS staff, the appreciation we have for their commitment, particularly during recent days and the difficulty in travelling? Even at times when police have said only to travel if it's essential, NHS and care staff believe their attendance to look after patients and clients is essential, and they've made that effort. I was at Neath Port Talbot Hospital on Friday morning—we weren't as badly affected—dropping my wife off to get into work, but I saw staff bringing in overnight bags, because they'd come from areas that were affected and they knew that they needed to be at that place of work to deliver the care for the patients. We should always appreciate that and never forget that.

You also highlight today that, clearly, there are record levels of staff in the workforce. I totally agree. There are record levels of staff in the workforce. But we also have to recognise that we're no longer generalists, we have a lot more specialists in different areas and, therefore, we have large numbers of staff, but some of them now specialise in areas that were far more general before. I will take my wife's area as an example. In radiography, we've got ultrasound, MRI, CT—computerised tomography, nuclear medicine, ordinary extra diagnostics, radiotherapy—[Inaudible.] There are so many specialisms in that one area that we might have more radiographers, per se, but perhaps less per different area. So, I'm also pleased to see the intent statement yesterday that highlights the work being done in that particular imaging area, which is good news, as well. We do have to recognise that that means there are going to be shortages elsewhere.

Dai Lloyd mentioned junior doctors, but let's not forget the out-of-hours GPs, which are also a big issue we have to address, because we are facing challenges with out-of-hours GPs. That's not necessarily the number of GPs, that's just some people being able to have time to do out-of-hours work and not feeling so stressed in their normal day work. That's part of the problem we need to look at.

But we also have to recognise that training is great, but it takes years. It doesn't happen overnight. There are several years of training and then they need experience, and, sometimes, we need the cover now. So, I'll go on to one of the issues for nursing, for example. Banking is an issue I think we need to look at very carefully across all health boards to ensure banking is consistent. I have met with trade unions that have concerns that—there is a limit on banking, or if you're going to do banking, you actually take out a new contract, so you're not being paid overtime. Therefore, the value of NHS staff—make them feel valued by simply not saying to them, 'You can't have overtime, you've got your own different contract and therefore you're getting flat-rate pay for maybe working 70 hours in a week.' We need to look at banking to ensure it's consistent across Wales and it rewards staff, because it's cheaper than having agency staff. Many people don't do banking now, and you get agencies in, and that costs you a lot more money. So, please will you look at talking to the boards to address this issue on banking?

You also talked about paramedics—fantastic news about paramedics, but we are also seeing a wider range of paramedics now—they're being used in GP practices as well. So, as we train more, they are being spread across areas more. So, I think we need to increase the numbers of paramedics being trained.

Similarly, as has been mentioned by Suzy Davies, the deanery—. The Welsh Government need to address some of the issues the deanery raised, to increase the number of doctors being trained to be GPs. The numbers have to go up to the limits of 170 that were being talked about. Now, I understand—. Can we fill the 170? That's the question, but if we don't put the number there, we'll never know. So, I think we should be addressing that as well.

Llywydd, I'll stay at that, because I see I'm out of time. But I think it's issues of valuing staff, not just simply saying the words, but putting into action the value we have for our staff.

Thank you. That's a really helpful point about the appreciation and the value that we do place on the staff, not just at extraordinary times, but, as Dawn Bowden has mentioned, all throughout the year, and the remarkable service that we are privileged to have within this country. I recognise your point about the balance of generalists and specialists to see—[Inaudible.]—about the shape of training in the medical field, but it's a part of what we need to understand and part of the work that Healthcare Inspectorate Wales will be there to understand and help the system to understand as it plans the different levels of staff and the different numbers of staff and how we then expect them to work together.

I'm pleased to hear you recognise the imaging statement of intent. I think you're the only Member to have mentioned that, but it is an important step forward, and it's been worked through with staff in the field as well to have a coherent vision for those staff in the service that we know that we'll need them to deliver. This impacts on a wide range of the national health service.

On the bank arrangements, I recognise there's a challenge for us here, and a real challenge about the rates of pay, how it's organised, how convenient it is, and I think there's a link to e-rostering as well—how we can make it work for staff to undertake shifts that work for them and for the service. There is a piece of work already under way on those areas. So, in the coming months I expect to be able to report back on those for you in any event.

On GP training numbers, you're right—I'm interested in seeing how we go this year, and if we again fill or overfill, we'll then have a different conversation about the infrastructure we have for how many training places we could accommodate, as well as an understanding of how many more people we think we can actually have to undertake GP training numbers here within Wales, and, of course, that conversation about the budget to support those people as well.

I'll finish with the point about paramedics. Again, there'll be comments about the numbers of paramedics we need to train. Paramedics themselves are a highly desirable commodity, and lots of people look to recruit them outside the Welsh system as well. But also the roles—and you're right, the roles are changing, as I recognised in my statement. There's something also about the rotas and how we expect them to work. Because if you take a paramedic out of the emergency ambulance service and you place that paramedic into primary care, if they're there for a long period of time, they may not be able to easily move back into the emergency service, and there's a potential to de-skill them for all parts of their role. There's something about understanding how experienced paramedics, in particular, have a rota and a job description, and a role map that allows them to move into different parts of the service and to continue to add value to those parts of the service. If it's about a regular rotation in different parts of the service, we may well see greater value both in terms of the delivery, but also for that person still feeling valued and having a job that they want to do and not being burned out by one part of it or the other.

