Plenary

The next item, therefore, is the questions to the Minister for Health and Social Services, and the first question is from Rhys ab Owen.

The Welsh Government published a summary of the consultation responses to our White Paper, 'Rebalancing care and support', on 29 June. The White Paper set out proposals to reform social care and to improve well-being. Our programme for government includes commitments to take forward these proposals, in partnership with the sector.

Thank you for that update, and thank you for the White Paper. May I encourage you, please, not to wait for the UK Government to do something? They've made pledges in the past, but have delivered nothing. Wales was in the vanguard with the national health service—Tredegar, Wales, and you in the Labour Party, to be fair. If Nye Bevan had waited for the Tories, then we wouldn't have had a health service. So, please take action now.

Minister, I'd like to ask a pressing issue with regard to the social care system, which can be resolved now, and this is a personal issue to me. In response to my colleague Gareth Davies last week, you said there hadn't been a blanket ban on care home visits. Technically, that might have been true, but the reality was very different and I can say that from a personal point of view, because my father, who was a Member here for two terms, is a resident of a care home nearby here in Cardiff Bay. He has advanced dementia. I'll never forget that Tuesday before the Scottish game, going there and being told by a tearful receptionist that the care home had been closed half an hour earlier, and it was closed then until August. Of course, it was then closed again for the second wave, and it's been closed again now for the last two months because of positive COVID tests by residents and care home workers, despite them all having two jabs, despite not showing any symptoms and despite not being hospitalised.

Deputy Minister, I appreciate it's very difficult; I appreciate the need to protect residents like my father, but we want to see our loved ones. I know the concerns about the delta variant, I know the concerns about the third wave, but, please, could you look again at the Public Health Wales guidance towards visiting care homes, so people like me and many others can visit their loved ones? Diolch yn fawr.

Diolch. And I thank Rhys ab Owen for that very heartfelt question. To start with his opening comments about not waiting for the UK Government, we would prefer a solution for England and Wales, but I absolutely agree we can't wait forever. We'd like a joint solution because of the interface with the benefits system and the taxation system. So, that's why we'd like that. But we have been waiting a long time, and I absolutely acknowledge that.

In terms of the care home visits, those have been some of the most difficult decisions that have been made, and it is a really difficult situation. I absolutely understand how hard it must have been in terms of visiting his father, who I knew well, and worked with when he was a Member here. What we have tried to do is we have tried to balance the safety of the residents with their need to see their family, and of course with the family's need to see the residents. Throughout the whole of the pandemic, at every stage, our guidance has not had a blanket refusal for any visits—there has always been the scope for visits when the situation is very difficult or desperate. So, there always has been that option.

At the moment, the guidance is clear that two visitors can go in to visit a care home resident. There is no approved list of people who can go in now; it has opened up more than that. But obviously, individual care homes are interpreting the guidance as they think is safest for their residents. I think the important thing really is to look at how this is being interpreted in individual care homes. But certainly, we do want families to be able to see their loved ones, and we want loved ones to see their families, because obviously, that is the essence of family life. I know how awful it has been for so many residents and their families.

Thank you, Deputy Minister, for your comments so far. May I add my support to the learned Member for South Wales Central in regard to care home visits as well? It's certainly a frustrating experience for many individuals at the moment. Minister, during the pandemic, we have seen the importance and the incredible work of many care workers, who have gone above and beyond to provide an exceptional service of support to some of the most vulnerable, particularly those on the front line in care homes, and carrying out domiciliary care support as well. I think the pandemic has highlighted the value and importance of our social care workers, but also the opportunities to enhance careers in the sector, by upskilling these workers, who could perhaps in turn relieve some of the pressures that are on our health service. As part of your review and reform of plans for the social care sector, I'd ask what views you have in regard to the remit of those front-line social care workers. What support would you provide to see them upskilled and to see this important workforce enhanced? Diolch yn fawr iawn.

