National Assembly for Wales

Welcome to this Plenary meeting. I just want to set out a few points, before we start. This meeting will be held in a hybrid format, with some Members in the Senedd Siambr and others joining by video-conference. All Members who participate in proceedings of the Senedd, wherever they may be, will be treated equally. A Plenary meeting held using video-conference, in accordance with the Standing Orders of the Welsh Parliament, constitute Senedd proceedings for the purposes of the Government of Wales Act 2006. Some of the provisions of Standing Order 34 will apply for today's Plenary meeting, and those have been noted on your agenda. And I would remind Members that Standing Orders relating to order in Plenary meetings apply to this meeting, and apply equally to Members in the Siambr as to those joining virtually.

The first item on our agenda this afternoon is questions to the Minister for Education, and the first question is from Suzy Davies. 

Thank you, Suzy. The review panel is currently gathering evidence and interviewing stakeholders. I will receive the interim findings, which will include key considerations for 2021, next month.

Thank you for that. It's just to raise the point that some in the sector have been contacted only this week, despite the review's findings due to be published by the end of October, so I'm not sure when the interim one is due. What they say does matter if preparations for the summer are to be practicable. Qualifications Wales have got their own summer 2021 stakeholder group to meet between now and December. So, could you tell us how that work and that of the review will relate to each other? And when will schools and colleges know exactly what they need to teach and how pupils' work will be assessed? Because that Qualifications Wales work won't be finished until a third of the way through the academic year. 

Thank you, Suzy. The interim report from the review body will be made available to me next month, and their final review will be given to me before the end of the year. Clearly, in the interim, Qualifications Wales are indeed carrying out their own piece of work, but they have already given evidence to the review panel, I believe, and they will need to be cognisant of any findings that the independent review panel make to me and any decisions I make as a result of the work of Louise Casella.  

Minister, you know I wrote to you in August, asking for a review of the system, following the results publication, and I am very pleased that the review is taking place. But I am concerned about next summer's examinations or possible examinations. We still don't know what will happen next summer, as of this point. I also know that many teachers and pupils are also concerned about what will happen with examinations next summer. Are you putting into place a plan B, which could be based upon teacher-assessed work again but, this time, moderated to ensure that there is fairness in the system and everyone receives grades that are equal and equivalent across Wales?  

Thank you, David. I recognise that practitioners, parents and pupils are concerned about what will happen in the examination series next summer. I have previously said that it is my sincere hope that examinations will be possible, but clearly we have to have contingencies in place if we find ourselves in the situation, for a variety of reasons, where examinations are not possible. As I said, in answer to Suzy Davies, the interim review panel is not just considering the examination series for this last summer, but will be making recommendations for next summer. And, as I said, the interim report will be made available to me in October. 

Thank you, Jayne. We have published guidance for post-16 providers to help them operate safely at this time. Colleges and universities must carry out risk assessments to ensure that appropriate measures are put in place to manage the risks of COVID-19 transmission in their institutions.

Thank you, Minister. Ensuring our young people are able to physically attend school or college is very welcome, and I know that the Minister and teachers across Wales have worked incredibly hard to ensure this has happened, and continues to happen, even in the difficult and changing circumstances we see. However, one concern that I've received from teachers and pupils is around post-16 education in schools. Those young people who are in school are more likely to work part-time and have social contacts from outside their school. However, the social distancing and guidance is the same as for 11-year-olds. There's a perception that sixth-form classes hold fewer pupils, however, I understand that, in some subjects, in some schools, there are over 30 students in a class. What discussions has the Minister had about the guidance for post-16 students in Wales and what has been learnt, following the first month, which could inform future planning?

Thank you very much, Jayne, for that. You're right—our sixth forms come in all shapes and sizes, with class sizes that can vary considerably, but it is correct to say that, sometimes, in popular subjects in large schools, sixth-form classes can indeed have a number of pupils. We have been very clear in our guidance to both schools and colleges that we should look to minimise contacts between groups of students at this particular time, and it is really important that practitioners are able to socially distance from their class. 

Clearly, we are keeping under very careful review the operation of both schools and colleges, following the first month, really, of operations. I'm pleased to say that the vast majority of schools have not had a case and, where we have had cases of COVID in pupils or teachers, that's usually a single case in a single institution. We have had cases in our FE colleges, but I'm pleased to say that, working with local test, trace, protect teams, the disruption to learning has been minimised. But, clearly, we're keeping under constant review the guidance to both schools and colleges as a result of the experiences over the last four weeks, and we'll be looking to review guidance in light of what we have learned so far. What's really important to remember is that the advice to date from Public Health Wales is that there is no evidence that schools or colleges are vectors for the virus spreading, and cases that we have seen in schools are a reflection of what we're seeing in our communities.

Minister, can I ask you what additional support is in place for learners who have extremely vulnerable people in their households who could be susceptible to COVID? I've got a learner in my own constituency who would like to continue with her post-16 education, but unfortunately her local college has told her that she must attend the college site in order to undertake the A-levels of her choice. As a result of that, she's not able to participate in education at present. Is there advice that you've been able to give to colleges to overcome this particular barrier that some young people are now facing as a result of having siblings or others in their families who may be extremely vulnerable?

Thank you for that, Darren. We have had regular discussions with both schools and colleges about what reasonable adaptations can be made to support students who may themselves be very vulnerable or feel very vulnerable at this time. It would be important for that student to have a discussion with her college, but if, Darren, you would like to write to me about that particular case, I will make further investigations.

Questions now from party spokespeople. The Conservative spokesperson, Suzy Davies.

If you could turn your microphone on, Suzy Davies—okay, try again.

Sorry about that.

Yes, Minister, I was listening to your response to Jayne Bryant there and that observation that schools and colleges aren't vectors for the spread of COVID. Yet we've seen considerable numbers being sent home from some schools—200 in one case, and over 400 in another. You say you're monitoring what's happening at the moment, but have you learnt anything yet about why further education colleges seem to be doing a better job of minimising face-to-face teaching? They're losing fewer students than schools. Why is that?

Thank you, Suzy. As you said, we are keeping in close touch with our local education authorities and our directors of education. And in the case you've just mentioned—400 pupils leaving a school—I myself have spoken to the headteacher in those circumstances to understand why that situation arose. That's why, as I said in answer to Jayne Bryant, we are learning the lessons of these four weeks, where schools have worked incredibly hard to operationalise the guidance that we've made available to them. But clearly, in the light of those experiences, we need to understand what more we can do, how we can improve our guidance in schools, so that they can limit the number of direct contacts, and what other support we can give schools from our TTP teams, to be able to help them make decisions around which students can safely remain in school and not disrupt their education, and which students will, indeed, need to isolate. So, we're looking to review our guidance and, as I said, work closely with our colleagues in Public Health Wales and TTP to ensure that the advice given to headteachers is as good as it needs to be and that we have consistency across TTP teams in Wales.

Thank you for that. I think it would be helpful as well if colleges within a certain area might be prepared to speak to some of the headteachers in schools within their area about some of the good ideas that they've had.

Further education and higher education have both received over £20 million each from the Welsh Government COVID pot, despite a projected funding gap of more than £400 million for higher education. You signalled in the Welsh Conservative debate last week that that's one of the reasons why you don't support a partial reduction in fees for students who've lost out on the experience they've paid for. But, as we've heard, some students are having to stay in their expensive rooms to log in when they could have done that in a more familiar and cheaper environment at home—a home that many students will be leaving for the first time. None of the £27 million for HE is ring-fenced for student support. What are universities in Wales telling you now about how much of that money is going to unanticipated and speedy emotional and mental well-being support for students, and will they be coming to you for a top-up to the £27 million because of that?

Suzy, you'll be aware that the £27 million additional money that we've made available to the Higher Education Funding Council for Wales will be delivered to our institutions by the funding council. I met with the chair and the chief executive of our funding council just yesterday. And in my remit letter to them, emotional and mental health support for students is a priority for me, and I would expect part of that £27 million to be used to support universities deliver robust mental health and well-being support to students at this time, and also, potentially, to use some of that funding to ensure that financial distress that some students may experience is also taken into consideration. Obviously, Welsh students who are residing in Wales and studying—well, wherever they study—are entitled to our support programme. But I recognise that many students would usually supplement their income with part-time jobs, which may prove more difficult to come by at this particular time. So, both financial support and mental health support are a priority for me and a priority for the funding council, and we await bids from Welsh institutions to that pot of money, to ensure that that support is available.

Thank you for that. That's a good, strong message there to universities, so I certainly hope they're picking that up, because, at some point down the line, of course, we'll be scrutinising you on the spend of that £27 million, and I'm sure you will want that reassurance in the reports that you get back from universities in due course.

On a related matter—you'll know this—concerns have been raised with me, in my region and elsewhere, regarding some confusion about students living in large, off-campus houses in multiple occupation. Now, some set-ups are clearly single-person households in one building, but others can legitimately say that they're one genuine household of friends, sharing all facilities and costs like a family. This will impact on how the occupants of those buildings can respond to lockdown, and those in the latter situation are certainly at an advantage. I accept that this applies to non-students as well. But can you tell us how far down the road Welsh Government is to allowing solitary students to have a limited extended household in order to keep them sane? And, more generally, what concerns have you brought to the attention of the Minister for Housing and Local Government about what is understood by students to constitute an extended household, bearing in mind that they all have their own families, who may be happy to accept their own child in a bubble but not a whole household of friends?

Thank you very much for that. Can I assure the Member that I am not just seeking reassurances from individual institutions or the funding council about the levels of support institutions are putting in place for mental health? I met this week with the National Union of Students Wales to understand from them how their members are feeling. I will meet again with them next week, and I will continue to meet with them on a weekly basis so that I can receive reports from them as to how members are feeling. So, there are a number of checks and balances in how we are understanding what is going on on the ground.

I think it’s really important, Suzy, that we make clear that students will not be treated in a less favourable way than permanent residents of Wales. Wales is now their home. Our expectation is that they abide by Welsh regulations and guidance, but we certainly won't be putting additional restrictions in place. Indeed, in some cases, recognising some of the challenges around student accommodation—both on campus and off campus—the ability to share facilities has been made an exception to some of the issues around single households. But, clearly, we will continue to work with the housing Minister to ensure that those students who would be described as a single household are subject to the same consideration when we look at the wider issues related to individuals who find themselves living alone in the pandemic—some who might be vulnerable, some of them who are not vulnerable. But we all need that human contact and, as a Government, we're looking at finding ways in which we can allow that to happen safely, recognising that periods of isolation for those living alone can be particularly challenging.

Plaid Cymru spokesperson, Helen Mary Jones.

Diolch yn fawr iawn, Llywydd. Yesterday, Minister, the First Minister said in response to a question from Adam Price regarding students returning home for Christmas that he wouldn't treat students differently from anyone else. Now, I'm very glad to hear what you've just said to Suzy Davies—that you won't treat them less favourably—but I would suggest to the Government that this is a very distinct group of citizens. There can't be many other groups of citizens that will be moving in such large numbers from one community to another at particular times.

If a student is in a situation that they are in a university at Christmastime that is subject to a lockdown, does that mean that they can't go home? Everything that you've just been saying to Suzy Davies about the welfare of students and their mental and emotional well-being is very encouraging, but I would suggest to the Government that students do need to be treated differently, and perhaps what we need is a system whereby all students can be tested before they return home for Christmas, so that they could socially isolate when they get back home, if that's what they need to do—if they get a positive test. Otherwise, we will face, potentially, groups of young people or young people on their own over the Christmas holidays, and I know that you would not want to see that any more than I would.

Thank you, Helen Mary, for that. I want to assure the Chamber and, indeed, I want to assure students and parents that it is a priority for me, and a priority for this Government, to ensure that students who are residing and studying at Welsh universities will be able to return home for Christmas. I say that as a Minister, and I say that as a mum who has just sent my eldest daughter to university on Sunday evening. Believe me, she might have views about coming home for Christmas, but I desperately want her home for Christmas with me.

So, we will be working with our health Minister, working with our individual institutions and, indeed, working with the UK Government to ensure that the circumstances can be put in place to allow that to happen. SAGE, in their advice to the UK Government, is very, very clear that this needs to be worked out on a UK-wide basis because of the student flows across our borders. Individual students will be wanting to cross county and country borders, so, therefore, Governments need to work together on creating the circumstances that will allow that to happen. I discussed this matter with the universities Minister in the UK Government yesterday. I will discuss it again tomorrow with Gavin Williamson, and we are determined to ensure that students, when they want to, will be able to return home. But, clearly, we need to put the circumstances in place where they can do that safely.

Thank you, Minister. So, what you're telling the Chamber today is that you will be treating students, potentially, differently from other groups of people. If that's the case, I'm very glad indeed to hear it. I fully support your point about trying to develop a UK-wide response to this, because, obviously, we have a lot of cross-border flow. I would put it to you, however, that if the UK Government acting as the Government for England fail to sort themselves out on this, I do hope that there will be a plan B from the Welsh Government.

If I can turn, then, to students who are currently at university but not receiving any direct teaching or only receiving very minimal amounts of face-to-face teaching, there will be some of those students who would wish to return home and to be able to do their remote learning from there. What's the Government's position on that at the moment? For example, if you're, let's say, a student in Aberystwyth whose home is in RCT, is it permissible for that student to come from Aberystwyth to RCT to study for a period of weeks if that's what they feel they need to do, and is it then permissible for them to return to the university when blended learning and face-to-face learning can start again? It is quite a complex situation, I think, for students, and I think they would appreciate more clarity.

I wonder if you can give us a sense as well this afternoon, Minister, because I know you'll have your finger on the pulse with this, as to how much blended learning is taking place, how much actual face-to-face learning are students getting. I don't support, as you know, the Conservative position that would have students having their fees repaid, simply because I don't think our institutions can afford it, but I do think that if students are only getting very minimal or none at all in terms of face-to-face teaching, they ought to be allowed to go home to be with their families, if we can do that safely, in order that they can get that emotional support. Many of them, especially first years, of course, will be self-isolating potentially with people they've never met before, and that's not a happy place for an 18-year-old to be.

Firstly, with regard to the suspension of face-to-face learning in Aberystwyth, that decision was taken late on Sunday evening; it will be reviewed on Friday and I know it is the sincere hope of the university to be able to move back to a blended learning approach. A quick survey of social media will demonstrate to you that our institutions across Wales are already delivering a blended learning approach, whether that be our medics back doing face-to-face learning in Cardiff University, whether that's engineering students at Trinity Saint David, whether that's history students at Swansea, or, indeed, something that is of particular interest to me, our ITE, our education students at Cardiff Met, who are out and about, actually, doing their learning outside as part of their induction into the university and developing their skills in delivering outdoor learning activities. So, universities are working incredibly hard to deliver that blended learning approach.