Thank you very much, Cabinet Secretary.

Item 4 on the agenda is a statement by the leader of the house on International Women's Day. I call on the leader of the house, Julie James.

Thank you, Deputy Presiding Officer. International Women’s Day, 8 March, is recognised around the world. It is a day to acknowledge and celebrate the achievements of women and girls everywhere. This year’s theme is Press for Progress. I want to take this opportunity to highlight the progress we are making in Wales and the challenges we continue to face. 

Gender stereotyping is both a cause and consequence of gender inequality. All too often, women and girls are still not given the opportunities to fulfil their potential. We are working hard to change and challenge this on many fronts. Our work around STEM—science, technology, engineering and mathematics—is an example of how we are working across the Welsh Government to tackle gender stereotyping. We are training physics teachers across Wales in gender-inclusive teaching methods. We fund computer coding classes, including specific workshops to engage and motivate girls. Gender equity is now being addressed in all our STEM-related funding. It's also being raised through the national networks of excellence in science and technology and maths. Our STEM Cymru 2 programme aims to encourage more young women to progress into engineering careers. To date, over 3,000 young women have engaged with the programme.

We are committed to delivering 100,000 all-age apprenticeships. Tackling gender bias is at the forefront of our approach to apprenticeships, and we have employed an equality champion to take this work forward.

This year, International Women’s Day coincides with the National Apprenticeship Week. Our network of training providers have a number of events taking place to encourage women to consider non-traditional routes.

We need more women at all levels of management in our private sector businesses. The Agile Nation 2 project aims specifically to develop women to take on management roles. It is supported by £8 million of European funding. Through this project we have seen that the right combination of leadership training, one-to-one support and encouragement can really pay dividends and help women to obtain a better job, a promotion or a pay rise. We've also seen how women, when they reach the top levels of management, can help lead organisational change to promote equality for their whole workforce, such as introducing flexible working arrangements.

We also need more diversity in decision-making roles and in public life, but progress is being made. In 2016-17, 47.8 per cent of new public appointments and 50 per cent of reappointments were female. Following the May 2017 local elections, four councils are now being led by women. We confidently expect to see more in the future.

All the organisations funded through our equality and inclusion programme have committed to delivering a more diverse pool of decision makers. As a part of this work, the Women’s Equality Network Wales has launched a mentoring programme for women, which begins later this month. Like many of you, I have signed up to be a mentor and look forward to supporting the participants to become the leaders of the future.

The Welsh Government has pledged its commitment to the 50:50 by 2020 campaign. Signing up to the campaign shows employers’ public commitment to working towards equal gender representation in decision-making and influencing roles in Wales. We have also pledged our commitment to the Equality and Human Rights Commission’s Working Forward campaign. We are committed to ensuring women do not face discrimination in the workplace in relation to pregnancy or maternity. I believe the public sector in Wales can lead the way and be an exemplar in showcasing good practice and by promoting the benefits of discrimination-free workplaces.

We are also working hard to support the women who face barriers when trying to access training and employment. We recognise re-employment is the best route out of poverty, and our key focus is on maximising people’s employability. The Communities for Work programme provides bespoke support to those who face significant and often complex barriers that prevent them taking up training or employment. It will provide over £70 million in employment support services in the most deprived communities in Wales until 2020. As of January, 5,730 women had received support from the programme.

The Parents, Childcare and Employment programme aims to support parents become more employable and to move into work when childcare is their main barrier to accessing education, training or employment. Over 95 per cent of PaCE participants are female, and over 84 per cent of the participants are lone parents as well. We know that affordable, available and accessible childcare will give parents greater employment choices, enable parents to work, and support our drive to increase economic growth, tackle poverty and reduce inequalities. This is why we have committed to provide 30 hours of Government-funded early education and childcare to working parents of three and four-year-olds for up to 48 weeks a year. 

We must also ensure that children are taught about healthy relationships from a young age. The new curriculum for Wales includes, as one of its four purposes, that all young people should leave our education system as healthy, confident individuals who can form positive relationships based on trust and mutual respect. Learning about healthy relationships at a young age is an important step in tackling gender stereotyping now and for future generations.

And, finally, I want to highlight the very important work being undertaken to tackle violence against women, domestic abuse and sexual violence. Statistics show that women are more likely than men to have experienced all forms of domestic abuse and sexual violence. This includes forced marriage, crimes committed in the name of honour, and female genital mutilation. Following on from the landmark Violence against Women, Domestic Abuse and Sexual Violence (Wales) Act in 2015, the national training framework was published in 2016. Over 70,000 professionals have been trained through the framework so far. That’s 70,000 more confident, more aware and more knowledgeable professionals working in our public services.

In January, the This is Me campaign was launched to tackle gender stereotyping and to encourage people to live fear free from gender constraints and gender norms. In the four weeks following its launch, it has been viewed over 200,000 times and use of the Live Fear Free website has increased by nearly 2,000 per cent. I will be making an announcement on Thursday, on International Women’s Day itself, highlighting the next step in our work to tackle violence against women, domestic abuse and sexual violence. It is important that those for whom this policy is made are able to influence and guide that policy and share what works for them. The next step will be to make proposals about how we do this. Ultimately, we intend to build a society that does not tolerate violence against women, domestic abuse or sexual violence.