Diolch. I think the pandemic has really highlighted the importance of social care workers, and I think many of the public were not aware of the value of the work that they do. So, I think we have to use this opportunity to make sure that we do use every opportunity to upskill them, as the Member said, and also to ensure that they get a better reward for what they're doing. That is why, of course, we are bringing in the real living wage for social care workers. We have set up the social care fair work forum, which is a group made up of trade unions, employers, and other relevant organisations. That group will be looking at all these issues related to social care workers. Because as well as wanting to raise the amount of money they earn, we want to see the job of a social care worker valued and seen as the really important work that it is. That group will be looking at all these issues, and certainly, training on the job and other types of training is one very important part of that. I think this is the opportunity to try to see that social care workers—their professional standing improves, and there is a much greater awareness of the job that they do.

Thank you very much. The Welsh Government works closely with the end-of-life care board and the all-Wales paediatric palliative care network to drive continuous improvements in palliative care and end-of-life care for adults, children and young people across Wales.

Diolch yn fawr. My question is in two parts. Can the Welsh Government outline how much of the £8.4 million invested into the end-of-life care sector each year in Wales goes towards paediatric palliative care services? Secondly, Tŷ Hafan and Tŷ Gobaith receive less than 10 per cent of their funding from the Welsh Government. This is a significantly lower proportion than children's hospices in England and Scotland receive from their respective Governments. Can this Government therefore commit to increasing state funding for Wales's two children's hospices in the long term, and to meeting with Tŷ Hafan and Tŷ Gobaith to ensure their needs are considered in the upcoming funding review for hospices? Diolch yn fawr.

Diolch yn fawr. Thank you. I can't give you the exact breakdown for the £8.4 million, but I can give it to you for the additional funding we gave during the pandemic. You'll be aware that we gave an extra £12.3 million to hospices during the pandemic, and of that, £2.3 million was specifically for our two children's hospices in Wales. So, that should give you an idea of what it would be proportionately also for that £8.4 million. You'll be aware that in our manifesto we made it clear that we do want to revise the way that we fund hospices in Wales, and we do want to strengthen our end-of-life care. That work has already started. There is a new programme for end-of-life care. We will be publishing the revised proposal and we will be sharing that proposal with stakeholders in Wales towards the end of the month. We expect that to take about three to four months, so hopefully that will report then in the autumn.

Minister, hospice care, especially for children, is a sensitive and emotive subject, but the pandemic and lockdowns have made a difficult subject worse. Last year, Tŷ Hafan and Tŷ Gobaith jointly published 'Family Voices', a report that gave voice to the most important concerns of families who have children with life-limiting conditions. They stressed that they urgently needed more of the care that only the hospices could provide, especially in relation to respite. Do you agree, Minister, that a sustainable model of funding would give the children's hospices in Wales confidence to plan and expand their services to better meet the needs of all children with life-limiting conditions and their families across Wales?

Thanks very much, Natasha. You're quite right that the 'Family Voices' report does highlight the importance of supporting those children with life-limiting conditions and, of course, their families as well, who are going through a very traumatic time supporting them. It does propose that lifeline fund for Wales; that's precisely what we're looking at in this revision that is being undertaken at the moment and that, as I say, will be reporting in the autumn.

I think you might also be interested to hear that actually I met with the Ministers from the four UK nations to share best practice, and to discuss in particular how teenagers and young adults affected by cancer are properly supported during their appointments. It was good to compare notes with the different health Ministers across the UK in terms of what they're doing to respond, and learning from each other to make sure that we're all doing the very best for people in this most difficult, sensitive area. It is important, in particular, I think, in the middle of a pandemic, to just deal with this situation as sensitively as we can.

Minister, I just want to continue with the theme of funding. I'm afraid I'm going to come back to it, because I do really want to pin you down. Thank you very much to Peredur and to Natasha as well for raising this important issue. I was really shocked to hear from Tŷ Gobaith and Tŷ Hafan that they only got 10 per cent of their funding from the Welsh Government. Let's just pin this one down: in Scotland, 50 per cent of their funding comes from the Scottish Government; Northern Ireland, 25 per cent; England, 21 per cent. And yet we only give 10 per cent. I'm sure we really could do better. So, my appeal to you is: can we really commit ourselves to increasing that in this really important area and can you be just much clearer about timelines? The autumn is four months; it's from September through to Christmas. Can you just be really a little bit clearer about how much you're looking at and when we'll get that result? Thank you. Diolch yn fawr iawn.