What's really important to me, Helen Mary, and I'm sure it is to you, is that it needs to be a quality experience. Lectures that are delivered online need to be good lectures and good experiences, as well as that face-to-face contact. That's why I've received assurances from HEFCW yesterday that they will be monitoring the quality of the blended learning approach very, very carefully. And let me say, blended learning and face-to-face contact is not just important in the context of learning. It is an important part of how universities can check in with the welfare of their students, by having an opportunity to see them face-to-face, and I know a great deal of time, effort and resources have gone in to, for instance, expanding university estates and creating more space to allow that to happen safely. So, for instance, in the case of Aberystwyth, they have actually recommissioned buildings that had previously been mothballed so that they can indeed deliver that face-to-face contact in small tutorial groups, and I know that they're keen to continue to do so as soon as is possible.

I have allocated funding of £400,000 to local authorities this year to provide support to home-educating families in recognition of the additional costs that these families may incur when providing resources and opportunities that are typically available free in school. This provision of funding is unique to Wales. 

I'm very grateful for that response, Minister, and very grateful for the funding that has been made available for home-educated young people. One of the challenges that many of those who have been home educated have faced over the past examination period is that obviously they're not at centres whereby grades could have been provided to them, and as a result, many are having to face the prospect, potentially, of examinations next year. Can you tell us what assurances you can give to the parents of home-educated learners that there will be an opportunity for them to sit their exams next year, so that they won't have to lose out when compared to their peers in terms of being able to have access to the grades that they believe they should have secured this year?

Thank you, Darren, for the recognition of the financial resources that have been made available. As I said in answer to earlier questions, it is my sincere hope that examinations will be able to go ahead next year. However, we know that this virus and the pandemic is unpredictable, so we do need to have other provision in place, and we will need to ensure this time—because we have more time to plan—that the specific needs of children who are not attached to a specific centre have the opportunity to be awarded a grade. So, I know that this is under consideration at the moment.

Minister, home education can be an informed and positive choice for families and children, so the additional funding from Welsh Government is really welcome. But in June, you announced that due to the pressures of responding to the COVID crisis, it wouldn't be possible to proceed with the proposals set out in the consultation on home education statutory guidance and draft database regulations. You wrote reassuringly to the Protecting Home Education Wales organisation explaining that you hoped they would be taken forward by the next Government at the earliest opportunity, and that new or revised proposals would be subject to public consultation. So, could I ask, Minister, would that consultation also take into account any further representations by the Children's Commissioner for Wales or by child and safeguarding organisations on how these proposals—recognising they're primarily focused on educational support—can also assist child safeguarding in Wales?

Huw, I can give you that assurance that any further consultation on these proposals will indeed take into consideration the views of everybody that has something that they feel that they can contribute. It is disappointing that we have found ourselves in the position where we cannot proceed in the way I had intended; it is regrettable indeed. But I should stress that despite the inability at this time, due to pressures of COVID, not to proceed with new legislation, local education authorities still remain under the legal obligation to ensure that all children are in receipt of a suitable education, wherever that education is delivered, and that hasn't changed. We issued guidance to local authorities earlier in the year about how they could continue to fulfil that function and support home-educating families during the pandemic, and we're looking to spread good practice across local authorities in that regard, so that where improvements can happen, and need to happen, there are examples of how that can be achieved.

I have remitted HEFCW to work with partners in the HE sector to address student mental health and well-being. To support this work, I allocated HEFCW £3.5 million last year to support well-being and health in higher education, including student mental health.

Thank you, Minister. I know that you are very well aware that I share the concerns raised by other Members about the mental health of higher education students at this very difficult time, and also that the committee has written to all vice-chancellors in Wales to seek assurances about support for students. But what I wanted to ask about today was specifically suicide prevention. I was very grateful to you for meeting with me and James Murray, whose son Ben tragically died by suicide at Bristol university two years ago. Can I ask, following that meeting, what update there is in terms of encouraging universities to embed Papyrus's excellent 'Suicide-safer Universities' guide in their work? Thank you.

Thank you for that question, Lynne, and also thank you for the opportunity to meet with yourself and Mr Murray, whose testimony was powerful indeed. He outlined, very clearly, the steps that all institutions can take to make them as safe as possible for young people. As you're aware, I gave a commitment, during that meeting, that we would be pursing the issue of Papyrus's advice, to see what steps universities were taking to implement that advice. I would like to reassure all Members that each university, prior to the start of the academic year, have been asked to prepare COVID plans, and one of the questions that we were asking in those plans is what steps they were going to take to support mental health at this time. So, whilst COVID brings new challenges, it is a particularly important aspect of universities' work at this time, recognising that people could feel additional vulnerabilities and additional isolation, worries and anxieties on top of what we would usually see at the start of the academic year. We will continue to monitor their progress via the funding council, and indeed with my regular meetings with NUS Wales.

Minister, in earlier questions you said that this has to be a UK-wide approach to get students home for Christmas, and I'd agree on that basis, given the cross-border flows that happen with students. The education Minister—the Secretary of State for Education I should say, sorry, in London, highlighted to the House of Commons yesterday that he could see that there'll be a formal suspension of face-to-face lecture time and tutorials, and everything would move online so that a two-week period of isolation could be undertaken by students before they left their universities to head home before Christmas. Is that a course of action you subscribe to?

Andrew, as you say, it's important that we have a UK approach, if at all possible; that is what has been recommended by SAGE. And, as you said, there are significant cross-border flows of students—Welsh students into England, Scotland and Northern Ireland, and vice versa, and therefore a co-ordinated approach, I believe, is best. I will be discussing a range of options with Gavin Williamson when I meet him later this week.

I published learning guidance in the summer, which set out our priorities for all scenarios, including blended learning. I have also announced a Recruit, Recover and Raise Standards programme and extra support for A-level students, and I have modified the curriculum requirements to take pressure off schools.

Thank you, Minister. Unfortunately, in recent weeks we have discovered just how hard it is to keep coronavirus in check. Future outbreaks are sadly inevitable. What we have to do is ensure that those outbreaks do not disrupt a single day of education. Minister, we have seen entire year groups sent home as a result of infections, and while we do everything possible to prevent the infections and stop such actions being necessary, we also have to prepare for the worst. Minister, what actions can you take to ensure a seamless transition from in-person to online learning, and will you ensure that schools are equipped to deliver classes virtually as opposed to providing self-paced learning?

Can I thank the Member for the supplementary question? Can I make it absolutely clear to the Member that whilst we have indeed seen disruption to education this term, 1,299 Welsh state schools have not suffered a COVID case to date? So, I think we just need to remember that, and give thanks to those teachers, support staff, governing bodies and local education authorities that are doing everything possible to minimise disruption to children at this time.

The Member will be aware that we have invested significantly in recent years in digital learning, both in terms of the infrastructure for individual schools, the provision of additional pieces of equipment for individual students and connectivity for students who don't have it at home. Just to give you an example of how schools are preparing to deal with disruption, during the month of September so far, since schools started back, we have seen the establishment of 25,000 Google classrooms; that is more Google classrooms set up in the period of one month than we have seen over a period of years. Teachers and schools are taking all steps necessary to be able to move to seamless synchronous and asynchronous learning should disruption happen to an individual group of students so that they can keep learning at this time.

Minister, good afternoon. I'm sure you'll join me in recognising the courage and resilience of our children as they return to school in what is a very worrying time for them and their parents. What thoughts have you given to providing more pastoral support and care to children in Wales, particularly in primary schools and nurseries at this time? In recent years, there's been an increasing demand for counselling services amongst schoolchildren, often discussed in this Chamber. Particularly now the COVID-19 pandemic is with us, we are seeing further disrupted children. So, how are you planning to increase counselling capacity in our schools, build resilience and support children? 

Good afternoon to you, Nick. Like you, I am in awe of the courage and resilience that have been shown by our young people at this time. Supporting them with their mental health and their well-being is important, and that's an important reason why we were determined to reopen schools fully for all children for this academic year and to keep them open, because we understand the impact that lockdown and not being in school has had on many children.

But, clearly, for some children, the return to school, whilst it is a happy one—they could, indeed, have anxieties as a result of the pandemic or the situation that they themselves or their families may find themselves in. That's why I have worked hard with my colleague the Minister for health to provide additional resources for school counselling this year, with a particular emphasis on being able to expand support in the primary sector, not through traditional counselling methods, which are not really appropriate for our younger children, but with a strong focus on family therapy and group work so that our youngest children can also be supported at this time. 

I just wondered if you could tell us a little bit more about the attendance rates at school, because I think that will give us an indication of how effective schools have been at reaching out to young people who may be feeling very anxious about returning to school and assuring them that they are going to be safe, and that they should be returning to school for their well-being.

Thank you, Jenny, for that. Overall, nationally, attendance rates run at approximately 80 per cent—just over 80 per cent—although there are some significant variations in that. Not surprisingly, those areas with a lower virus transmission are seeing higher levels of attendance. So, we see particularly high levels of attendance in Monmouthshire, in Pembrokeshire and in those areas, as I said, where we see lower levels of transmission. But even in areas of higher transmission, the vast, vast majority of children are continuing to attend school.

Undoubtedly, where there is a case, that can have an impact. Yesterday afternoon I had the privilege and pleasure of talking to the headteacher at Ninian Park Primary School here in Cardiff. They started off the term really, really positively with high attendance. Unfortunately, they had an individual case, which did see their attendance immediately after that case drop. But as of yesterday they were back to attendance in the region of 86 per cent, and that's because the teachers, the headteacher and the governing body had worked really hard to provide the assurance to parents that they needed that even with a case it was safe for their children to be back in school.

We will continue to work with local authorities to ensure that the Welsh Government is supporting them and the teaching profession in providing reassurance. In some cases, we know that parents are being incredibly cautious and trying their very best. It's cold season, so I know that our chief medical officers are working together across the United Kingdom to be able to provide more advice to parents to help them make decisions about when it is right for a child to be sent into school and when a child, perhaps, should be kept at home and get a test, if necessary. I know that teachers are working very hard to have those conversations with parents and to provide the necessary reassurance.

Diolch yn fawr, Helen Mary. Local authority Welsh in education strategic plans outline how demand for Welsh-medium education is met. Our annual monitoring of plans suggests an increase in learners accessing Welsh-medium provision in the majority of Mid and West Wales. New WESP regulations set out a higher expectation of targets, and that is aligned with Cymraeg 2050.

I'm grateful to you, Minister, for the answer. I know that you will want to join me in congratulating Powys County Council, who have recently put out to tender again to build the 150-place Ysgol Gymraeg y Trallwng in Welshpool. As someone who grew up in Montgomeryshire and was educated there, albeit a very long time ago, I very much welcome this investment.

I'd like to ask you about the next steps for the new Ysgol Gymraeg Dewi Sant in Llanelli. I'm aware that there are still issues with regard to finding an appropriate site. In the meantime, my inbox is full of people who are concerned about the difficulties of providing distanced learning safely on the existing site. Can I invite you once again, Minister, to reassure the families and the staff at the school that, when a new site is identified, the funding will be available for a new build and that that won't be lost because of the very unfortunate, and we won't rehearse the circumstances, inability to proceed on the original site? 

Like you and many other people, Helen Mary Jones, the re-provision of a new school for that community remains a priority for me. I look forward to receiving an application from Carmarthenshire council so that we can proceed with that project.

Minister, a report by Estyn earlier this year showed that standards in literacy, numeracy and Welsh second language require improvement in around half of primary schools and all secondary schools inspected since 2017 in Pembrokeshire. Given that Pembrokeshire local government education services are causing concern and require follow-up activity, can you tell us what discussions the Welsh Government has had with the local authority and, indeed, regional consortia about raising standards and improving outcomes, particularly in relation to the teaching of Welsh as a second language?

Thank you, Paul. Improvements in teaching Welsh as a second language is important right the way across Wales, not only in Pembrokeshire, and it'll be an important part of our reformed curriculum, our professional learning opportunities and our new initial teacher education provision. I myself met with representatives, with my officials and with representatives of Pembrokeshire, prior to the summer recess, to talk about what additional support the Welsh Government can give to that local education authority to help improve standards across the piece. 

The Bill is currently being scrutinised by the Senedd and therefore I do not intend to make a stand-alone statement on this matter. Though, as I have already indicated to Members, I am open to discussions and will listen to concerns.

I was going to say, 'Thanks, Minister', but I don't think I can now, really, because it's a very simple question about evidence. What I would have appreciated would have been some interaction on the question of evidence so at least we can have a grown-up discussion about this.

I think, having spoken to professionals in the field—this morning, actually—again, one question that comes to my mind is, 'If it ain't broke, don't fix it.' I think what we need to have is an understanding of the Welsh language, the special conditions that it takes to learn a language in immersion circumstances. And I think we really need to pay at least some attention, some real attention, to the so-called figure of a million speakers, which I think is just paying lip service at the moment, because I see no evidence.

I'm disappointed with the lack of engagement with the question. All I was asking for was some evidence, and you clearly have none. Thank you. 

I can assure the Member, Presiding Officer, that there are plenty of grown-up conversations being had about how we can deliver the targets of Cymraeg 2050. I am perfectly aware of the success of the immersion model in helping children acquire Welsh. My own children have benefited from it. There is nothing currently in the Bill that will prevent immersion from happening, but I am aware of concerns about how the Bill might inadvertently make immersion, or the increase in immersion, more difficult and therefore, as I said, I am willing to listen to those concerns and to engage positively with those people who positively engage with me.

Thank you for your answer to Mr McEvoy and also your previous answers to the last couple of questions, because it's all along the same theme. But I think the real barrier to being able to provide and to meet the Cymraeg 2050 target is actually the difficulty of getting Welsh-speaking teachers in play. We need more of them and we need them in all the different areas of Wales. There are some parts of Wales where it's incredibly difficult to get Welsh-speaking teachers. Conversely, we also have young people who are training as teachers who don't yet have Welsh and they're finding it sometimes difficult to find jobs that are non-Welsh-speaking. So, how are you going to address that balance in order to meet the Cymraeg 2050 target? And how can we encourage more people to become Welsh-speaking teachers so that we can not only do immersion learning but actually learning in the non-Welsh schools?