But to come back to the focus of today, it is about celebrating the women of Wales and their contribution to all areas of Welsh life. Our role as a Government is to press for progress and to ensure that women and girls have the same opportunities to fulfil their potential. We are pressing for progress, and we are making that progress, but we are not complacent. There is much more to be done. We all have a duty to tackle gender stereotyping, in all its forms, to ensure that current and future generations are not subjected to it, limited by it or harmed by it, to create a Wales where everyone can aspire and achieve and be the person they were intended to be. Diolch.

Thank you very, very much, leader of the house, for your statement today. It's very difficult to criticise anything in there, and I don't intend to do so. And I certainly welcome the list of activities that the Welsh Government has been involved in, and the number of women that have been encouraged to take part in those activities. I've no doubt that they will feel the benefits of that and progress well with those ambitions in their lives. But I'm wondering if there's any way—or even whether it's appropriate, actually—that we could monitor the progress of the women, and particularly the younger women, who have been involved in those programmes. I certainly don't want to spy on them, and of course their choices are their choices, but if we can come up with strong evidence—I don't know, even in 10 years' time—to prove that these have been really, really worthwhile and repeatable activities, then I think that that's good for all of us.

I'm really pleased to see that there's a focus on apprenticeships in the statement you've made today. I'd like to do a quick shout-out for Bridgend College, which has just won the apprenticeship provider of the year award—I've done my duty to my constituents there.

But there's still some very concerning information out there about gender stereotyping, and I refer in particular to a piece of work done by the Careers and Enterprise Company very recently, which found that young people have more, not less, gender-conservative views of the world than their parents did. Fifty-six per cent of young women aged between 17 and 19 believe that their gender limits their career options—only 37 per cent of young men felt that. And the research went on to confirm that career aspirations showed particular gender disparity, with 18 per cent more young men than women wanting to be engineers and IT professionals—perhaps not something we're surprised to hear here. But it showed that those biases are projected onto others by young people themselves, so that it's peers, in one way, who are encouraging young women in particular to go into careers that perhaps they went into. And the fact that gender equality, if you like, isn't a given, I think, is demonstrated in these brand-new figures, and a good reason why these debates, and these statements that you make, Minister, are still essential. I'd love to say that the job is done, but we're miles away from it, judging by these new figures.

As well as apprenticeships, I wonder if the Welsh Government has given some consideration to returnships as well—I don't know if that's a word I can use. The UK Government's just announced some money to support people back into the private sector after time off for caring. Of those people, 90 per cent are women—perhaps again no huge surprise. And I find this interesting if we're asking women in particular to go back into careers, rather than jobs, as certainly when you consider the recent statistics we had from 'Who Runs Wales? 2017', despite the good work that we're doing here, only 6 per cent of chief executives in the top 100 per cent businesses are women—that's in the private sector. Surely, we can be doing better than that. So, if there is a particular work stream here that you think you might be interested in developing, we'd be certainly happy to support you in that.

On childcare, obviously we want this to work. And I'm wondering if I could just draw attention to the pilot on childcare in my area—which, of course, is yours as well—where it seems that nannies aren't included in the scheme, for reasons of registration; I completely get why they're not. But it would be easy to jump to the conclusion that nannies are just for families who can afford them, rather than, on occasion, it is the welfare of the child that demands it. And the reason I'm raising it is because, apart from potentially reducing the number of jobs available to nannies, who tend to be women, there's a risk that it's the women in those families who will choose to stay at home to look after the children, rather than going out into the workplace, because of the needs of that particular child. So, I'm hoping that's something—I believe that it's an unintended consequence of the policy—that could perhaps be looked at.

And then I just want to welcome your very important comments on violence generally. I'm very pleased to see the level of training taken up by professionals, which you referred to. But even that's only going to pay dividends if you get the healthy relationships part of this right. I appreciate what you say that the curriculum will now involve that, but we do have the sort of pre-Donaldson gap, which I think—you may not be able to give me information today—we need to have some information on, particularly at secondary school level, where both young men and young women will have missed the opportunity for this to be very normalised at primary school level. So, if you're able to share any information on that, that would be great. Thank you.

Well, going in reverse order, because that last one is very important indeed, I do think there's a real issue about teaching healthy relationships, in the context of gender stereotyping, and some of the cultural things that are going on in our society today. We are running several schemes across Wales, actually, pre-Donaldson, as you put it, and I went to see one run by Hafan Cymru only very recently. And the young woman running it was amazing, I have to say; I had the privilege of sitting through one of the sessions. But she told me, Deputy Presiding Officer, something that really cuts to every one of our hearts. Before the session—and this was for year 5 and year 6 students—she asked a mixed gender group whether boys or girls were better, and it will be no shock to anyone to know that the boys thought the boys were better and the girls thought the girls were better, because that's what you do. But then she asked the boys why they thought they were better, and they said that they thought that boys were better because they were stronger and better at sport. And then she asked the girls why they thought girls were better, and they couldn't come up with anything, which is really horrible, isn't it?

I had the privilege of being there, so I asked them if they'd heard of Jessica Ennis, and I happened to have a photograph of her on my phone, because I'd been at a different event. And they had heard of Jessica Ennis, and I asked them if they thought she was both strong and good at sport and they agreed that she was. So, we had quite an interesting discussion about what that gender stereotype was about. But it was quite shocking to me that those young women wanted themselves to be better—if 'better' is the right word—but they couldn't actually come up with anything, because already at that young age they'd been subjected to such gender stereotyping that they struggled to say a characteristic that is associated with femaledom that is 'better'. 