Thanks very much, Jane, and just to make it clear that we recognise that we do need to do better in this space and that's why we're undertaking this review; that's why it was in our manifesto and that's why we've moved on very quickly—we were only elected a few weeks ago on that manifesto and already, we've got that workshop in place that is going to happen later this month. So, if you want more specifics, it's anticipated that that review will take about three to four months. So, I can be that specific. You're quite right: the autumn can go on for a long period, but that should give you a better idea of exactly when we hope to report on this situation, which we have made a commitment to.

Questions now from the party spokespeople. Conservative spokesperson, Russell George.

Diolch, Llywydd. Minister, do you feel it would be appropriate to apologise on behalf of the Welsh Government for its failure to contain hospital transmissions during the first and second waves of the pandemic?

Thanks very much, Russell. Of course, every death in this pandemic has been difficult, and for those who've caught COVID in hospital it's even more tragic. We are very aware of the difficulties of the situation. Of course, what we have to remember is that the people who are serving in those hospitals also belong to the community, and when transmissions were high in those communities, there was always a possibility that COVID could get in in that way. Also, we just heard, passionately, how Rhys ab Owen was keen to see his loved one; there are also people who wanted to see loved ones in hospital. That should demonstrate to you the difficult balance and the difficult calls we have to make in this situation. Every time you let somebody in, there is a risk. And that risk, in particular in a hospital—you're allowing people to go into one of the most difficult and sensitive areas, where, if people catch COVID, the problems could be catastrophic, and have been. So, I just think that this balance has been extremely difficult. Of course, if you're already in hospital, you are likely to be more vulnerable, and therefore if it gets into hospital, as it has, and as, I'm afraid, it will continue to—. But we have put all measures in place; we've set out very, very strict guidelines. We have tried to learn as we've gone along in this area, and, of course, with all of those infections, where we've had those incidents of patient safety, each case has been investigated thoroughly to see what we can learn.

Thank you for your answer, Minister. I appreciate what you've said. I think, from my perspective, we as Welsh Conservatives were raising deep concerns about the level of hospital-acquired infections in Wales from last summer onwards. There was a sense, I feel, that the Welsh Government was shrugging its shoulders at the time, with your predecessor saying that lessons had been learnt. [Interruption.] I can hear the former health Minister; he should be listening to what I'm saying rather than dismissing what I'm saying. But what I would say to you, Minister, is that there was a great focus last year on community transmission—and I wouldn't dismiss that; that is correct, there should be that focus—but there wasn't that focus last summer and last year in terms of infection in hospital settings.

Now, we now know that one in four deaths across Wales were probably or definitely as a direct result of ward-to-ward transmission. In Hywel Dda itself, it's one in three deaths. That's significant, and I'm sure, Minister, you wouldn't disagree how significant those figures are. That's 1,000 people who have sadly died, with countless loved ones bereaved, when this could have been avoided to a large extent, or to some extent, if the Welsh Government had acted differently. Now, a group of 35 clinicians have also written to the Welsh Government calling for a Welsh public inquiry, and they believe that one of the questions for that investigation should be how healthcare organisations can be guided to reduce this death rate. This is a specific Wales issue, so will you and the First Minister heed the growing concerns and calls, and agree to a public inquiry into the handling of the COVID-19 pandemic in Wales? You yourself said in your answer that you're learning as you go along. That's the right approach, but that's surely a reason why we need a public inquiry to properly scrutinise the process.

Thanks very much. I, too, would refute the implication that we haven't been taking seriously the nosocomial transmission in hospitals, this infection transmission in hospitals. We've been taking very careful steps, and anybody who's been to hospital will understand how strict they are in terms of who's allowed in and wearing PPE, and I absolutely refute that. As you say, we are investigating every case, and we are trying to learn as we go along. I know and I hear the calls for a public inquiry, and I have read carefully the letter that has been written, but I've got to tell you that we are still in the middle of a pandemic. We have all our hands at the pump at the moment, and this is not over. We know, if you look at the projections in particular in England, they're talking now of the possibility of two million cases a day. So, we've got to be really serious, and take this seriously and understand that this is not the time for us to get involved in a public inquiry, but we are learning as we go along.