Thank you very much, Angela. The first thing that we need to do is increase the number of students who are studying Welsh at A-level, because we know that that qualification is often a precursor for people to go on to study Welsh at a higher level and then converting then into teaching Welsh, and we are promoting a Welsh A-level take-up scheme to promote that subject so that more students take it. Within initial teacher education, we are indeed providing opportunities for those students who currently do not have Welsh skills to be able to acquire those skills as part of their initial teacher education, so, even if they don't intend to go and teach in a Welsh-medium school, they can deliver high-quality Welsh lessons within the English-medium sector.

For those teachers who do, indeed, intend to teach through the medium of Welsh, we have provided funding—although, I have to admit that COVID has created some disruption to this programme—that will allow primary school qualified teachers to convert to be able to teach through the medium of Welsh in the secondary sector, because that is where we have particular shortages—in the secondary sector. And, indeed, those wishing to pursue a career teaching through the medium of Welsh continue to attract the highest level of ITE financial incentives if they choose to go to study for a teaching qualification in Welsh. 

Last week, I met with Coleg Cymraeg Cenedlaethol to talk about what more they can do, learning from the expertise that they already have in expanding Welsh-medium provision in the HE sector—what more they can do to work with our individual higher education institutions and the Education Workforce Council to ensure that we can increase the number of people who are acquiring those skills necessary to teach Welsh successfully in a Welsh-medium school or in an English-medium school.

I'm pleased to say that we have an uptick in the number of recruits onto ITE this year, but one swallow doesn't make a summer and we need to continue to press on this agenda.

Finally, question 8, Rhianon Passmore.

I understand that, for the week 14 to 18 September, attendance at maintained schools in Caerphilly was running at 77 per cent.

Diolch, Minister. Thank you for that answer. The Welsh Labour First Minister, Mark Drakeford, has stated that keeping schools open was a top priority for the Welsh Government. For the parents and children in Islwyn, it is imperative for their social and mental well-being that they are able to continue their education in school with all the necessary precautions. From Risca Primary School in the primary sector to Blackwood Comprehensive School in the secondary sector, children have had to leave school to self-isolate for a period of time.

From Welsh Government data that I saw on Wednesday, eight out of 10 Welsh children were in school, compared to six out of 10 for the previous week. So, Minister, with attendance rising, how can the Welsh Government reinforce to our communities that, for our children to be educated, there needs to be, on public health grounds, reassurance? When will they be asked to stay away from school and what actions can the Welsh Government take to encourage the ever-increasing rise in school attendance by Islwyn's children?

Can I thank the Member for her question? And can I assure her that this Welsh Liberal Democrat education Minister is taking all necessary steps and actions to ensure that children, whether they be in Caerphilly, or, indeed, anywhere else in Wales, have the disruption to their education minimised?

I thank the Minister.

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

Thank you for the question. Whilst we have seen a rapid increase in cases in some areas, the specific advice to people in the former shielding group has not changed at this point in time. They do not need to take the strict shielding measures at this time. The Chief Medical Officer for Wales is liaising with CMO colleagues across the UK on advice to this group on minimising their risk of harm, and we will be writing to those on the previous shielding patients list in the coming days ahead.

Thank you, Minister. I know that the measures put in place by Welsh Government to support the most vulnerable were greatly received. However, I'm now receiving correspondence from those who were shielding asking for further guidance. So, I'm pleased to hear that there will be some correspondence. Those contacting me are not asking to go back into shielding, but that, when announcements are made on any restrictions, communication is also made with those who were shielding. In particular, as the local restrictions are in place, people just want to have comfort that they're doing the safest and the right thing. While I appreciate that we're learning more about the virus all the time, what discussions are you having with others about the communication with those who are most at risk?

Thank you for the follow-up question. Of course, we had an opportunity to discuss some of this in the Health, Social Care and Sport Committee earlier this morning. So, as well as a direct contact that we expect from CMO correspondence with people in that former shielded category, we'll use the variety of our channels, and, to be fair, there's been such interest in the former shielded group that I expect we'll get significant pick-up in national and local media when we recommunicate where we are.

I think it is important to emphasise the lessons we've learned from the first six months. We do think we've prevented significant harm for people on that shielded groups list, but it comes at a cost. There was a cost in terms of people's mental health and well-being, because many of the people felt lonely, even with the support that was provided. So, shielding isn't an end in itself with no harm that attaches to it; it's always a balance. We also know that the previous approach of having a list of medical conditions doesn't take account of all the evidence of harm from COVID. We know that if you're less well off, you're more likely to suffer more significant harm—that point about health inequalities has been re-emphasised with a vengeance with the first phase of the pandemic. And, also, if you look like me, you're more likely to suffer harm, so the point about ethnic origin isn't taken account of in a medical conditions list. And, equally, if you look like me, and if I were to weigh three or four stone heavier, I'd be at a greater risk again as well. Not all of those things are picked up with a medical conditions list approach, so we're learning from what's happened. We're going to have to apply that, with the advice we get from the chief medical officers, in advising people how best to take care of themselves. But that will definitely involve direct contact with people on that former shielded patients list.

Good afternoon, Minister. Local coronavirus help and support groups, like Feed Newport in Pill, and the ones I set up in Wyesham and Usk, did a fantastic job during national lockdown at protecting vulnerable people, making sure they didn't feel isolated, and delivered food and prescriptions to those who were previously shielding and self-isolating. These vulnerable people are now at risk now the virus is on the rise again. Shielding for extremely vulnerable people was introduced at the start of the pandemic in March and only recently lifted. However, your Government's advice, as you've just stated, is that these people do not need to shield at present. Can you explain a bit more your reasons for that decision, Minister? And in what circumstances would you feel the need to reconsider this advice for those shielding, as it's confusing for people, as outlined by Jayne Bryant? There does need to be more communication and more detailed communication, and I welcome the fact that you're going to send letters out, but also for COVID groups to prepare to help those people shielding again. And, Minister, will you just take this opportunity now to join me in thanking all the fantastic work done by voluntary groups throughout this pandemic in helping those most vulnerable in our society?

I'm very happy to reiterate the thanks that myself and other Ministers, and other leaders of local authorities in every part of Wales, have given to all those people who've volunteered to help other people out, that's both in combating loneliness and isolation and helping with services, from the specific schemes we've had to delivering pharmacy medication to, if you like, the wider befriending and some form of social contact, albeit not the physical contact that we are used to and value. I know that this is also an issue where families and friends are taking care of each other outside organised activity as well. I have continued to do my mother's shopping, in the main, and to deliver that each week. I can't go into her home, because I present a bigger risk to her than my sister does, who has less contact, and all of those individual calculations about managing risk are taking place in families and communities around the country.

We need to take account, as I said in answer to Jayne Bryant, of the learning from the first six months of the pandemic, of our understanding of the benefits and disbenefits of a medical conditions list, and we will then set that out for people on the former shielded list, but for the country at large, because, whilst we're seeing coronavirus cases rise, we've been very clear that people on the former shielded list should be particularly vigilant in following the advice on restricting the number of contacts they have, because, actually, managing your own contacts, restricting them to as few as you need to have, obeying the rules, and, indeed, having good hand hygiene and following the whole-nation requirements, are especially important for that group of people with a medical vulnerability. But, as I say, it's a more rounded approach we need to take, and that comes from learning not just from the figures, but also from our direct contact with people who were formerly shielded, and I'm more than happy to keep not just the Chamber but the country updated about the changing advice and decisions that we make.

Minister, thank you for your answers to the questions on this already. I think you'll agree with me that one of the major things that has been of assistance to people when they have been shielded is the priority delivery slots that supermarkets have offered to them. My understanding, from speaking to constituents, is that lots of those supermarkets are now bringing those priority slots to an end, at a time when we see coronavirus on the increase in so many of our communities. This is something that concerns not just my constituents, but me as well, so could I ask what discussions have you had with other Ministers around these protected delivery slots and just urge you to take some action on this?

That's an important point, I think, from Vikki Howells about the practical support that people have been provided with. The food delivery scheme actually didn't reach huge numbers of people, because they didn't need it. Everyone who needed it had a delivery from the free food scheme, but, once supermarkets had significantly expanded their own online delivery slots and prioritised people on that shielded list, the need for a free food delivery scheme was less than we had originally anticipated. So, that significant expansion in online slots needs to continue, and I'll certainly take this up and have a conversation with my colleague Lesley Griffiths, who has regular contact with supermarket retailers on a range of measures, and it's very helpful you've raised it with me today, because it's certainly something to take forward, as I've not previously had direct intelligence brought to me that there's been a reduction in slots. We absolutely want to see that continue, as we face up to what will undoubtedly be a very challenging winter and autumn.

Thank you. This winter, with the continued presence, indeed the resurgence, of COVID-19, we want to ensure that more people than ever receive the flu vaccine. That is why we have extended the eligibility criteria. We're working with key partners to maximise the uptake of the flu vaccine, and additional vaccine supply will be available to support anticipated increased demand.

I thank you for that answer. In his evidence session with the Senedd's health committee last week, Dr Quentin Sandifer from Public Health Wales said that

'in ordinary times, we would aspire to a 75 per cent flu vaccination uptake in eligible groups'

and that would 'maximise the protective effect'. So, clearly, we want to hit at least that this year. So, what, then, is being done to ensure that we achieve that maximum uptake? Has everyone eligible for the free flu vaccination been contacted by the NHS and are the stocks and the logistical arrangements in place to deliver a record number of doses on time? Given the spike that we've seen in coronavirus testing and absences at the start of the new school term and, given the increased danger of having both coronavirus and flu at the same time, where are we in terms of take-up and delivery of the nasal spray flu vaccination in primary schools?

Thank you for those questions. And it is a really important campaign, this year more than ever. In an average flu season, 8,000 to 10,000 people across the UK lose their lives as a result of flu, so this is a significant cause of mortality in normal times. Given the additional risk of corconavirus, it's even more important than ever that we have people taking up the offer of a free NHS flu jab, and indeed for other members of the public to protect themselves, if they can do so.

What we have done is we have, together with other UK nations, procured more of the flu vaccine than ever before—about 50 per cent more. That is to maximise take-up in the at-risk groups, and those people are regularly notified through their healthcare providers and will receive the same notification. We already see, though, positively, evidence of an increase in demand for the NHS flu jab, so that's good news. That does mean, though, that there is a need to make sure that people have ready access, whether in general practice or community pharmacies—our two main delivery systems for the flu jab for adults and adolescents—and it's important that continues.

On the nasal spray for younger children, both pre-school and in early school, we've actually, again, had increased supplies available to us, and that is rolling out within each health board as we speak. So over the coming weeks—. We've had a letter in my own household for our primary school age child to get consent for him to have the nasal flu spray as well during the season.

It's important that we get as much done, as far as possible, before we get into December. So we want as many people vaccinated as possible by November, if at all possible, because flu tends to circulate in larger numbers, in larger volume, from December onwards. So I am confident that the enhanced profile that this campaign has this year will lead to a continuing strong demand for uptake, and if we can have that high level of vaccination within our most at-risk categories, we'll then move to roll out another campaign for over-65s and, then, the over-50s.

But it's been a good start thus far and I do really think that, this year, we have seen a much heightened profile of the flu vaccine campaign. It normally receives a period of interest for a brief period of weeks and then largely rolls into the distance, but I think, with the additional threats of coronavirus, we will see more and more people wanting to take up the offer. 

The increase in demand, Minister, is very, very welcome, as is the extension of the eligibility criteria, but, unfortunately, I've got people in my own constituency who have been told they cannot schedule a flu jab appointment with their GPs until a month hence, which is clearly completely unacceptable, particularly for those in those vulnerable categories that you've already referred to. And, of course, it's not just the flu vaccine that some people need to access; there's also the pneumococcal vaccine to protect people against pneumonia, and I'm aware that there are shortages of that vaccine across Wales and, indeed, other parts of the UK at present. What action are you taking to make sure that there is sufficient capacity within the system to be able to meet the request for vaccination from all those who need it?

There's a mix in terms of the provision. So the UK Government normally procure flu vaccine supplies for across the UK, and that's where we've agreed to have an increased UK procurement exercise, and a range of GP practices also procure their own as well. We are aware of some challenges in supply and those are short-term matters, is our understanding. So, for example, one of the major manufacturers has decided to stagger the release of the flu vaccine this year, which is why some community pharmacies and some practices may experience a delay and a staging in the way they can deliver the vaccine.

In terms of what is and isn't acceptable, I think it's the case, as I said, that because flu circulation tends to take place later in the winter, through December, the important point is to use September, October and November to get as many people vaccinated as possible to provide that level of protection ahead of the peak of the flu season. We'll continue to work with both general practice and community pharmacy. And I would say that if there are real challenges in the supply, as opposed to a staggering of the supply, because the two are different, as ever we'll continue to work on this issue in a constructive way across the UK. It's one of the areas where all four Governments, regardless of political leadership, do have a very grown-up and, I think, effective way of working with each other.

I feel that Joyce Watson's question is hugely important, particularly in the light of the COVID crisis, where there are figures to show that the take-up of flu vaccines is much reduced amongst the most vulnerable. Perhaps this is because people are fearful of attending surgeries—a fact that may well be the result of doctors being reluctant to engage with all but the seriously ill. The low take-up is particularly worrying given the fact that in the last 14 weeks, the flu killed 10 times as many people as COVID. Is this part of the statistics that would prompt some scientists to say that the lockdown measures could kill 75,000 people? Minister, given the devastating effects lockdowns have on society as a whole, can you assure the people of Wales that the lockdowns will only occur once all available scientific advice is sought and that they will end at the earliest possible date that data no longer supports the lockdown?

I'm afraid, I think, that there was a large amount of misunderstanding in the first part of that question. Joyce Watson's question really is important because of the additional risks that we know come, not just in a normal flu season, where, as I've indicated, 8,000 to 10,000 people across the UK lose their lives as a result of the flu and its effects each year, but actually we're in a position where we are already seeing increased take-up. It isn't that there is a reluctance from people to have the flu vaccine this year—far from it. People are keen, not just in Wales, but my understanding, in terms of the sharing of information between all four nations, is that in all four of the nations of the UK people are keen to take up the flu vaccine and are looking to have it early, which is good news for all of us.

When it comes to the restrictions that have been put in place, both the current local measures we have and indeed the fuller lockdown measures that were introduced in March, they're only being introduced on the basis of the information we have available to us: on the medical and scientific information on the spread of the virus, on its impact and its likely impact if measures aren't taken to halt its spread. We will only introduce these measures where there is an evidence base to support them and it will reduce the harm from coronavirus, and we will lift them when the evidence is there that they are no longer a proportionate intervention in the way that people live their lives. 