This is not about being better, this is about every single human being being able to be the best person that they can be regardless. It's nothing to do with your gender. I happen to like mucking about with cars. My son happens to like cooking. Apparently, that's against the gender stereotype. Well, that was news to me when I was growing up and it's news to him as well. And that's the point, isn't it? 

So, we support in the Government a large number of these schemes. We support the campaign Let Toys be Toys, for example, where we don't encourage people to gender stereotype their toys. If you want, in your shop, to segregate your toys for ease of shopping, then do it by age appropriateness. I'm sure you all know my anecdote about stopping in a local shop in Swansea, and having a go at the manager and asking him what was in the aisle of boys' toys and girls' toys and telling him that he and I were going to have to go outside if there were engineering toys in one aisle and domestic appliances in the other. And he cordially invited me to have a cup of tea, while he checked and sorted it out. So, he wasn't too sure himself, is the point. In fairness, when I went back to that shop the next week, they'd organised it back into age, so, he took the point straight away. I was very grateful for that. But it shows you how pervasive this stuff is and how destructive it is of relationships. We know that domestic violence is driven by some of this gender stereotyping as people try to live in to roles that actually don't suit them and they are stressed by trying to do that. It's a very important part of that. 

In terms of some of the specific things she said, I was delighted to see that Bridgend College had won the award, and it is very well deserved. We have worked very hard to put some equality gender stereotyping awareness into some of the apprenticeship things and we have initiatives that encourage both boys and girls to take part in experiential learning across the gender divide—so, programming a robot, plaiting hair, planning childcare activities—for both genders simultaneously regardless, because, why not? And that's been very well received and very well taken up.

Just in terms of returnships, it is worth mentioning the Sêr Cymru scheme at this point, which is now being copied by the UK Government—I'm always delighted when they do that for Wales. One very large part of the Sêr Cymru programme has been to encourage researchers who have gone out of research—usually because of a career break, but sometimes just because they've gone some place else—to come back in to science. And you'd be amazed to discover that about 95 per cent of those returnships are female, because they've taken career breaks and are coming back. So, we are on that, but I think there is undoubtedly a great deal more to do before we get anywhere near, unfortunately, gender equality. 

Every year, we do mark International Women’s Day. We recall the successes of our predecessors, and pledge to do everything within our ability to improve things for the women who will follow us. I do believe that this year feels different. In light of the scandals in film and television, in politics, journalism and many other areas of life, there is a new conversation that has started, and I do believe that the Me Too movement has created a new awareness of behaviours that have been seen in the past as being acceptable. Now, younger women and younger men are challenging these stereotypes and are calling for an end to sexual inequality, sexual harassment and violence based on gender. There is change in the wind, and we will no longer accept sexual harassment as an element of life that is unavoidable. I don’t believe that we can avoid having that conversation here in Wales, either.

We should be in the vanguard of taking forward the progress that has been hastened by the Me Too movement. So, I’d like to know, leader of the house, what work has been done to better understand the experiences of women in Wales of discrimination, and, specifically, of harassment. We need to learn more about the best way of changing inappropriate behaviours, as individuals and as a broader society. So, one idea that I am looking into this afternoon is whether the Government would be willing to carry out a national survey as a means of starting the national conversation that we need, and specifically around sexual harassment.

Unfortunately, violence against women and domestic abuse is still a part of the lives of too many people, and I know that you share the same aspiration as me to see this eradicated, but, unfortunately, it is increasing. More than one in four women in Wales and England suffer domestic abuse during their lifetimes—13 per cent of men. If we’re to change behaviour, we need to start from the early years, educating children and young people about healthy relationships, and provide comprehensive sex education. You’ve just described that problem, because there are deficiencies in terms of that sort of education, but I am seeking solutions here. So, will the Welsh Government cease flip-flopping on this and commit to introducing compulsory, comprehensive education on sex and healthy relationships in our schools as soon as possible?

We don’t have to wait for changes to the Welsh curriculum. We need to take action on this as a matter of urgency. We also need to tackle the barriers that prevent young women from taking full advantage of the educational opportunities available to them, and something as simple to put right as having problems in accessing sanitary products can have a huge impact on the confidence and well-being of women. So, will you join with me in thanking Councillor Elyn Stephens for her campaign in the Rhondda to introduce a policy of free sanitary products in schools? Her work will assist young women who suffer period poverty and will tackle the shame that occasionally still holds women back in this area. And will you, as a Government, assess this situation and also consider introducing a similar policy to what is being introduced in the Rhondda, and do so across Wales?

Finally, we need to take positive steps to create equal representation between men and women as elected representatives. How on earth can it be right that half the population is under-represented so appallingly in public life? Only 27 per cent of councillors are women, for example, and we should be setting an example of equality, which would then help in generating change in other areas of public life. So, would you agree with me that we do need positive discrimination if we are to do away with generations of imbalance between the genders?

Yes, I largely agree with everything you said, Siân Gwenllian. There are some nuances, but the nuance isn't awfully important. I'm going to jump about all over the place just because that happens to be the way my particular papers are, but, for example, in the diversity and democracy programme, we ran that programme and we have kept in touch with the mentees—I should have said that to Suzy Davies, actually—because they voluntarily want to keep in touch with us, and we know that a large number of those stood for election in 2017, and four of them were elected and they were all women. Those programmes work, so we're going to pursue those, and I hope that we all take part in the mentee programme, men as well as women, because actually the larger the number of young women who we can make understand what public office looks like, the more likely they are to put themselves forward.