I also refute the fact that this is a specific Welsh issue. Let's not pretend that there haven't been deaths in hospitals as a result of COVID in hospitals in England and that transmission in hospitals in England. That is simply not the case.

Well, I wasn't suggesting that is the case at all. That'll be the case in countries around the world, but I was suggesting it was to a greater extent in Wales and that lessons need to be learned from that specifically. Now, a Wales-only inquiry, and not being willing to bring that forward—. I was very careful in my question not to say an inquiry immediately now. I specifically asked about agreeing to a public inquiry—that's what I should add to that. But not agreeing to that, I suspect, I believe, shows a lack of transparency in terms of the Welsh Government's role in looking into how it has handled the pandemic.

This leads me on to my final question, Minister, with regard to the confidence in a COVID-lite environment, and I would be very concerned—I know you are—about the over 4,000 people who have not turned up for cancer diagnosis treatment. I would suggest, is there any wonder that there's a concern about turning up into a hospital setting when we hear about the figures I've outlined and that we're aware of. Now, you and I will both know, and both agree, that it's going to be a real challenging situation where we've got coming forward now people with advanced cancer and more complex treatment, and the Welsh Government was again warned about this last summer by medical professionals, but we've not seen any significant work in terms of COVID-green sites or COVID-lite cancer hubs, which have been present in England for over a year. I would suggest, after the context of my earlier questions, that there's a greater need now to have COVID-lite hubs here in Wales. Sadly, these decisions will bring more pressure onto palliative care services as cancer becomes untreatable at later diagnosis, of course. So, can I ask finally, Minister, will you therefore tell us how many people your department has calculated are missing from diagnosis, and how long are the backlogs? Will you bring forward before this Senedd specific plans on tackling the backlog of cancer patients as well as telling us when the cancer quality statement implementation plan will be published? Thank you, Minister.

Thanks very much. It's interesting that this has been presented as some big, sensational news story. It's not. We have been transparent about this the whole way through, about how many people are contracting COVID in hospitals. It's published on the Public Health Wales website on a regular basis. That is not done in England or elsewhere. So, if anybody wanted to see these, this is not new, it is not sensational, it has been there the whole time and you could have been tracking it.

When it comes to the public inquiry, it is very difficult to disaggregate what was going on in the rest of the UK from what's going on here. If you just take PPE, there was a relationship there. In fact, the relationship, very interestingly, was us giving parts of England some PPE. On vaccines, we were dependent on the supply working together across the United Kingdom. So, it is really difficult to disaggregate this, and that's why I do think the right approach is to have a UK inquiry but with a kind of subsection for Wales, where there will be a need to look in detail at what we can learn. But I can tell you that we are trying to learn as we go along as well.

We are very concerned about the number of people who haven't turned up in relation to cancer diagnosis and the fewer people who have presented relative to other years. That's why we have undertaken a very comprehensive advertising campaign to try and encourage people to come forward. And, of course, cancer treatment has never been stopped. We've been making sure that that has been seen as an essential service throughout the pandemic.

When it comes to COVID-lite hubs, I absolutely don't object to this in principle. The problem we have is that the implication of that is that you have to separate them off from A&E and the kind of hot issues that are coming into hospitals. Now, Russell, you might want to go around closing A&E departments, but I don't. So, I just think we've got to be really careful about the practicalities of making that happen, but we are trying to look at what alternatives there are, and I'm pleased to say that health boards have come forward with some ideas and we're analysing those at the moment.

The Plaid Cymru spokesperson, Rhun ap Iorwerth.