We're acting now to avoid the sort of harm we saw in the first wave of coronavirus. I do not want to wait until our hospitals are full and I am having to report on significant increased death figures every day before we are prepared to act. Acting now is about avoiding even more draconian impositions on the way people live their lives, avoiding even more significant harm to families and communities across the country.

Questions now from party spokespeople. Plaid Cymru spokesperson, Rhun ap Iorwerth.

Thank you, Llywydd, and I'll pick up on the important questions about flu vaccination. I draw your attention to a recent study in Italy that has noted a relationship between flu vaccination rates and the severity of coronavirus symptoms and survival rates. In regions where more people over 65 had taken up the flu vaccine last year, there were fewer deaths or people having to go to hospital because of coronavirus this year. We can only guess, at this point, at the reason for that, but because we're very eager to restrict the spread of the flu anyway, it strikes me that ensuring that the flu vaccine is available for everyone who wants it, and not just the target groups, would be a very valuable investment, not only in tackling the usual winter pressures on the NHS, but also in reducing the impact of the coronavirus. So, as well as the commitment to encourage more people to get the vaccine, would you be willing to commit to extending it to everyone because that could be a good investment?

Well, first, to plan and to deliver an effective seasonal flu campaign, and this will be our largest ever seasonal flu campaign—we expect to deliver more flu vaccines than ever before to the people of Wales this winter—we need to make choices in advance of the season to be able to do that, and we have chosen to target and to increase significantly the amount of flu vaccine that we procure for the people of Wales and that we then deliver.

The question about whether we should have whole-population coverage in terms of the NHS campaign is rather out of the scope of where we are at present, but it's something that we can consider in the future. It's not currently supported by the joint committee that advises the Welsh Government and all UK Governments on the delivery of vaccination programmes. But, as ever, as the evidence base changes, then we're of course prepared to shift and to change our position, because the objective here is how we protect as many lives as possible, and avoid as much harm as possible, whether that's from COVID, the flu or indeed a range of other infectious diseases and conditions that we know are a regular challenge for how we live our lives today.

Thank you. I'll move on. As more restrictions are imposed on people across Wales, it's very important to show that we have learned lessons from the full original lockdown. And I've seen one report that says that as many as 50 per cent of people just didn't want to see professional health workers in terms of medical conditions during that lockdown because, very simply, they didn't want to bother the NHS. But even though the Health, Social Care and Sport Committee this morning did hear that the number of visits to doctors and A&E departments, and so on, have risen—that's a good thing—Tenovus Cancer Care estimates that there may be 2,000 people who are living with cancer without diagnosis, and still haven't visited a GP because of the pandemic. So what assurance can you give to those people—people who do feel more nervous now, as the new restrictions come into force—that the NHS is still open to everyone, and to encourage those patients who are lost in the system to look for medical advice?

Well I think we've been very clear and consistent about the concern we had for the harm that is caused as a result of non-COVID conditions. That's both the harm that could have been caused if our health and social care system was overwhelmed—and it wasn't; it was under significant pressure in different parts of Wales, but it wasn't overwhelmed—and also the harm caused by non-COVID conditions because people are not undertaking treatment, either because they're opting out of treatment because of the concerns they have, and we definitely saw that, or indeed because it isn't possible because of the system being overwhelmed.

You'll have heard me say on a number of occasions over the past months the concerns we had about the fall in emergency admissions. That's partly because some people didn't really need and don't need—and we discuss this every year—to go into an emergency department, there are other routes for their care, but the much bigger concern was that there are people who really do need emergency care who weren't coming into our health service. And that's not just cancer; stroke, we know that there was a significant fall in people attending the national health service with stroke conditions. Now, I don't believe and there's no evidence to support the view that that meant that, suddenly, there was a significant reduction in the incidence of stroke across Wales. It's about how people were behaving, and their concerns.

We have definitely learnt from the first six months. And so we now have streaming in terms of COVID-light or COVID-green zones, and COVID-red, COVID-positive or COVID-possible zones. That's important to give people confidence, and the way that we manage patients who are coming into our health service through either one of those routes, primarily for hospitals, but also we've had to change the way that primary care has worked. So the ability to consult and to see people virtually, to speak to people on the phone, there's been a significant increase, and that should give people more confidence. But the message from me, and from our whole national healthcare system, is we're open for business, we've learnt from the first six months, and if you have a serious healthcare condition, you should continue to come forward, you should continue to seek advice, support and treatment, whether via primary care or indeed hospital care, because the NHS has certainly not closed up and we look forward to people returning in larger numbers. The case for reform in our healthcare system will be remade about the need to change the way that we work, but that does mean people need to present at the earliest opportunity to allow us to intervene in the least invasive way possible.

But there are people though who are already in the system and who've faced a journey that's much, much longer than it would have been. And you'll have heard me make repeated calls about the need to structure services in a way that will allow treatments to resume, diagnosis services to resume, and so on, at a much faster rate than they are currently. Again this week I've heard concerns from surgeons—one of the royal colleges—that this isn't happening still to the extent that it's needed.

It might be understandable that the publication of referral-to-treatment data was suspended at the beginning of the pandemic, but here we are now on the last day of September and the last available data was published in March, and those were figures for January. RTT data provides a crucial insight into how long people are in the system, how long they're waiting, across all health boards, all specialities. And with elective services across Wales, we know, decimated by the outbreak, without the data we have no way of knowing the scale of the backlog problems we're facing within NHS Wales. And every statistic is a patient, waiting in pain, quite often. So, now that we're over six months into the pandemic, will you urgently make this data publicly available?

In health committee this morning, I and the chief executive of NHS Wales, Dr Goodall, provided a range of information about the scale of the backlog that has built up and the range of that backlog. I'll certainly look to see how and when we release information to provide more detail on that. I think returning to publishing RTT figures and percentages would be incredibly unhelpful, because it would give the impression that the NHS is somehow failing, when actually it is about how we're managing to cope with the demand that is coming through and a very different way of working. We're not in a position where we're going to be able to eat into that backlog through the winter. We're still in the mode of surviving the pandemic and maintaining as much activity as possible, but I've been very upfront about the fact that that means that we won't undertake the same level of activity. It would be wholly unrealistic, and set an impossibly unfair task for the NHS, to demand that it both prepares for and manages the pandemic, which is not finished, and eats into the waiting times that have built up. That's not just the picture here in Wales; it's right across the UK, and I'm sure you'll have noticed comments from the Royal College of Surgeons in response to the NHS Confederation report about England and the challenges they face, where they've been sharply critical of an attempt to eat into the backlog when actually their staff haven't had a rest following the first phase of the pandemic.

So, I still believe it will take pretty much a full Welsh Parliament term to get back on top of the activity that has not taken place, about the fact that people wearing additional PPE cannot undertake the same amount of activity as we would have expected in February this year. So, I'll happily go away and look again at how we provide information to inform people about the scale of where we are, not just people who want to read the transcript from this morning's evidence session with the committee, but to see how we do that in a way that is regular and reliable for members of the public and, indeed, of course, elected representatives. 

The Conservative spokesperson, Andrew R.T. Davies. 

Thank you, Presiding Officer. Minister, in the news today we've seen the outbreak at the Royal Glamorgan Hospital, and tragically eight people have been reported as losing their lives. We send our condolences to the families of the ones who have lost their lives. There are 83 cases of COVID at that hospital. Earlier in the year, we had an outbreak at Wrexham Maelor Hospital. Both hospitals have major accident and emergency departments for their particular areas, of which we have 13 across Wales. Can you highlight today if there are any similarities between the two outbreaks and, if there are similarities, how will you ensure that this doesn't occur in other A&E receiving hospitals? Because as we go into the winter months, obviously we know what winter pressures do, but with the disruption an outbreak like this causes, as well as the tragedy of loss of life and the general upset that it causes, this is something that we want to avoid at the other hospitals across Wales. 

I think there are differences as well as similarities. So, we picked up the issues in Wrexham Maelor, and we definitely learnt from what happened in Wrexham Maelor, about the need for clear executive leadership and for buy-in across the staff group for the measures that would need to be taken, about prompt isolation and reinforcing enhanced infection prevention and control measures. So, our whole system learnt a lot from what happened within Wrexham Maelor, and those lessons are being applied within the Royal Glamorgan. That is why we are, for example, testing staff who work on that site, it's why a number of wards have been closed, it's why there's an early diversion of activity away from that hospital, to allow the hospital to manage and to recover, and it's why there's been a reinforcement of the need to test patients on admission, whether emergency or elective.

It's also the case that some of the transmission in the Royal Glamorgan, as with Wrexham Maelor, came from transmission within the hospital, whether between patients or staff. What is different, though, about the Royal Glamorgan is that we have a higher reservoir of coronavirus within the surrounding community. So, a number of people have come into the hospital and needed treatment because of coronavirus, and we also know that some transmission has taken place within the hospital itself. There are risks for every hospital and closed environment if coronavirus takes hold within the staff or the group of people who are either being cared for or living within that environment. It's why we continue with our testing programme in care homes. I expect that we'll not just have more information from the health board, but there'll be a continued focus on whether the infection rate peaks, as it did in the Maelor, and recovers, and how long that will last for. So, I'm expecting to have regular updates from the health board themselves about the picture within the Royal Glamorgan each day. And I know that the chief executive of the health board is expecting to make further statements to the press about the measures that have been taken and the action, including, as I said, the diversion of patients away from that site. 

Thank you for that answer, Minister. As you highlighted, the reservoir in the local community is obviously one issue that does need to be understood, and the transmission into the hospital as well as in the hospital itself. Just this afternoon, we've had information from Public Health Wales that they've become aware of 2,000 test results that they were completely unaware of, and, obviously, when you're trying to understand local data, being able to understand the test results is a critical component of being able to track the virus in communities. Today, I welcome the news, obviously, that Rhondda, for example, and Merthyr have got their own local maps now that show the level of infection rates in those communities—something that I've been calling on you to bring forward for the rest of Wales. So, clearly you have that information. There are two parts to this, if I may seek assurances from you: can you enlighten us more as to these 2,000 results that Public Health Wales have been made aware of, as to why the system didn't alert Public Health Wales to the outcome of those test results, given their importance; and secondly, will you commit to making that data available that Merthyr are highlighting today and Rhondda are highlighting today about infection rates in local communities so that people can understand the prevalence of the virus within their communities?

On the second point, I have already indicated that I am looking to see how we can regularise the provision of that information so that it's not just ad hoc. And we're looking at what Public Health Wales already publish to give people the understanding of what is taking place on a local level. And it's not just the Rhondda area; it's actually the whole of Rhondda Cynon Taf where I think they're producing maps showing the rates that exist, together with Merthyr. I think it would be useful to provide that information on a regular and predictable basis. So, I am already looking at how we do that and to see what is already provided by Public Health Wales.

On your first point, unfortunately this has been a data glitch with lighthouse labs. The data haven't come in to NHS Wales Informatics Service to provide to Public Health Wales, and so Public Health Wales have alerted us to the fact they're awaiting those some 2,000 lighthouse lab test results. It's a matter that has been taken up through our normal management and information arrangements with colleagues in the UK testing programme. As soon as those figures are available, we'll need to make sure we understand where they are and how far back those test results go as well, because we have had some improvement in the turnaround delays in lighthouse lab test results, and so I'll want to understand how that tracks back and changes our understanding of the shifting picture of positive coronavirus cases across Wales. So, it's certainly not ideal, but, as I say, I expect us to resolve that with the people responsible for the lighthouse lab testing programme. 

Earlier in the response to my questions, you highlighted, and I highlighted to you, the disruption that's been caused by the outbreak at the Royal Glamorgan Hospital to services, and today in the news we're hearing that a million breast cancer screening appointments have been lost because of the COVID outbreak across the whole of the United Kingdom. What's really important is when GPs, obviously, have concerns and refer patients into the health system, people get the diagnostic tests that they require and then the treatment within the NHS. In Neath Port Talbot, there is already a rapid diagnostic centre that is available for such a service, but obviously we need such centres across the rest of Wales. Can you commit today to the rapid expansion of the rapid diagnostic centres, so that GPs do have that option and so that when patients are suspected of having further inquiries required when it comes to cancer procedures, they can get into the system, have the diagnosis and either get the all-clear or progress within the health service, in whatever part of Wales they live? Because we all know that, when it comes to cancer, time is of the essence, and if we do have disruption in the service, as we do because of COVID, then we need to use the best practice that's available to us, and I would suggest that rapid diagnostic centres are one of those avenues that need to be opened up. 

Two points: the first is that we have already restarted screening services, as I've previously reported back to Members. The second is: you may not have picked this up, but Tom Crosby has confirmed that there has been agreement within NHS Wales to roll out a national programme of diagnostic centres, following the trials that have been undertaken in Neath Port Talbot and, actually, at the Royal Glamorgan, at the diagnostic hub there as well. So, I will be providing proper detail to Members on the detail of that roll-out programme, but it's a good opportunity to say that the trial that we've been running in Wales has been successful, and we expect that to take place in a national roll-out. So, I think perhaps we're already half a step ahead of the question that's been asked today. 

Yes. We recognise the challenge of delivering essential services and routine surgery during the COVID-19 pandemic. Management information indicates that treatment activity is around 40 to 50 per cent of that pre the COVID pandemic. Face-to-face out-patient activity is around just over half but it is increasing each month. We continue to see changes in the delivery of services, with virtual review in both new and follow-up out-patient appointments significantly increasing by a factor of 700 per cent, when comparing March 2020 to our current understanding of September 2020 figures. 

Minister, I'm pleased, of course, to hear that the resumption of services is actually increasing, but I have been contacted by a constituent who is desperately waiting for her son to receive dental treatment and has been told by the local health board that the approximate waiting time is 81 weeks, despite being added to a priority theatre list. Now, I'm sure you'll agree with me that an 81-week wait is just completely unacceptable. Therefore, can you tell us what discussions the Welsh Government is having with health boards about exploring other avenues for patients to receive treatment, such as outsourcing, so that constituents like mine are not facing an 81-week wait? 

In terms of the specifics, I think it would help—and I'd be happy to look at this—to have the specifics of the matter that the Member raises from his constituent, to understand the detail behind that and to be able to provide a more useful answer about that constituent. I want to be helpful in being able to do so. 