I've also asked Chwarae Teg to refresh a piece of work it did under the previous Minister around equality and public life for me, and they should be bringing that forward very shortly so that we can accelerate the progress of equality in public life. We have done reasonably well, but reasonably well is not where I want to be. I want to be equal. So, I don't see any reason why, in this Assembly term, we shouldn't get to 50:50 on every public body sponsored by this Government, and Chwarae Teg is going to bring some proposals forward for me to consider to see how we might manage that, and that's very important indeed.

In terms of period poverty, I've got officials working very hard indeed on what we can do here, alongside education officials. We're closely looking at RCT; they have done something that is very interesting indeed, and we have been having long conversations with the Trussell Trust—that's hard to say, Trussell Trust—about where they are with work with homeless young women as well, but I'm determined to do something very soon in that regard. So, as soon as I've got some data together, we will be announcing some schemes that we can take forward to see what works best. Even if we provided free sanitary products to every woman who requires them in Wales, that's not that many people. This is a thing that I'm determined to take forward in one way or another. So, it's just about the best way of doing it, which is where we are at the moment.

In terms of sex education—absolutely right, we do need to do something. We've just had the sex and relationships education panel report, and it was a very good report in my view. The Cabinet Secretary for Education and I have been considering that for just a little while. She'll be responding formally to it shortly, but I don't think I'm pre-announcing too many things by saying that we both thought it was a very good report indeed. And, as I said, we are sponsoring some organisations already to take forward some of that work in healthy relationships. We will be considering what the best way of getting that into the education system is, and that may well be that we make a change to the Violence against Women, Domestic Abuse and Sexual Violence (Wales) Act 2015 itself, or we include it in the curriculum reforms that we'll be taking through the Assembly shortly. There are a number of ways of doing it, but we will be doing that as fast as possible.

Then just to say at the end, because we know—all the research shows us this—it's this gender stereotyping thing that's actually at the bottom of all of this. People are taught, from the second they open their eyes, that their gender matters, and actually it doesn't matter—unless you're actually looking to form a family and have a sexual relationship with a person, why on earth does it matter? I just really don't understand that genderisation of five-day-old babies and so on. We've really got to work very hard as a society to stop that happening. We need to make sure that all of our processes in Government don't in any way assume that that's a good thing to do, and that they afford equal opportunities right across the piece. But I'm not in any way complacent; we have a long way to go yet.

Thank you to the Government for bringing forward this statement today. With permission, I'd just like to put on the record that, four months ago today, we lost a true advocate for women's rights and someone who stood up for women's suffering, domestic abuse and sexual violence. I don't think there's any one of my dad's suits that doesn't have a white ribbon pin badge on, and I'm very proud to be standing here today in the Chamber wearing mine. 

I have three questions for the leader of the house. Firstly, we know my dad supported the White Ribbon campaign, and that my colleague Joyce Watson has played a vital part in that, with her annual event. Will the Government join me in my campaign to ensure that all public service providers in Wales, like the police, like the fire service, follow south Wales police and fire service and Gwent's lead in having white ribbons on their vehicles all year around?

Secondly, I also want to pay tribute to RCT council and all the campaigners that made the announcement that free sanitary products could soon be available to all schoolgirls possible. I know that my colleague Jenny Rathbone just here has been a vital advocate in that as well and she was working closely with my dad on this issue. So, I also wanted to know if the Government will commit to ensuring this is replicated across Wales and help make that happen.

Just finally, I'd like to finish with: can I just urge the leader of the house and all Members and staff who work in the Assembly to read Rachel Williams's new book, The Devil at Home? Rachel's story as a survivor of domestic abuse is devastating but truly, truly inspiring. Her story of hope tells all of us how you can always find light, even in the very, very darkest of times. She's a true inspiration and I urge you all to read that book at your leisure. Thank you, leader of the house.

Absolutely. I hadn't actually realised it was an anniversary date, but we all very much remember your father's contributions here in the Senedd. He managed to be both amusing and forthright and also compassionate and committed on a subject that he clearly cared a lot about, and I'm very proud to have inherited some part of his portfolio and to be able to, in some small way, step into his shoes and take that forward. I do have a great photograph of him, actually—talking of gender stereotypes—wearing the worst red high heels you've ever seen in all of your life. I had to support his weight on my shoulders as we tried to walk a mile—it wasn't a mile, it was about five steps—in somebody else's shoes. [Laughter.] I'm not too sure whether I was worse at standing in high heels or he was, but we weren't—it wasn't a great sight, but it was funny. So, it's a fitting tribute, and I hadn't realised it.

In terms of the White Ribbon campaign, I know that the Cabinet Secretary for public services has been working very hard with first line responders and other public services on this, and I'm sure he will be taking it forward. We're very proud of the police for having done what they've done and the multi-agency work that they're undertaking and absolutely committed to taking that forward as fast as possible. It's a very important symbol, actually—it's not just about the campaign; it's a very important symbol of the commitment of public services to that kind of equality, and, of course, just to remind ourselves—Joyce has worked endlessly in this regard as well—of that pledge about never committing violence or condoning or being silent in the face of violence. The white ribbon is a very public reminder of that pledge, which is very important to have, especially for first responders, who are often going into situations where domestic violence is the issue.