Thank you very much, Llywydd. I want to ask about the recovery of the health service too and reference a number of areas. I, too, will refer to this backlog in terms of cancer diagnosis, looking at a different aspect of that. It's a concern to think that thousands of people—over 4,000 people according to Macmillan—who haven't had a diagnosis. But it's a concern to me that what's happened over the past year is that we've exacerbated a problem that already existed, and one problem we had in cancer services was a shortage of workers to do that diagnostic work. I think the Royal College of Radiologists has mentioned that we we are 97 radiologists short here in Wales. You can't have an effective diagnosis and a swift diagnosis service without those staff in place. So, in looking to recovery, can you tell us what resources you will put in place to deliver specifically on resolving some of the workforce problems we have?

Thank you very much. As it happens, I've just come from a call with HIW where we were talking about the problems specifically in relation to radiologists. Now, they have put a system in place where we do produce about 20 new radiologists every year, so that is quite a big increase from where we've been in the past. And of course, what's important is the quality of training that they receive, and I've asked them to also consider what else we can do. Is it possible, for example, for us to send some of the images that we get abroad so that they are analysed overseas?

So, I think that there is scope for us to be imaginative in terms of how we approach the issue of dealing with this backlog, particularly when it comes to cancer. But you'll be aware as well that we have provided £25 million in additional funding in order to ensure that the equipment is available, so that we can increase and accelerate that process, and that has already gone into some of our hospitals.

If I could turn next to orthopaedic services, there are huge challenges facing you in building capacity. I and every other Member here, I'm sure, will have heard about far too many patients waiting far, far too long in pain. In April of this year, there were 88,000 people waiting for trauma and orthopaedic treatment, with 60 per cent waiting over 36 weeks. The figure back in 2019 was around 11 per cent. Over half now wait for longer than 12 months. Of course, these waiting lists, again, were too long prior to the pandemic, so what assurance can you give us that, in trying to deal with the acute problem of the backlog caused by the pandemic, you will do far more than just restore services to where they were previously? How will you now try to create services that are more sustainable for the longer term, because that is what we are looking for in coming out of this pandemic?

Well, I want to ensure that we don't miss this opportunity presented by the pandemic to change things. A lot has already changed, and we need to tie in what's good as regards the changes that have happened in terms of how the workforce operates, but also the systems that we use. I was pleased to be part of a conference over the weekend with an orthopaedic society from India. A lot of our orthopaedic surgeons in Wales come from India, and it was good to hear their ideas about how we should be accelerating the process. And, of course, that will include the possibility of having direct hubs or centres—these cold centres, the direct centres that I was talking about. So, we're just analysing how that could happen in practice and how that could be funded. But we're very eager to see how we can use this pandemic to deal with this problem and to get us to a different place in the medium term.

I want to finish, Llywydd, if I may, by turning to long COVID. It's a huge concern for me. I have huge concerns about young people, if truth be told, at the moment, as restrictions are relaxed. We'll have an opportunity to discuss that again. But I want to look specifically at the impact of long COVID on the health and care workforce. From my work as joint chair of the cross-party group on long COVID, I see that an incredible percentage of the people I speak to are people who have fallen ill as a result of their work in health and care. We need to look at this. We need to provide support to them, and I want to know what the Government will do to support them, because they deserve that support for the work that they have done and the fact that they put themselves in harm's way during this pandemic. But if we look at the recovery work, will the Minister tell us what she is going to do in order to push for assurances that these people get the support they need to return to the workplace, because we need to ensure that our workforce is fully staffed, and sufferers of long COVID within the health and care service want to return to work to do what they've been trained to do? We can't wait any longer for an assurance that treatment will be provided to the high number, I fear, of workers who are suffering in this way, and that they will be treated fairly.

Thank you very much. You'll be aware, in our publication on the new recovery plan, that we did give specific attention to those working in our health and care system who are suffering from long COVID, and we did ensure that guidance is available in order to give employers an idea as regards ensuring that they know how the health and care system should be responding to those suffering from long COVID. So, I would hope that that is clear in that report.

I am pleased the council is moving toward commissioning services that have person-centred care as the focus. I am also pleased to note the consideration of staff remuneration, in line with my recent oral statement setting out our Welsh Government's commitment to the introduction of the real living wage.