On the broader point about the waits that exist, there isn't huge capacity within the independent sector here in Wales, and the challenge is, as we move through the pandemic, how the independent sector is already looking to maximise the work that it undertakes individually, and, indeed, we still have provision with the independent sector to help us as part of our winter protection plan and the ability to have surge capacity. It will take a significant period of time to recover all of the activity that has been delayed as a result of the COVID pandemic. As I said in answer to earlier questions, the NHS Confederation report for England sets out a very similar picture in that nation about the range of activity and the length of time it will take to recover.

I think that the objective view would be that everyone would understand that that is what has happened, with the significant loss of life that has already taken place and the risk for even more significant loss of life if we don't take measures to ensure that we don't suffer in the next phase of the coronavirus pandemic. But that does have a consequence for the rest of our national health service activity. The objective view may be on the one hand, but if you're somebody who is waiting a long period of time, and living with discomfort, for activity, that may not be of much comfort to you individually. That's why, in terms of recovery, once we get through the survival part of the pandemic and understanding of what we're going to be able to do to provide, hopefully, a vaccine or effective antiviral treatment, we will then have a significant task ahead of us in Wales and in every other UK nation to understand how we successfully recover that. And that's why, as I say, I think it will take pretty much a full Welsh Parliament term to get back on top of that. That's not scaremongering; that's me being straight and honest with people about the level of challenge we can all face up to. 

Thank you for the question. Data produced by the Office for National Statistics report that there were 460 deaths involving COVID-19 registered in Betsi Cadwaladr University Health Board residents in hospitals by 29 September. Those are the most up-to-date figures I have available to me. 

As large parts of the north move into local restrictions tomorrow, of course, we need assurances now from this Government that lessons have been learnt from this summer's outbreak in hospitals, such as Wrexham Maelor. Thirty two COVID-related deaths in six weeks—now, that isn't a criticism of front-line staff who have worked tirelessly throughout this pandemic, but it does raise serious questions about the Welsh Government and senior management's handling of the issue. People need to know why staff on COVID wards were sent back to work on other wards without being tested, why patients admitted to A&E were placed on wards before their COVID test results were back, why patients were released back to the community before their test results were known, why COVID-positive and COVID-negative patients were placed on the same ward. You go into hospital to get better, Minister, but that certainly wasn't the case for some people in Wrexham Maelor over the summer. So, given that Betsi Cadwaladr health board has been under your Government's direct control for the past five years, will you accept your part in this failure, and what steps are you now taking to make sure that that isn't repeated?

Well of course I have responsibility for the national health service here in Wales, and I'm proud to do so. When the health service gets things wrong, I'm the Minister responsible for the health service, just as when the health service makes a huge difference in saving lives and caring for people in the compassionate way that we've come to expect as a normal everyday reality of what our health service does the overwhelming majority of the time.

As I indicated in answer to Andrew R.T. Davies's questions earlier, we definitely have learned from the outbreak in Wrexham Maelor earlier in the summer, and those lessons are being applied in the Royal Glamorgan at present. It's important we continue to learn as the coronavirus pandemic continues. So, the leadership from Gill Harris in particular, as the nurse director, now acting chief executive until the new chief executive arrives later in the year, was particularly important, as was the way that stakeholders were brought together—not just the leadership team, but also the staff and trade union representatives—and the communications with families.

The risks for this particular virus are real and significant, and every one of these particular outbreaks—whether in a care home, a hospital or in community transmission—highlights the risks and why it's important for our healthcare professionals to adhere to the best infection prevention and control advice, and also why members of the public need to help them in doing so. So, there are, of course, lessons to learn, and I think it may be helpful, in terms of not just the Member's question, but, potentially, in dealing with the committee, to set out and highlight what we think some of those lessons learnt are as we go through the Cwm Taf Morgannwg challenges in the Royal Glamorgan at present, and to understand where we think there is room for improvement and what that means. You'll already see, though, that the chief medical officer's department has already written to all health boards reiterating a range of guidance and advice, and indeed the chief nursing officer has also reiterated the advice and expectations on infection prevention and control across the whole service.

I've been contacted by ambulance staff in north-east Wales concerned that the lack of ambulance staff testing could contribute to deaths due to COVID-19 in hospitals in north Wales. When I pursued this with the Welsh ambulance NHS trust, the chief executive stated that for asymptomatic ambulance personnel, testing is deemed neither appropriate nor reliable. Their deputy chief executive said, 'If and when the scientific evidence supports repeated testing of asymptomatic individuals, then it will become Welsh Government policy and will be adopted by us at that point'. How, therefore, do you respond to the statement to me by these ambulance staff that although it's of paramount importance that ambulance crews are protected from the transmission of the COVID-19 virus, most ambulance crews have not once been routinely tested, and only symptomatic staff have been given tests? Surely the scientific evidence that necessitates testing for care home staff would apply to ambulance crews, who also work in close proximity to the elderly, the vulnerable and patients with serious underlying health issues who could die in hospital?

The statements of the chief exec and the deputy chief exec are correct. The current scientific and medical evidence does not support the wholesale testing of asymptomatic ambulance staff. If it did, we would shift our position and make sure that we have the capacity deployed in accordance with that advice. The surveillance testing of care home staff has been something that has provided confidence in the sector, and meant that we have been able to deliver not just the testing for people that go into residential care, in particular when discharged from hospital, but that the staff themselves feel protected and we've been able to understand where outbreaks are taking place. The special vulnerability of care home residents is a different factor to the way that paramedics undertake their jobs and the range of people they come into contact with. It’s also a fact that we don't see the same level of staff change within direct contact when it comes to the ambulance service and dealing with people within the community. That isn't really a comparable position to the regular teams of people that need to care for people in care homes. It is the case that if the evidence changes, we will, of course, be happy to shift our position. There's nothing inconsistent with the current policy decision and the best, most up-to-date scientific evidence and advice.

The Deputy Minister to respond.

We have provided £400,000 to Age Cymru to establish a national telephone befriending service to provide emotional support to older people. We've also worked with local government and the third sector to ensure that wider practical and emotional support is in place, such as digital inclusion and buddy schemes. 

Can I thank the Minister for her response? Many older people, especially those living alone, are suffering from loneliness. Will the Government promote Zoom sessions for those who are living on their own so they can see and talk to their friends when they have access to ICT? And also, can more be done to increase the number of people getting the benefit from Age Cymru's excellent telephone befriender service?

I thank Mike Hedges very much for that question. I know that many people, including older people, are lonely. There are also many people not confident digitally, don't use the internet and don't have access to the appropriate devices, and that is why we did fund Age Cymru to establish a telephone befriending service, and as I said, we've given them £400,000 for the fund. We feel that the Friend in Need service is an excellent service, as Mike Hedges says, and our Welsh Government officials have worked with Age Cymru to ensure that links are made in each local authority to ensure that what Friend in Need supplies fits in with what the local authorities are doing as well. And then, through Digital Communities Wales, we are coordinating initiatives in local communities for people, including older people, to access skills and to have the motivation and the confidence to take part in Zoom meetings, as Mike Hedges says. But I think he's asked a very important question and we're certainly working on those ends. 

Deputy Minister, they say that often the loneliest place to be is in a crowd and you will know of the older people's commissioner's report that was issued earlier on care homes and loneliness, isolation, the whole blanket bans that we're having on care homes and how difficult it is with all the lockdowns. Before we go back down that road again, how can the Welsh Government ensure that this time around we can be far more compassionate and more targeted with how we treat each of the individuals that are involved in this scenario? Because we may have people in care homes, but there are an awful lot there who simply find it incredibly difficult to engage with the staff, incredibly difficult to engage with fellow care home residents—people who have got faculties, who do understand what is going on, it's that their bodies are not strong; their minds are absolutely fine. I've had distressing tale after distressing tale told to me of people who just felt so abandoned during the last lockdown and the blanket ban saying, 'You can't see the people you love, that's the end of the discussion', when they were locked up, or felt they were locked up, in their rooms on their own, with very little social contact with anyone.

Thank you, Angela, for that question. Certainly, we're very well aware of this very important issue about how we enable older people in care homes to have access to their loved ones. It's really treading a very difficult line between the protection of the health of the older people in the care homes and the staff and their mental health in terms of having the contact with their loved ones that they need and desire. So, we certainly don't support any blanket bans; we're looking to local authorities to try to approach this on an individual basis and to see where safe visits can be made. We also think it's really important to use all the technology that's available for residents of care homes to keep in touch with their loved ones. We did, of course, provide £800,000 for digital devices for care homes and hospices to enable that to happen, but I absolutely accept the point that there are many residents who won't be able to take advantage of those digital devices. So, we've given guidance about visiting outdoors, and during this very brief period of time—certainly not today—but some time before the winter comes, outdoor visits could still continue. Obviously, it's up to the provider and the local authority, but with our guidance, we want to encourage as much flexibility as possible and we absolutely accept that it's really important for residents of care homes to see their loved ones whenever it's possible for them safely to do so.

Minister, your microphone.

There we are. It's normally the other way round.

We continue to monitor the impact of the pandemic on mental health and well-being through a range of surveys and other evidence, both in Wales and across the UK. I will be making a detailed statement on our actions to respond to changing mental health needs in the near future. 

Minister, we look forward to that statement, because the longer the coronavirus is with us and the longer we have to adjust our lives, then the more profound the potential impact on mental health and well-being is. But some have been more severely affected because of enforced social isolation and shielding, because of financial loss or job loss, and the ever-present worry of exposure to infection, not least those who work in our health and our care sectors and our retail sectors too. Add to this the daily onslaught of social media and traditional media—this means that even when you relax in the comfort of your own home, the virus seems to seep into your living room too. Clubs and organisations like choirs, rugby, knitting clubs, community bingo, sports and arts, which normally provide a safety net of friends and support for all ages, have fallen quiet, too. So, Minister, as the COVID restrictions threaten to stretch into the months ahead, how can Welsh Government and partners provide resources and support to counter a gathering storm of loneliness and isolation and mental health problems that face us?

Thank you. We'll continue with the implementation of our all-age loneliness and social isolation strategy, which we published in February, but more specifically, we do take account of surveys and evidence from ourselves and partners about the direct impact upon mental health and well-being of loneliness and isolation, which is part of the reality of the measures we've had to take to keep Wales safe and to protect the maximum number of lives. The measures we've taken in local restrictions, where we've had to unfortunately take apart the extended household bubbles—I recognise that there's a consequence to that. So, what we have done in terms of working with partners is both on the immediate response to the pandemic and actually planning for the future. Our work has focused in the immediate stage on access to tier 0 and tier 1 support—that's the low-level intervention and support—and the current improvements include strengthening the core mental health helpline, the launch of the young persons mental health toolkit, and SilverCloud, which is an online cognitive behavioural therapy programme. We're also providing additional funding to the third sector to help fill gaps in this time of provision.

We're also looking ahead to the future and understanding that we expect an increased level of anxiety within the public at large that we may need to do something about, what we're going to be able to do in terms of access to specialist mental health services, but also, we need to actively think about what we're going to be able to do in terms of the mental health and support needs of our staff, in particular front-line health and social care. The impact of what our staff have had to do to keep people alive, safe and well is something that affects some people now, but we all know there's a well-known evidence base that some of that impact won't manifest itself for a period of time. So, during the next stage, the next term of this Welsh Parliament, we're going to need to have planned for and to understand how we can help to support our staff, and that's why we've already introduced additional support mechanisms across Wales for staff within health and social care.

Thank you for the question. Following a sharp increase in cases in Rhondda Cynon Taf, new restrictions were introduced on 17 September to reduce the spread of coronavirus and protect public health. Welsh Ministers reviewed these restrictions on 24 September, and at that time we agreed to retain the restrictions for at least another seven days.

Minister, thank you for that answer. Residents in my constituency will be extremely concerned by the news of the major COVID-19 outbreak at the Royal Glamorgan Hospital, which has sadly led to the death of eight patients, with a further six in intensive care, Minister. I'd like to express my sadness and shock at this news, but, of course, our thoughts are right now with their families.

I met with the health board chair today, and support the action being taken by the health board to ensure this outbreak is fully contained. Minister, could you update me on the latest position from the Welsh Government perspective, and in particular, can you give details of the support being provided by the Welsh Government to help control the outbreak? Could you also provide any details of the implications for those who have had operations postponed? And finally, Minister, I'd be grateful for a general update on how the local lockdown in Rhondda Cynon Taf is progressing in respect of infection rates, and with the Royal Glamorgan outbreak in mind, do you see a need for further testing resource to be targeted on RCT?

Thank you for that series of questions. In terms of the actions that the health board are taking, my understanding is they had a meeting with local partners, crucially the local authority, yesterday, where they discussed and agreed the range of measures being taken, and I do think it is a sensible safety precaution to minimise routine care when they are experiencing an outbreak of infection. That does mean that people will have procedures delayed and rescheduled at a later date, but that is in the best interest of those patients—not to admit them onto a sight for routine procedures where we understand there is an outbreak where harm is being caused. And that is a temporary measure while the outbreak is being brought under control.

At this point in time, the chief exec of NHS Wales is in regular contact with the health board to have a proper understanding of the measures that are being taken, and the oversight, as indicated earlier, for the measures and the control measures to understand what is happening, with both the staff testing that's in place, to understand if there's a need to do more. As a result of the staff test results, we get to see where the outbreak actually is, and to see how well contained it is. So, we're learning and applying the measures from the Wrexham Maelor Hospital. 

In terms of your broader point about measures within the community, I think it's important to reflect that whilst we haven't seen the same reduction in cases that we have seen, fortunately, in Caerphilly—and Newport is also making good progress—there is some cautious evidence to think that we may be seeing a plateau. It's still at a very high level, but we'll want to understand if that really is the case, and that will give us some further hope for the future. But the evidence of Caerphilly is that it is possible to see a reduction in rates, and that this is not a one-way escalator to further and further restrictions. We'll continue to measure and weigh whether there is a need to do more to help control the spread of the virus across the RCT area. 

The key point is that it's in the hands of people in their communities to look after each other, and the rules are there for the benefit of everyone. If we get a high level of adherence to that, then we can expect to see a reduction in the spread of coronavirus and the harm that we know it has already caused and is likely to cause. We'll continue to review matters on a regular basis; that includes a provision of testing services. We've actually seen a fall in the number of people taking up the testing services available, so the concern that the health board have is not that we don't have enough access to testing, but that actually there are people who should be getting a test who are not. So, again, it's an appeal for people to use the testing resources that are available within RCT, and we'll continue to review how and where they're provided to make sure they're readily accessible for the communities that need to access them. 