In terms of period poverty, as I just said to Siân Gwenllian, we are looking at it very carefully. I'm absolutely committed to doing something. I'm not yet convinced that one scheme fits every single woman in Wales, so it's just a question of trying to tailor it so that we get it right and to persuade the Cabinet Secretary for Finance that we can afford some of it. I'm sure he—. Look—he's not demurring. [Laughter.] But we are committed to doing it—absolutely committed to doing it.

In terms of Rachel Williams's book, I haven't read the whole book, but I've read extracts from it. One of the things that's absolutely front and centre in our policy in terms of tackling all kinds of domestic violence and sexual violence is to have the survivor's voice right there in the centre of the policy so we can understand the effect that it has both during and after, and in the recovery phase, for all of the victims of that kind of domestic violence. So, I certainly am hoping to read it when I do have some leisure time—I'm not too sure when exactly that will be—but I have read extracts from it, and I've heard Rachel talk, actually, and she's a very powerful voice. We're very keen that our policy takes that survivor voice into account, and, in fact, Carl Sargeant, your father, was the first to put that right at the centre of our policy, and I certainly will be carrying on in his good footsteps.

Thank you very much for your statement, leader of the house. I certainly welcome the work being done to encourage girls to enter non-traditional professions, to study STEM subjects and to tackle gender inequality and stereotyping. I note the STEM Cymru 2 scheme and would like to ask: out of the 3,000 young women who have engaged with the scheme, how many of those have gone on to a career in engineering? I really do welcome these efforts, but girls need to have the confidence in maths before they can excel at subjects such as physics, and it's essential that we get the basics right.

The more girls who leave primary school and enter secondary school confident in their ability to do maths, and the more who are encouraged to think about studying for STEM subjects and to go on to study STEM subjects, the more women we'll find in engineering and the scientific professions. So, I would be really, really interested to know how you're monitoring the effectiveness of the programmes that you've introduced. I think, potentially, they're very good programmes, but we need to know how effective they're being and, hopefully, there'll be some very good news there.

What worries me, and I'm sure you're also concerned about this, is that it's been more than 40 years since the advent of the Equal Pay Act 1970, and women are still earning 80 per cent of men's pay. Roughly about 20 years ago, women were earning 75 per cent of male earnings, which means that the narrowing of the gap by 5 per cent over 20 years is progress of sorts, but at this rate it's going to take another 80 years to eliminate the gender pay gap. The Welsh public sector could lead the way here and empower working women in the public sector by introducing pay transparency, so I'd be interested to know what your thoughts are about that.

I welcome the programmes that the Welsh Government have set in place to tackle gender stereotyping, but I'd suggest that gender stereotyping needs to be tackled much, much earlier, and I think you probably agree with me there. Girls and boys absorb gender norms along with all of the other norms and values that they learn from the people around them, and this process begins at birth. So, how are staff in nurseries and infant schools, as well as adults working with older children, being trained to spot gender stereotyping and how to avoid it?

I welcome the efforts made by the Welsh Government to tackle domestic violence, and the training of professionals is a very good move. Can the leader of the house give us an update on the progress of those schemes in due course? I realise that you wouldn't be able to give a detailed update now. 

But coming on to another big issue, no practice exemplifies the subordination and abuse of women more than female genital mutilation, and yet there have been no meaningful prosecutions. So, can the leader of the house please tell me what Welsh Government policy is regarding referring cases of FGM for investigation by the police? And can she also tell us what Welsh Government is doing to directly challenge the patriarchal cultures of the communities in which FGM occurs, and that result in FGM? Thank you.   

The Member makes a very important point—that last point, in particular, is a really important point. We have been working extremely hard in a range of areas to make sure that reporting and prosecution takes place. They tend to be very complex cases to prosecute and, actually, prevention is better than prosecution anyway. So, we've been rolling out our training across all professionals who have contact with young girls, particularly young girls who are in the at-risk category, so just before puberty, to spot the signs of a young girl that's at risk and start the protection programme as early as possible. But also, we've been working very carefully with the criminal justice authorities across the UK to make sure that we have the right training in place, so that the police and the first responders also pick up the right signs. And also that we work inside the communities so that communities themselves start to self-police. So, it's hugely complicated, but we will be seeing some more prosecutions shortly. I don't think it is just about the prosecution. It's much more about changing the culture—as you say, the patriarchal culture—in some of those, although, actually, in a large number of the cultures, it's the women themselves who are actually involved in it. So, there's a huge cultural issue here that we have to be very cognisant of and we have to work very hard to change. That's partly why we're having the whole-society approach to the gender stereotyping issue, because that's the fundamental basis of this. 

In terms of some of the specifics that you asked me about—in terms of physics, for example—one of the contributors to the Val Feld plaque unveiling that we had just outside the Senedd now said something that really resonated with me. She said she was looking forward to the day when somebody addressed a young woman about her figures, and what they meant was her contribution in maths or scientific advancement, and not what she looked like without her clothes on. I, too, would second that. I hope you've all seen the film Hidden Figures, which was a very good demonstration of the contribution that women have made throughout scientific history, which is then hidden over completely. I have to say that I was completely unaware of the contribution of black women on the space programme until I'd read the book and seen the film.

That's what the unveiling of that plaque was about. It's about making sure that young women across Wales understand the contribution that women have made in those fields, and therefore aspire to that contribution themselves. Because if you haven't seen it, how can you aspire to be it? So, I think the plaque was a very good first step. My next step, Deputy Presiding Officer, is to make sure that we have one of those QR codes on the bottom of it so that when you put your phone up to it, it gives you a biography of the woman being honoured in that way, so that young women across Wales can have the positive role models that will make them succeed. 