Minister, it's obviously a very serious event in the Royal Glamorgan. This is September—when we face the pressures of winter in late November, December and January, we could be under more severe pressure yet. Now, I know, throughout Wales, part of the management of the COVID risk has been moving some operations to other facilities—cancer operations, for instance, to the Vale Hospital and in Cardiff to Spire. And cancer treatment is going on, as I understand it—emergency treatment will continue at the Royal Glamorgan, but all other elective care has now stopped. Cancer patients in particular have to be protected from infection—you can have a very bad outcome if they've been operated on and are under immunosuppressant drugs. So, can you assure us that zoning hospitals, or moving certain care to specific sites, is going on and will be a way of ensuring that higher levels of cancer care can be delivered than otherwise when we face these sorts of emergencies?

Yes, I'm happy to provide that direct assurance—that is exactly what the health board are planning for with their partners. They've not just worked with the local authority partners about the need to have people leave the hospital to create more space in general terms, but in terms of your broader and more specific point about cancer services, they're already working with other partners too to see what can be moved to make sure that treatment continues as far as possible. So, I'm happy to provide the direct assurance the Member looks for.

I'm deeply concerned about the outbreak of, and the deaths from, COVID-19 at the Royal Glamorgan Hospital and what this will mean for both patients and staff. My sympathies, obviously, go to all of those who've been affected.

Many elective surgeries have already been postponed during the pandemic, and now the backlog is set to get worse. Emergency patients will now be transferred by ambulance to other hospitals, thereby adding a potentially crucial delay to them receiving life-saving treatment.

I want to know what the Government can do to bring this crisis within the hospital to a swift end and create a safe environment for patients and staff. You can improve on testing. Can you boost testing capacity on site so that we can track and trace the virus better? Can you improve the turnaround time for results so that people get those results quicker? The staff need improvements in testing and faster testing, so what can you do to help with that? Finally, do you have any confidence left in the lighthouse labs now? 

I think there's a range of things to run through, hopefully to provide some reassurance to the Member and any people watching. When it comes to outbreaks and outbreaks management, you'll have seen from the previous outbreak in Wrexham Maelor that we actually ran the tests through for the staff and for patients when an outbreak had been declared through our Public Health Wales labs, and they provided a very fast turnaround. The tests for an outbreak are prioritised, so they do have very, very fast turnarounds, so you can expect the 90 per cent plus that we achieved in Wrexham to be turned around within a day.

So, we're actually using NHS Wales tests for this, for the management of the outbreak, and that's exactly what they're intended for, with that additional capacity and the surge capacity that exists in our system. That should provide reassurance for staff and, indeed, for people going onto the site as well. If they do still require treatment and that is the right place for them to have their treatment, then they should be tested. Again, they can expect that to happen through Public Health Wales labs as well.

When it comes to the assurance about people being transferred to other sites, then people will be transferred by professionals within our Welsh ambulance service trust, and they can expect to receive a high quality of care. We're in the fortunate position that there are hospitals that are relatively near to the current site for the Royal Glamorgan, and I don't think that there's a basis for people to be concerned that life-saving treatment could be unduly delayed by that transfer. It's, as ever, a balance, in that if people need to be transferred away from that site, it's because there's a risk to those people in otherwise admitting them, and that's the risk that has to be balanced and the judgment that has to be made. I'm confident in the leadership of the health board; I'm confident in the way they have worked with partners to do so. I believe that we can look forward to the outbreak being brought under control. Certainly, there is no lack of testing or the availability for testing on site for people who really do need to get tested, and I think we demonstrated that with the previous response to the Wrexham Maelor outbreak.

Yes, I welcomed the recent Audit Wales report on the redevelopment scheme at Ysbyty Glan Clwyd. As recognised in that report, improved governance and assurance procedures for capital projects have been introduced and are now embedded into health board and Welsh Government processes.

That remains to be seen, Minister, because in 2012 the Welsh Government approved a project to remove asbestos and refurbish Glan Clwyd Hospital. The project was completed in 2019, at a cost of £170 million—55 per cent more than the original budget. Now, in the Auditor General for Wales's report, the findings are scathing: the Welsh Government never formally approved the health board's outline business case; auditors issued a 'no assurance' opinion on the health board's arrangements for governing and managing the project; and when approving the business cases, the Welsh Government did not sufficiently consider the risks associated with their advisers; concerns too that project design and costings were underdeveloped. Now, I do appreciate, as you mentioned, that steps have been taken to improve arrangements for approving business cases, but let's be honest, you are and were the Minister responsible. So, what assurances can you provide this Senedd with that you will not allow such bad financial management in this health board again? Thank you.

Well, when the project was agreed in 2012, I wasn't a Minister in the Government. It's important to make that factual point of accuracy. Actually, the characterisation of the report is partial from the Member. The comments I made in direct answer at the outset come from the conclusions of the Wales Audit Office report itself. It recognised weaknesses at the time, it recognised that the rationale for that was a desire to see the remedial work undertaken, it also recognises there is a significantly better clinical environment for patients and staff to work in as a result of the work that's been undertaken, and it also recognises there are improvements in the process and in the governance arrangements for capital projects, not only within Betsi Cadwaladr for north Wales, but, indeed, across the service as well. That is a more honest and rounded review of the report, rather than the partial version provided by the Member in her second question.

I thank the Minister.

The next item is the 90-second statements, and that's because no topical questions had been accepted.

So, the first 90-second statement today is from Mike Hedges.

Diolch, Llywydd. At approximately this time each year, Senedd Members from all parties don pink items as part of the Wear it Pink for breast cancer campaign. These photographs end up on social media and in local papers. This year, due to the pandemic, we cannot take part in an event in the Senedd, but I do not wish to miss the opportunity to show my support for the breast cancer campaign. I think it is very important. 

While we have a COVID pandemic, breast cancer has not gone away. Since launching in 2002, Wear it Pink has raised over £33 million for breast cancer research, which I believe is a remarkable achievement. I urge everyone to support Wear it Pink and help to make possible life-saving breast cancer research and life-changing support for those affected by the disease. 

Each year in Wales, around 3,000 women are diagnosed with breast cancer and over 550 women die of the disease. That's why I'm encouraging everyone today to support breast cancer awareness day. We cannot dress up and meet with breast cancer survivors, but we can show our support for breast cancer charities, and I'm trying to do that today.

Thank you. Now, with particular pleasure, I call Elin Jones, the Presiding Officer. 

Radio Bronglais is ysbyty Bronglais's radio station. It broadcasts all day, every day, and this week it is celebrating its fiftieth anniversary. The station was established in 1970 when members of Bow Street youth club presented a Sunday evening requests show for patients. Since then, the station has gone from strength to strength. A permanent studio was established with lottery support in 2001, and since 2013 Radio Bronglais has been streaming live online to all corners of the globe.

The station is run by a large group of volunteers and provides a platform for new local talent—the best known being Aled Haydn Jones, whose first contribution to the station was as a 14-year-old pupil at ysgol Penweddig. Aled has just been appointed head of BBC Radio 1. From Radio Bronglais to Radio 1. Well done, Aled, Aberystwyth is very proud of you.

The station has been nominated for multiple awards over the years. Some of the most challenging, and certainly some of the longest, interviews that I have faced have been on Radio Bronglais. And, of course, the station is appreciated by patients and hospital staff alike.

In the maelstrom of this health pandemic, let us celebrate and thank every hospital radio station, and wish Radio Bronglais a very happy birthday.

Diolch yn fawr. There'll now be a break for 10 minutes to allow changeover in the Chamber. 

Order, order. The Senedd is back in session.

We move to item 5, which is a debate on the Health, Social Care and Sport Committee report on the impact of the COVID-19 outbreak, and its management, on health and social care in Wales, and I call the chair of the committee to move the motion. Dai Lloyd.

Thank you very much, acting Deputy Llywydd. I'm very pleased to open this debate on the Health, Social Care and Sport Committee's report on the COVID-19 outbreak.

Before I turn to our findings, I'd like to pay tribute to the commitment and dedication of everyone who has contributed to the work of keeping our front-line services operating in the most difficult of circumstances. Whilst our thoughts turn automatically to the health and social care sector, we must also recognise the tireless efforts of so many other sectors and professions, often behind the scenes.

The public has also made huge sacrifices, and we need to recognise that. Families and friends were separated, and the most vulnerable were isolated from their wider support networks. Their collective efforts in adhering to the lockdown rules significantly suppressed the spread of the virus. Sadly, we now face similar challenges, and we are asking the Welsh public to show the same collective spirit to help curb this insidious virus once again.

When the first case of coronavirus in Wales was confirmed in March 2020, very few of us, I imagine, realised that the virus would have such a devastating and long-lasting impact on us all. It's been cruel and ruthless and it's stolen the lives of friends and loved ones. As a committee, we felt that it was important to consider the impact of coronavirus, and its management, on health and social care services in Wales. We have considered the response of the Welsh Government and relevant public bodies, as well as the impact on staff, patients and others receiving care or treatment in clinical settings or in the community. Our purpose in undertaking this work was to seek to identify what worked well and what didn't work so well, in order to learn lessons and to apply them quickly to any rise in infection rates.

We've taken evidence from a wide range of professionals in health and social care, public bodies and stakeholders, and we continue to do so. We carried out a survey of front-line staff, patients, carers, and those receiving care or treatment, to understand the impact of the pandemic on them. We also issued an open invitation to anyone who wished to share their experiences with us. I'd like to thank everyone who took the time to contribute to our work.

Our recommendations include 28 recommendations, and 21 have been accepted in full, and I'd like to thank the Minister for his detailed response. I won't have time to address every recommendation, but I will try to cover some of the key messages, turning first to personal protective equipment. Now, in the early days of the pandemic, a great deal of coverage focused on concerns regarding the adequate and continuous supply of PPE. Much of the early evidence we received reflected the fears and concerns of front-line staff about the availability of appropriate PPE. According to a survey carried out by the British Medical Association, 67 per cent of doctors in Wales did not feel fully protected from COVID-19 at work, and 60 per cent had had to purchase items of PPE directly, or had received supplies as a donation, because the NHS had not been able to procure adequate supplies.

The Royal College of Nursing also reported that many of their members, particularly community nursing teams, had called because they were distressed at being unable to access PPE. It said that 74 per cent of nursing staff had raised concerns about shortages of PPE, with over half having felt pressurised to care for a patient without adequate protection. Indeed, the Minister for health told us that the situation was a very real concern for Government at the time.

This position has improved, and we welcome this, but we cannot afford to be complacent. We need assurance on the continuity of PPE supplies, particularly in light of the recent rise in infection rates. We therefore made the following recommendations: the Welsh Government must, as a matter of urgency, publish a strategy for securing a resilient supply of PPE; stockpile sufficient quantities of appropriate PPE for any future outbreak; keep under review the PPE that it has stockpiled to ensure that it remains of adequate quality and is fit for purpose; publish a strategy for ensuring the resilience of distribution arrangements; work with partners to ensure that guidance on PPE is kept up to date in light of the most recent scientific advice, and communicate this advice clearly to staff. That's recommendation 1. I am very pleased to say that this recommendation was accepted and that a strategic plan for the procurement of PPE for health and social care is being developed.

Given that Wales has traditionally been reliant on supplies from China and other Asian countries, it is vital that we support manufacturers in Wales to develop our own homegrown supply. We therefore recommended that the Welsh Government review its own systems to ensure that the mechanisms are in place to enable manufacturers in Wales to respond quickly in supplying appropriate PPE in the event of any future outbreaks. That's recommendation 2. In accepting this recommendation, the Minister acknowledged the important role of Welsh businesses in strengthening our resilience to withstand a second peak of COVID-19, and said that the PPE procurement plan for health and social care will blend local manufacture and international supply.

Now, in turning to care homes, testing in care homes proved to be a controversial issue, with both the UK and Welsh Governments coming under criticism, as we know, for lack of testing in care settings. The Office for National Statistics figures show that there had been 663 COVID-19 deaths in Welsh cares homes.

According to Care Forum Wales, the practice of discharging hospital patients to care homes played a major role in enabling the infection to spread at such an alarming rate in care homes. The Older People's Commissioner for Wales said that she had concerns that older people’s rights may not have been sufficiently protected. The number of COVID-related deaths in care homes was a source of great concern to us. We believe that the Welsh Government’s initial attitude in terms of testing in care homes was deficient at the outset and their response was too slow thereafter. As a result, the number of deaths in care homes accounted for 28 per cent of all coronavirus-related deaths in Wales.

Recommendation 9 in our report called for the Welsh Government to ensure that all patients being discharged from hospital directly into a care home have been tested, in accordance with latest best practice, in order to ensure that residents and staff have maximum protection. This recommendation was accepted in principle. The Minister said that there had to be test results available before patients could be discharged from hospitals. I'd like to thank the Minister for this reassurance and for accepting our recommendation.

In turning to test, trace and protect finally, before I finish this first part, I'd like to talk about the test, trace and protect strategy—the contact tracing system of the Welsh Government. The test and trace programme under the strategy has a number of key purposes, including: diagnosing the disease; population health surveillance; contact tracing; and business continuity, enabling key workers to return to work more quickly and more safely.

A number of witnesses have highlighted the importance of the timely return of test results to secure the success of the TTP strategy. As Sir David King, a member of Independent SAGE told us,

'the turnaround time after testing is critically important. If you get the test result five days after the test is made, and that person is still wandering around in their community, imagine the number of people infected during that period.'

We agree that the speed of testing, the turnaround of testing results, and the accuracy of those results will be critical to the success of the TTP strategy. The longer the end-to-end turnaround time, from sample collection to the reporting of results to individuals, the greater the delay at the point when the disease is most infectious, or the greater the likelihood of—[Inaudible.]—.

[Inaudible.]—recommend therefore that the Welsh Government, working with Public Health Wales, should seek to ensure that every test result is returned within 24 hours. That is recommendation 19, and that recommendation was also accepted in principle.

We also heard that public support would be crucial to the success of the strategy. People must be willing to be honest in sharing details about their movements and their contacts, and to self-isolate if they are at risk for the benefit of the wider community. We recommended, therefore, that the Government, working with its partners, should ensure that they present clear public messaging and to rehearse those consistently at a local and national level, highlighting individual's responsibility to self-isolate, if they have symptoms, and the importance of seeking a test immediately. That's recommendation 25, and that was accepted.