But in terms of how we'll know we're succeeding, when the number of women in Wales goes above 20 per cent taking A-level physics, that will be a very standard place. That hasn't moved for 40 years, so I'm very much hoping that, in the next five, the measures we're putting in place now will move that. 

Thank you. We have nine minutes left on this statement to run and we have five speakers, so I shall leave you all to do the maths on that. So, what I'm asking for is: can we have short contributions and short answers? Then we'll get you all in. Dawn Bowden. 

Thank you, Deputy Presiding Officer, and I will try to keep it brief, but I do have a couple of points I want to make. Firstly, can I thank you for your statement and the positive actions that, clearly, the Welsh Government have been carrying out already? And can I say in particular that today was absolutely fantastic when we saw the unveiling of the purple plaque for Val Feld, and that campaign to deliver other purple plaques across Wales for remarkable women? I'd like to congratulate Chwarae Teg for taking that campaign forward. 

It's in that same spirit of recognising remarkable women across Wales that I'd like to ask you, leader of the house, to join me in making that call for action towards women across Wales, for me particularly in Merthyr Tydfil and Rhymney, obviously, but across the whole of Wales, to celebrate the contribution of women to all our local communities. In my constituency, for example, we could look at perhaps women from the past like Rose Mary Crawshay, who was a suffragette, or women who served civic life as councillors, mayors and leaders. It could be the contribution of women, again in my constituency, like Laura Ashley, in design and fashion, Marion Jones, leading the fight for equal pay at Hoover, Winifred Agnes who was the international president for the confederation of midwives, the amazing Aberfan wives, and, of course, those incredible women that supported the miners through the strike through Women Against Pit Closures. In truth, we have very little public recognition of many of the incredible women who have made a mark in my constituency throughout the years.

On International Women's Day 2018, can I ask you to join me in making that call to the whole country to work together to celebrate the contribution of women in our local communities so that we see purple plaques and other forms of recognition in all our communities right the way across Wales?  

Indeed. Very swiftly, Deputy Presiding Officer, I would say that absolutely, I agree with that. There's an enormous list in every constituency of women who've been absolutely instrumental in moving every walk of life in Wales on. I'm looking forward to the 100 notable women campaign that WEN Wales will be putting forward and we've already said that we will put Government money behind the purple plaque campaign to get as many of those purple plaques as we possibly can, and there'll be a public appeal to do that as well. I'm determined to get those QR codes on as well, not just the name and the fact that they lived there. I want somebody to actually be able to understand what that woman actually did and what you, therefore, can aspire to in each of our communities across Wales. 

I think the thing about the plaque unveiling today, for me, was the enthusiasm with which Val Feld's granddaughters were taking part in the ceremony—that's absolutely wonderful.

Anyway, just moving back to period poverty, there's no doubt in my mind that there are people who are amongst the most disadvantaged in society who are having to use socks and rags and other materials in order to deal with their period. In the sixth largest economy in the world, that is completely out of order. I'm delighted to hear that you're working on that with the Trussell Trust. I read with great interest the RCT report, which included the input from retired teacher Jayne Brencher, who's obviously very experienced in the matter of period poverty and schools. I think there were several things to take away from the report. One is that I'm not convinced that it's period poverty that is keeping some pupils away from school during their period; I think it's much more to do with dignity and people feeling good about themselves and confident. So, I know that RCT has allocated £50,000 for the trial period in their schools and up to £98,000, but most of it is to do with making sure that there are bins for disposal of sanitary pads and towels in schools, which one would expect to see as a matter of course.

I think that it's very interesting to hear from the girls themselves. Nearly 800 pupils took part and I was really interested to see that 15 per cent of them said they would like Mooncups to be made available, which is obviously the most sustainable solution because otherwise we're simply adding to the refuse mountain, which we've got to put to landfill or incineration. So, I'd hope that you might look at that as a sustainable solution for ensuring everybody has a method for dealing with their period. But, obviously, if you're going to have Mooncups in schools, you're going to have to have hand washing facilities in the toilet. So, it is a complicated issue. I was very surprised, however, to see that whilst most schools do provide sanitary towels or tampons in a few cases, and most of them for free, they didn't have any sort of budget for this beyond, in some cases, £100. Either staff were buying them themselves to ensure that girls who were caught out were not embarrassed or they were getting it reimbursed from petty cash. And 17 per cent of headteachers reported that they did not provide sanitary bins for disposing of towels and tampons, which is just a recipe for a blocked drain, frankly.

I think this is a really interesting issue. I think it's fantastic that we are able to talk about it today in light of International Women's Day, because we have to remember that, around the world, girls are not able to take part in prayer, they're not able to take part in school. In some cultures, they're actually thrown out of their house during the time of their period because they are considered unclean. Instead, we must be celebrating periods as a demonstration of women's fertility, which is what it is. Therefore, it's really important that everybody understands the importance of periods and that it is a natural process. Girls don't need to be missing school because of it. They need to be provided with the wherewithal to ensure that they're able to do it with dignity.

I completely agree with absolutely everything you've said. There is an issue about dignity and embarrassment, and that's very much part of the sex and healthy relationships agenda. Actually, there's a real issue in primary schools as well, because many girls start menstruating before they're 11 and move on to secondary schools, and that's a real issue for them. So, it is about making sure our entire education system is geared up to make sure that people have dignity and respect and privacy and the right equipment of whatever sort.