Of course, if contact tracing is successful, people could be asked to self-isolate multiple times and this is a particular worry for people in low-paid employment who cannot afford to take time off work. According to the current guidance, anyone who is self-isolating is entitled to statutory sick pay, which is £95 a week, but this is not a sustainable wage or a living wage. The temptation to ignore symptoms and advice and to attend work is therefore a very real concern, and it's an area that requires urgent attention from the Welsh Government, particularly given that arrangements for statutory sick pay are not devolved. We've therefore called on the Welsh Government, as a matter of urgency, to pursue with the UK Government the arrangements for statutory sick pay for social care workers and others in Wales who do have to self-isolate. I welcome the fact that the Minister has accepted this recommendation and his assurance that he continues to raise concerns with UK Ministers about the financial impact of self-isolation. 

In closing, I would like to acknowledge that the scale of the challenge facing Governments and their partners in dealing with the effects of COVID-19 has been unprecedented. Enormous efforts have been made across the board, resulting in many significant achievements. Unfortunately, infection rates are on the rise once again. We must use the experience that we have and everything that we learnt in battling the first wave of the disease to ensure that any new measures introduced to control the virus are effective, timely and proportionate. Thank you very much.

I welcome the opportunity to contribute in this debate today. I appreciate I wasn't on the committee at the time of this review that was undertaken, or this inquiry that was undertaken, but I'd just like to pay tribute to my predecessor, Angela Burns, for the work that she did in her time on the committee, and also the Chair of the committee, the staff and the other Members who have produced a very detailed and concise piece of work, with some key recommendations, to say the least on it. And the Government, by and large, has engaged with those recommendations, although, as a politician of some 13 years standing, you're always a bit reticent when you hear 'agreed in principle' because, regrettably, that very often doesn't get delivered, and many, if not all of these recommendations, if taken in their entirety, would add hugely to an improved offer, an improved response, now that some months after this report was published we're seeing what many would call the second wave of COVID hitting many of our towns and cities and communities the length and breadth of Wales.

I think, in the report, as almost like a third person coming to it, reading it from cover to cover, the index of dates at the back is a timely reminder of how quick we've travelled in this year, from January right the way through to when this report was published in July, and the level, the volume, and the complete transformation in services, the way Government responds—I mean, you only need to look at our work here today and yesterday, how COVID has consumed everything that we do because it is all-encompassing.

Reading some of the comments around PPE and the recommendations around PPE, it was a timely reminder of the real challenges that the sectors face, both health and the care sector in particular. And reading it, it emphasised the point how health and the care sector need to be taken as equal partners, rather than one sector getting the provision of PPE in the first instance and then maybe the care sector getting what was left over and maybe playing catch-up. That does need to be rectified, if that situation of constraint of supply does happen again. And I'm pleased to hear the assurances of the Minister, saying that the supply of PPE has been greatly enhanced since the beginning of the outbreak, but it is really important that that parity of esteem is listened to and understood. In particular, if the Minister in his response could highlight what progress has been made in relation to the work that the Government have commissioned from Deloitte about the demand mapping around PPE, again, that would be good to understand how, if that squeeze comes on in the winter months, there will be equity across Wales in the supply chain of PPE.

Testing, as we hear much about these days, and the concerns around testing—in the absence of a vaccine, testing is really our only defence to be on top of this virus and to understand where the prevalence of the virus is and, ultimately, how it is tracking through our communities. Reading some of the recommendations that have been put in place, and, importantly, how they'll be deployed is of critical importance, in particular when you think of ramping up the volume of tests that will be available. It is a little discouraging to see that, in July of this year, the Welsh Government's own testing capacity was at 15,000; here, some two months later, in September, it's still on 15,000, and the comments that the First Minister himself made—I applaud him for his honesty—that maybe we'd be able to deal with that on a day basis, but it wouldn't be sustainable over any long-term period of time to use that full capacity. And so, working united across the United Kingdom, despite the problems of the lighthouse labs, will be the only solution to bring a real volume of testing here into Wales, and indeed other parts of the United Kingdom. It would be my sincere hope that many of the glitches that have hit the system can be ironed out.

I hope the Minister can give us an up-to-date position on how the testing numbers are being deployed, because, very often, as politicians, as the report highlights, we fixate on capacity, but it's the ability for the whole system to work, from the capacity through to the number of tests that are done, to the response rate, as the Chair highlighted, and the importance of getting that response back within 24 hours. Any effective testing system has to get at least 90 per cent of its results back within 24 hours. If it fails to do that, then we're really missing the goal of achieving that best effect from the testing regime.

I appreciate that my five minutes are nearly up on the clock. TTP: the scale of test, track and protect is enormous, as the report highlights, and the BMA's evidence in particular spoke of this enormous programme that will be required from between 7,500 to 8,000 contacts in a day, up to 0.5 million people at any one time being in the system. That gives a sense of the scale of operation that we're talking about, and if at the start of this year people said to politicians, 'What do you think are going to be your top-five challenges?', I don't think anyone would have touched on a COVID outbreak and the all-encapsulating nature of it.

So, I do commend the report to the public at large and I do commend the activity of the committee in undertaking this report, and I look forward to continuing the work of the committee when it revisits some of the recommendations to see that they've been implemented in the future. Thank you, Deputy Presiding Officer.

Once again, our Chair has given a very thorough and strong introduction to the report in his contribution this afternoon, and I wish to join him in paying tribute to all the NHS staff and social care workers across Wales for what they did during the pandemic at its peak, since then and are continuing to do now, and I'm sure that they will be doing through all of the winter. We clapped them every week at that time, but they deserve so much more than that. Their commitment is undying and unquestionable.

I think we need to remind ourselves, also, why we put the report in, because it was about the impact of the virus and what lessons we would learn from that. There are still so many families that have been devastated by that virus and the loss of loved ones, others who have suffered severe health conditions as a consequence of contracting the virus and spending a long time in hospital, and we must never forget those people in everything we do.

But we have come a long way since the start of the pandemic, and, hopefully, we have learnt a lot. There is much to learn, because if we look at the report and some of the issues that are raised, and I'm repeating some of the comments that Dai Lloyd introduced, but if you look at them, they are still relevant today, they haven't gone away. The PPE question: I'm very pleased that we do now have sufficient PPE, but when this came out, we didn't. No matter how much we thought we had, we didn't. I'm very pleased, also, that local businesses are now using opportunities to create and develop PPE—I've got one in my own constituency, Rototherm, which has transformed itself. Fantastic work is being done to ensure that Wales has a supply of locally based businesses that are producing the PPE.

But also, let's not forget what wearing the PPE does for staff, because if we read our survey of the staff, and some of the comments they made, they found it very difficult to work in those circumstances, and it took its toll on them. Sometimes we need to reflect upon that, so that we ensure that we protect our staff as well, and that we get this PPE right. We don't want to put people in a position where they are facing life-threatening positions when they are going to care for people because we haven't got the PPE for them. We must get that right. I know the Minister will say that we're doing that; we've got larger numbers now, and I very much appreciate that. But I also want to ask him, perhaps—because halfway during the pandemic, the guidelines for PPE were changed, and I want to ask whether there are more changes to come in those guidelines because of the lessons learnt during that pandemic, and people's ability—. Because paramedics are saying that sometimes they go into a situation wearing simply an apron and gloves, which is not sufficient on occasions. We need to make sure our staff are protected.

Can I also raise the issue of care homes? We know full well that, during the initial stages, they were vulnerable, and the residents, who are vulnerable themselves, became, unfortunately, victims of the virus. We saw many, many residents hospitalised, and some of those unfortunately did not survive. Dai has highlighted that there were over 600 of them. We are in a position now where we have put better protection in place, but we did ask for testing to be done on a regular basis. I know that's being done, and I'm very pleased about that, and we must make sure it continues, but I'm still concerned on the home testing agenda and the quality of training given to people to do that. There are too many false negatives and false positives coming through the testing system, and we have to minimise those. One of the ways of minimising that is by following recommendation 10, bullet point 2, which says, 'Ensure it's done by a suitably qualified individual'. There are many nurses already employed in care homes, and there could be others being used in those that don't have them, so I don't think it's something that the Government should have rejected. I think that the Government should have accepted that and made sure that there were appropriately qualified people taking those tests to minimise the possibilities of false negatives and false positives, because that does give misleading information, and it does give misleading confidence on occasions, so we need to address that.

The other issue, obviously, is testing—people have talked about testing—in general, and we raised this question about testing and getting ready. In fact, we actually said, I think in recommendation 8, that we need to prepare for a second wave, and that we should work with partners to take steps for sufficient capacity. Yet we're still talking about capacity. We're still talking about whether we're using lighthouse labs or not. There's a question there still being raised. I appreciate the Minister's already had this many times, but I hope he takes on board the fact that testing is not going to be something that will go away—it is something that is going to drive the agenda forward, and we must ensure that we address the capacity issue, both of the ability to take the test, but the ability to analyse the tests as well. Because that's where people are getting confused; they think, 'Oh, I can have a test', but don't forget it's got to be analysed and the results have got to be provided. We said at that point in time that we want more within 24 hours, and we're still not seeing some of those figures increasing. We need to address that point.

I'll close by saying I want to give huge thanks to the committee staff. Many people don't always appreciate it, but committee staff worked unstintingly throughout the period, and over the summer period, to ensure that we had the evidence we needed to provide this report. We must give thanks to them and to the witnesses that gave us the evidence. Those witnesses represent the people on the front line, and we can't forget that, either. So, thank you very much. And please, Minister, I appreciate we have come a long way, and I appreciate we are not where we were back in March, but let's make sure the lessons are learnt and that the advice is followed. Thank you.

I just have one more speaker before I call the Minister, and that's Rhun ap Iorwerth.

Thank you, Chair. I'd like to echo the thanks to the amazing work of the committee team, the clerks and the research team and so forth, who have worked so tirelessly through this period. I've been very pleased to be able to be part of this inquiry, which is ongoing, of course, and will continue for some time. It's the first report in a series, focusing on a number of specific areas. I'll go through those. One of the major elements that we looked at was testing, which is such a key part of the battle against the virus. We know that the system isn't as robust as it should be. There are a great number of my constituents who have contacted my office—people not being able to have tests at home and having to travel a long way to testing centres; people failing to have tests because they don't have an e-mail address or a mobile phone—not everyone has those—and some people having trouble driving to certain test centres. We have to ensure that this aspect is strengthened. 

I am pleased that the Government has accepted recommendation 8, namely that they should assess carefully the likely demand for tests in the future and ensure that there is enough capacity to test in the future so that anyone who needs a test can access one quickly and easily. But the truth is that there is a failure to meet current demand, let alone the demand over the winter. We need to differentiate between capacity and how much testing is happening in practice. The First Minister talked about 15,000 capacity, whereas actually very often it was only 2,000 or 3,000 tests that were being done.

I know that the problems of having tests have come to the surface as schools have opened, and capacity has been short when it was needed. I would have expected there to have been more preparation for that and more robustness in planning or building for the start of the school term. And despite the pledges that things will be better in a few weeks in terms of the lighthouse labs, it doesn't give much confidence in terms of winter robustness, as the second wave continues to grow.

I'm pleased that the Welsh Government has accepted recommendation 7 in terms of developing a clear plan for regular and repeated testing of health and social care staff, including asymptomatic staff. I have been calling for that consistently, and there are still too many people on the front line who are nervous. I hear stories about community nurses, for example, who don't get offered tests and are very concerned about passing the virus on to patients. We need to expand the scope of asymptomatic testing at home, for example. 

Another issue is the financial implications on local government during this pandemic. I do welcome the recognition that the Government needs to confirm as a priority the support package for local authorities to support the work of employing tracing professionals, as they've been doing. And that's recommendation 24. That's something I raised with the finance Minister in July. There were volunteers in local authorities and workers who had been pulled from other departments into the tracing teams, and I think that it is obvious that, even though the number of tracing staff has grown, as we heard in the committee this morning, there will be further support needed by our councils on this front. 

Further work that local government has been leading on is helping people to shield. And you've seen a great number of references in the report in terms of supporting people who have been shielding and ensuring that people are being fed, and so forth. And on that point, I was disappointed with the response I had to a letter from me asking for support for local authorities to be able to plan for providing food and so forth for vulnerable people during the second wave. There was a great partnership in Anglesey, being led by the council, with Menter Môn and local businesses, and Dylan's restaurant, and so forth, ensuring that food packages were being distributed. And Dylan's were very eager to see that preparations were in place to be able to respond quickly to a second wave. The response was very quick in Anglesey the first time, but of course we need to learn as we go. We have the background information now, and we need to ensure that there is better preparation, and I didn't hear that in that letter. So, I'd like to have an assurance that planning work is being done. 

And finally, I echo the recommendation in terms of adequate PPE during this pandemic. We've heard the word 'thanks' being said time after time to health workers and care workers but, of course, what they need is information now and in the future that the resources will be there to allow them to do their work properly. 

Diolch yn fawr. I call the Minister for Health and Social Services, Vaughan Gething. 

Thank you, acting Deputy Presiding Officer. May I first begin by thanking the committee for their time in considering this important topic, and what is an interim report? The scrutiny continues; I had the pleasure of more than two hours in the company of the committee today answering questions about the continuing work that we do on how we keep Wales safe, and the response of our health and social care system. I want to put on record my thanks to the staff across our health and social care sector, not only for their incredible hard work and dedication to care for people with COVID-19 and their incredible compassion and resilience—they really are a credit to each and every one of us—but also the work that they have done with others in addressing urgent health and care needs to protect those who are the most vulnerable within our community. 

I support and accept or accept in principle the majority of the recommendations from the committee. Our national winter protection plan has now been published and this is an overarching plan that sets out our expectations for health and social care, and informs engagement with wider partners and stakeholders. This ambitious plan will seek to embed our learning from the report to strengthen our approach over the forthcoming winter period.

On testing, the testing strategy published on 15 July outlines our plan for testing health and social care staff, and I've recently provided a written statement on the priorities for testing at the start of this week. Our strategy is based upon the latest evidence. As ever, it is subject to change as the evidence base may change during the course of the pandemic. And I would gently say to the committee that they will hear and they'll continue to hear anecdotal demand for asymptomatic testing. The committee can't demand a broadly evidence-based approach and demand fidelity to the scientific and medical evidence to help keep Wales safe, and then choose when to cherry pick and amplify demands that are made to overturn the evidence that we rely on to help keep Wales safe. 