We are investigating the whole sustainability agenda as well, which is a huge issue, and the issue about sanitary protection, both for the individual and for the disposal and washing facilities and all the rest of it. That's why I'm saying that we want to be sure that when we bring a scheme forward it actually works for everybody in Wales, because we have various women in different stages of their menstrual and reproductive cycles, obviously.

So, it's a very important point. We are working very hard on it. We will be looking very closely at some of the trials that are going on in RCT and elsewhere, and we are talking to various homelessness charities and so on, and I've been working with the Minister for housing on some of this as well. We will be bringing forward a scheme; I just want to make sure that that scheme works for everyone and fits in with our sex and healthy relationships agenda in general.

Minister, I'd like to ask about automation, which, as far as we can tell, is likely to have a hugely gendered impact. There is no reliable study or prediction about what is going to happen, but the World Economic Forum estimates that, for every new job created, three male jobs will be lost but that, for every new job created, five female jobs will be lost, because many of the jobs with a high chance of automation are back-office administrative functions, and many of the new jobs are in STEM professions, where women remain vastly under-represented. So, will the Welsh Government commit to undertaking a wholescale gender impact assessment of automation in Wales? As Annalise Moser reminded us,

'what gets measured is more likely to get addressed',

and undertaking a gender impact assessment won't just reveal the extent of the challenge we face but will spur action to ensure simply that women aren't left to feel the brunt of automation.

Yes, indeed, that's a very important point. I've actually been discussing with the First Minister and a number of other colleagues various gender impact assessments that we should be making—budget gender impact assessments not least—and we will be bringing forward some proposals in that regard. I had not thought of automation, but I'm more than happy to include that in it. The real issue there, of course, is just making sure that we have the largest number of people with the flexible number of skills necessary to be able to ride that wave rather than be pushed under by it. That's very much part of our STEM agenda in general. We need more engineers in general, not just women engineers, but clearly we need everyone with every kind of protected characteristic to have the best chance available to make sure that we actually stay on top of that curve. So, I'm more than happy to say that we'll do that.

I thank the leader of the house for her statement. This year, we are celebrating the centenary of women getting the vote, but of course it wasn't every woman, was it? Let's be clear. It was those with property and older than 30. So, immediately, we see the Representation of the People Act 1918 deliberately excluding working-class women from voting, and that, in my opinion, set immediately the difference and the fight that women would have to have thereafter. Feminism has always been aligned to social justice because they are two sides of the same coin. International Women's Day is rooted in a fight for workers' rights, and it did begin in a garment workers' factory in New York City, protesting pay and conditions. In 1917 in Russia, women protesters started a workers' revolution. So, we must remember where those fights started. I don't suppose many of you here—if any of you here—have heard of Rachel Parsons. She was the first woman to read mechanical science at the University of Cambridge in 1910. So, if you take that then, I don't suppose she actually had her degree because she would have been denied it, and I think that we need to clearly understand where the fight has come from.

The fight has come here, because we are all aware of the unveiling, and rightly, of the Val Feld plaque today, where it was immediately embedded that we would have equality within our system. And it is always a process when we're talking about equality, and women's equality is no different. One of the issues I believe that requires legislative attention right now is something that is called 'upskirting', whereby intimate pictures are taken underneath the victim's clothes. At the moment, it is not a criminal offence, but it is extremely offensive, and it is extremely disturbing for all those individuals who are affected. So, whilst we seem to think that we travel a road and we reach equality, somebody, somewhere, thinks about the next way of offending another person by the new tools that they have in their hand. So, could you please have some discussions with the UK Government about bringing forward some legislation to make upskirting a criminal offence? The report in The Guardian either today or yesterday clearly states that this isn't only women, but these are girls as young as 10 who are being subjected to this. Thank you.

I think that's appalling, and I most certainly will do exactly that. I'm very happy to do that. Deputy Presiding Officer, I will just say this, because the clichés sometimes make the point: we've all heard of the congresswoman's sign on her desk in America—'To do this job, you have to be twice as good as any man. Fortunately that's not difficult.' But, actually, I was taught while I was at university by a feminist woman called Cora Kaplan, and I know that the Cabinet Secretary for Finance knows this quote, but she said, tellingly, and you have to really think about the phrase:

'We'll know that we have true equality when there are as many mediocre women in power as there are mediocre men.'

Deputy Presiding Officer, we have a long way to go before we get to there. [Laughter.]

And finally, Jane Hutt. 

How do I follow that, leader of the house? I just want to thank everyone who attended the purple plaque ceremony today; it provides now a lasting memory of former Swansea East AM, Val Feld, a champion for equality. Now, Cerys Furlong, chief executive of Chwarae Teg, was at the event. She spoke about her commitment to progressing women's equality, very much in line with your statement today. Do you welcome the Chwarae Teg LeadHerShip initiative, which brought 16 to 25-year-old young women into the Assembly last week, shadowing many of us as Assembly Members—young women like Nia Watkins and Chloe Pierce from Barry and Llantwit Major in my constituency—inspired by what they saw and how they could take this forward? And secondly, will the Welsh Government sign up to the Chwarae Teg fair play employer benchmark? It was launched last November, and obviously, the Welsh Government needs to be at the forefront as an exemplar employer, and I think the commissioner's already signed up, so Welsh Government must follow suit.