We've openly set out the evidence base from the technical advisory group, and the committee have had the opportunity to hear evidence from the co-chairs of TAC, including the chief scientific adviser on health as well as access to the chief medical officer. We're continuing to openly publish that evidence and to make choices based upon it. 

We are acutely aware of the challenges posed by delays in the testing from lighthouse labs; that's been highlighted again today in the questions from Andrew R.T. Davies highlighting the delay of 2,000 results from lighthouse labs to flow into our system, and that's an important factor. In the overall lighthouse labs testing programme, those 2,000 tests aren't a significant amount but, actually, in terms of the overall numbers for Wales they could make a material difference about our understanding of disease prevalence in communities across Wales. So, I do recognise that that is a real challenge for us and, as I say, it's something we're looking to work constructively with different officials and, indeed, different Ministers and I'll continue to have those discussions not just with the UK Secretary of State for health, but also ministerial colleagues in Scotland and Northern Ireland. 

We were, at the point that I gave evidence to the committee, expecting to have the lighthouse lab in Newport open over the summer; that's now delayed and expected to open in October. That should help us in improving the volume of tests available, but there's also something about the robustness and access to the largest population base in Wales. So, that should be a positive step forward for us. But Welsh lab capacity is already being used for rapid deployment of outbreaks and incidents, and for NHS Wales. We continue to work urgently with Public Health Wales and our NHS to build on the work that is already taking place to supplement capacity from lighthouse labs with those that are operated by Public Health Wales.

Again, I was able to run through some of this with the committee this morning, with the update, for example, on the increased testing availability we'll have in north Wales, where this week we expect to increase the testing capacity by some 40 per cent. That is largely because of our deployment of Public Health Wales lab tests. We'll utilise and prioritise Welsh lab capacity as we see pressure and demand rising across the UK and, of course, to deal with hotspots here in Wales. I recognise that turnaround times are critically important to the effective functioning of our test, trace, protect system. And test, trace, protect is a successful Welsh innovation and delivery, designed and delivered between health and local government in partnership, across all the different geographies and politics of local government, working with their local and national health service. I recently announced additional funding of £32 million to increase capacity to process tests at Public Health Wales laboratories. That includes six new hot labs that are due to open in the month of November, and extending regional labs to operate on a 24-hour basis should take place before the end of October. And in the most recent week that we've been able to publish figures for, 94 per cent of new cases were successfully traced by our test, trace, protect service, and 86 per cent of their contacts.

I recognise the comments made by committee members about support for self-isolation. Our test, trace, protect service does contact people who are isolating. It's how they understand how successfully people are or aren't isolating. I've had feedback from my own constituents and others about the difference that call has made to them successfully continuing with self-isolation. But I recognise the issues raised by not just the King's Fund report, but also by SAGE and others about the concern over people not successfully self-isolating. So, it was welcome when Michael Gove, in a call with First Ministers across the UK, confirmed there should be new money available to match the policy offer that had already been announced in England—of a £500 additional payment on top of statutory sick pay for low-paid workers. We now expect the UK Treasury to honour that commitment, so the First Minister has been in a position to confirm that we will introduce that payment to make sure that people can successfully self-isolate.

Care home providers, as well as people living and working in care homes, have faced an unprecedented challenge this year, and my sympathies are with those who have faced months of separation from family and friends, and especially to those who have lost loved ones. We supported the sector through this exceptionally difficult period, and we'll continue to do so. We'll be publishing our care home action plan that the Deputy Minister has committed to. That will set out the actions we're taking to ensure that the care home sector is well supported ahead of the challenges of the winter period.

We have been challenged—we heard it again today—about the approach we took in discharging people from hospital to care homes during the initial phase of the pandemic. And if I can take this opportunity to draw the committee's attention to recent research undertaken by Public Health Wales in partnership with Swansea University. That research found no evidence that hospital discharges were in fact associated with a significant risk of a new outbreak in a care home. However, the size of a care home was found to be associated with this risk. Research investigating into how other factors, including policies around staff and visitors, might affect risk continues to be prioritised in support of our efforts to reduce or eliminate care home outbreaks.

Restricting visits to care homes has been exceptionally difficult and, in fact, heartbreaking, and we heard this again today in the committee. But it has been one of the necessary measures that we have had to take at various stages in the pandemic to reduce the risk of infection to care homes. We've worked collaboratively with the sector to produce guidance to support providers to reintroduce visits safely as lockdown restrictions were eased over the summer. That work continues, and I know that the group met again this week to consider how the guidance is working in practice, and, again, the understanding that there should be not be an entire blanket policy—there should always be an individual circumstance where the care needs of that individual could or should be met by visits.

Recent local restrictions mean that local authorities have again had to make some very difficult choices about care home visits, striking a balance between people's continued well-being and the risk presented by increased community transmission. And I again encourage our local authority partners to engage with Public Health Wales, working with their local incident management teams in reaching those decisions. I expect restrictions to be temporary, to be as least restrictive as is safe, and to be kept under review. A rapid response system is in place for local health boards to deploy mobile testing units to those care homes where there is a positive case, and a dedicated care home testing portal is available for ongoing testing of care home staff.

It is worth pointing out on PPE, which the chair spent time on in introducing, that since 9 March, NHS Wales Shared Services Partnership have issued 342.3 million items across our health and social care system, and 167 million items have been issued to social care—that's 48 per cent of the total of items. And we're still issuing around about 13 million items a week. The scale of activity is still significant, and since the very early days of the pandemic, we have provided that free of charge to care home providers. It is the legal responsibility of employers to provide PPE for their workforce. The NHS Wales Shared Services Partnership stepped in because otherwise we would have had an unacceptable risk of harm to staff and the people they care for, and I'm pleased to see that England have recently announced they will follow the lead that we have taken in making that provision of PPE freely available to the care home sector.

We've also been able to provide mutual aid to other UK countries, we have a healthy supply chain of future orders and we are in a much more robust position and we are stockpiling for the winter ahead and for future provision. In fact, I think our system stood up well to the extraordinary pressures and the very sharp tightening in the international market that we saw. That's both in ordering and delivering more PPE into the country, and, in fact, we've provided some assistance in terms of the conversations with England where they've had to reconstruct a central purchasing and procurement operation that was lost in the Lansley reforms. But more than that, we've also, as Dai Rees mentioned, seen Welsh businesses and manufacturers respond significantly to the challenge of creating more PPE. And in the future we'll need to have a different balance in what we procure from other countries and what we continue to provide from manufacturers here in Wales. There may be an additional cost per item to that, but it's the right thing to do to make sure that we have a more robust system in place.

Minister, you've now taken 11 minutes. We're not pressed—[Interruption.] Hold on. We're not pressed for time and this is an important debate, so if you take a minute or two to conclude, that's fine, but we do have to pay some attention anyway to the time limits.

Thank you. I'm fortunately drawing to the conclusion of my remarks, and that is that we have learned from the initial six months. We've learned about working closely with local authorities and public health experts on all of the local restriction measures. We've met with local authority leaders regardless of geography and political leadership, and that's a real strength of the position that we've taken here in Wales, in contrast with some of the choices where leaders have found that out in other parts of the UK, especially in England.

But we all have a part to play to keep Wales safe: the Government, health, social care, public services, businesses and, crucially, us as individual members of our families and communities. The rules are in place for all of us, they apply to all of us, they're for the benefit of all of us, and if we all play our part, then together we can keep Wales safe. Thank you.

I call on Dai Lloyd to reply to the debate.

Diolch, Dirprwy Lywydd. I'm conscious of the time. Can I thank everybody who has contributed, first of all, to this debate? Excellent contributions all around, making a variety of points that come from our analysis in what was our first report as a health committee into COVID-19, fulfilling our scrutiny role as a committee and as committee members. There are other reports to follow.

Now, it's fair to say, obviously, that it's been a completely and totally devastating year. There was real fear on our hospital wards during those early days in February, March—real fear—and obviously we've heard about the challenges as well, outlined by colleagues, Andrew R.T. Davies, David Rees and Rhun ap Iorwerth: challenges around testing in those early days and we still have those challenges on testing, and similarly with PPE, although the situation appears far healthier as regards PPE.

We've taken a lot of evidence about social care and how as a society we view social care. And if this pandemic emergency had done nothing else, surely it must crystallise our view that we need to do something about how we organise and view social care generally. If we totally view it as having parity of esteem with the health service, should we not look to reorganise care along the same lines as we organise health? Mental health issues have been prominent as well in a lot of the evidence we took, and it's not surprising and it will be the basis of the next report from the health committee.

But in closing, can I pay a huge tribute, as I did at the start and as others have done, to the massive, heroic and epic response to this pandemic, not just in the health and social care sector, but also, as we've heard from Rhun, local authorities really came good during this—local authorities have shone, absolutely shone indeed. As well as thousands of volunteers in the background who have been doing everything from delivering food, medicines, sewing gowns, sewing masks, and also to the thousands of unpaid carers who really have felt the strain of the last six months. It's been a horrific time for many, and some who have recovered are debilitated by long COVID now, as we speak—chronic, debilitating and still suffering. Rehabilitation services are going to be key as time goes on, and that'll be the basis of another further report from this health committee. My thanks also go to clerks and researchers and legal support, and everyone that makes this health committee function so very well indeed. It's an excellent report, as I've heard many say, and a lot of that is due to excellent research and excellent clerking response.

So, in closing we say: stand firm and do the basics in terms of social distancing, in terms of hand washing, in terms of wearing a mask and in terms of decreasing social contacts—that's what we need to carry on doing—and support the motion. Diolch yn fawr.

Diolch yn fawr, Dai. The proposal is to note the committee report. Does any Member object? The motion is therefore agreed in accordance with Standing Order 12.36.

Item 6 is the Member debate under Standing Order 11.21, and the subject is universal basic income. I call on Jack Sargeant to move the motion.

Thank you, acting Presiding Officer. I'm very grateful to the Senedd Business Committee and to those that supported this motion allowing our Senedd to be part of the growing conversation around a universal basic income. The universal basic income is not a new idea, but it is an idea that is starting to make its voice heard. As always, there is resistance to change and some will always insist that looking to improve people's lives just isn't possible. These voices have been raised before in the cause of resisting change, saying we can't afford to do better: when children stopped being sent down the mines, when the introduction of the welfare state and pensions were mooted and, of course, when our magnificent NHS was brought into being.

In making the case for a UBI trial in Wales as a first step to Wales adopting the policy, I thought I would share with you what sparked my own interest in the subject. It was initially a very basic question: how do we avoid the ills of poverty in a world that is so chaotic and changing? How do we create a platform of security that allows people to grow, to learn, study and to fulfil their potential in an age of increasing uncertainty? What COVID has shown us is that we can and we should intervene to ensure everyone can be an actor in a market economy. As always, the people in the forefront of my mind are the amazing residents of Alyn and Deeside. My community has seen economic calamity before. My generation grew up in the shadow of the huge job losses at Shotton steel, and it is still the single biggest redundancy in western Europe. This devastating event could be repeated again across a whole range of industries due to automation job losses. This time, the Government needs to be working for us and not against us.

Artificial intelligence is set up to take even more jobs, and we could even make it serve humankind and embrace it, or we can allow it to create a wave of job losses that are not replaced. Alyn and Deeside has been identified as the constituency with the most to lose. It is not just manufacturing, retail and transport where changes have happened; thousands of white-collar jobs in the legal profession, accounting and healthcare will soon be done by AI. There are other huge changes that we are already going through or that are hurtling towards us that mean we may need to intervene to ensure people have the stability of a genuine safety net and springboard.

Llywydd, the first factor is already with us, and it can be seen all around us: poverty. Poverty is becoming endemic—homelessness and food poverty being the most visible signs. Footballer Marcus Rashford has recently shone a light on this issue, using his own personal story to explain just how terrible it is to go to school hungry. The effects of this can and often do last a lifetime. Now, we often kid ourselves that poverty is an issue for other people, but, friends, let this fact sink in: one third of households are a month's paycheck away from homelessness. Now, in a world where people's lives are increasingly precarious, what answer do you think we would get if we stretched that figure to four months? Another important contributor to needing to look at a UBI is the increasingly insecure nature of work, and the flatlining of wage growth for all but a wealthy few. A recent Trades Union Congress report stated that much of the employment created in the UK in recent years has been low paid and insecure, as reflected in the increasing use of zero-hour contracts and the growth in gig economy jobs.

The final factor is global warming, and the very real risk that, if we don't change the way we think about growth, there will be nobody around to benefit from it. Unsustainable booms where we don't take into account the need to go carbon neutral will be catastrophic. Now, this change, whilst necessary, will not be pain free, and there will be losers as well as winners. So, how we do we support them through it? Prime Minister Jacinda Ardern really sums up my position: growth is pointless if people aren't thriving. Ardern said that Governments should instead focus on the general welfare of citizens and make investments in areas that unlock human potential. She pointed to New Zealand's new well-being budget, which seeks to expand mental health services, reduce child poverty and homelessness, fight climate change and expand opportunities.

'Economic growth accompanied by worsening social outcomes is not success'—

Ardern said—

'it is failure.' 

So, what exactly am I asking for? After all, a trial seems quite vague. But, Members, really, it is quite simple. I want the Welsh Government to select a group of people and see if their outcomes are improved by a UBI. Such a group could be care leavers or the recently redundant in an industry particularly hit by COVID. We would then support this group while seeing if our trial matches the positive results of trials elsewhere. A trial in Canada demonstrated that young people are more likely to stay in training; a study in Finland demonstrated that people in receipt of a UBI are more likely to work. Now, this is in contrast to universal credit, which actively punishes work. 

I understand many, particularly on the small-state Conservative wing of politics, will say we can't afford to support people in chaotic times. But I often wonder why these same voices do not pipe up when universal credit costs spiral out of control, when billions are given to outsourcing companies that deliver appalling services, or major infrastructure projects, like the HS2, see costs rocket. And I also know many on my own side of the political spectrum are also unconvinced, not because they don't want to support people, but because they are worried about the finite resources in a country that has already seen the Tories cut so much of what we all value. So, what I would say to them is: look at the list of problems I've discussed today—what pressure will the consequences of these changes place on public services? 

Now, Llywydd, I am looking forward to hearing Members' contributions today, so I will leave you with this: if a market economy is to thrive, it needs all its citizens to be able to participate in it. It needs them to be able to absorb the coming shocks and be home owners, consumers, creators and entrepreneurs. If we are to give them the space to take responsibility and ensure that they can be this, then we are going to need a much better springboard—a much kinder springboard—and that springboard is a universal basic income. Diolch yn fawr.