Well, I really welcome that response to my question, because I draw the Minister's attention to the letter that was sent by Bridgend on 16 June, where they put forward, I thought, an interesting offer in their recommissioning of domiciliary care, which will take place this year, not only to pilot a move towards the real living wage—it's a timely moment to do it—but also to introduce more flexibility into the way they provide domiciliary care, based on the approach of what matters to you as the end user, much more flexible, based around not just the care needs but the social needs of that individual as well. And we've seen this work well in other areas I visited when I was doing the role that you're now doing in Cardiff and the Vale, and seeing how that worked so well not only for the user, but also for staff themselves to feel empowered and to use their skills and experience properly. So, I wonder if you've had time to consider that, and also the invitation in that letter that they made to come and visit the integrated care teams that they're running with Cwm Taf that have been the subject of excellent reports and feedback from Care Inspectorate Wales.

I'd like to thank Huw Irranca-Davies very much for that question. I am aware and have received the letter from Bridgend, and I was very interested to read about their proposed pilot to pay domiciliary care workers at the level of the real living wage and also to introduce more flexibility into the provision. I think he's described how flexibility can be of great advantage to users of the service.

He knows that we have set up the fair work social care forum and I'll be asking them to consider which part or parts of the sector should be our starting point for rolling out the commitment, because we are very keen to do this in a co-productive way, working with the trade unions and employers and, of course, working with local government. I mean, of course, our overall aim is that all eligible social care workers will be receiving the real living wage within the term of this Government. But in terms of where we start, I will be discussing that with the forum and I'm very grateful indeed to Bridgend for putting forward their proposal.

Thank you to Huw Irranca-Davies for tabling this question. I think it's very important, and as Huw correctly says, domiciliary care workers in Bridgend and social care workers across Wales have played a really important part in this pandemic.

But I think domiciliary care doesn't just start and end with those social care workers. One aspect of domiciliary care—and it's sometimes overlooked, actually—is the role of community pharmacies and their provision of medicines and other services for those who are either shielding or can't leave their homes. I recently visited Porthcawl pharmacy, which provides services to those shielding or can't leave their homes to deliver medication or other services across the local area into the wider community. Very often, the people who are receiving domiciliary care are most likely to receive services like this, but despite the good work being done by Porthcawl pharmacy on this issue, the provision is quite patchy across Wales, which means that many vulnerable people in other areas are left out of accessing these vital services. So, can I ask what assessment you have made of the role of community pharmacies in the provision of certain services for those receiving domiciliary care and what action the Welsh Government is taking to improve these services to standardise them across Wales?

I thank you very much for that question. Obviously, community pharmacy is absolutely crucial in terms of delivering services and delivering services to those who are in receipt of domiciliary care as well.

I think community pharmacies have got a very good record in terms of providing services, and I'm personally aware of many individuals and families who have depended on community pharmacies in delivering the medication and in being a link to other services. So, we're certainly very well aware and very supportive of the role of community pharmacies, and we'll be looking to do all we can to increase their role, because I think it's absolutely key that we do reach all those people who need this additional help in having the services. We see community pharmacies as absolutely crucial.

It is the responsibility of health boards to ensure that they provide services to meet the needs of their local populations. It's a requirement for health boards to use the local capacity of the health service in the first instance, and then, any capacity available in the English health service, using capacity in the independent sector only when there is no other option.

Thank you for that.

We've heard already this afternoon of the tremendous pain and suffering of people across the whole country who are waiting for services, following the pandemic or as the pandemic dominates the national health service. Is it not time now, Minister, that we consider suspending the use of NHS resources for private work to ensure that all of the resources of the national health service are provided for those who are most in need and most in pain who require services, and not for those who are able to pay?

It's the anniversary of the national health service, of course, this week, and when Nye Bevan was creating the national health service, he wanted to create a service that met the needs of people who were in need, and not those who can afford to pay. So, is it not time, in this crisis that the national health service is facing today, that we suspend all of the use of the private sector and private work within the national health service to ensure that those in need have their needs met?

Diolch yn fawr, Alun. I'm very aware of the fact that there are literally hundreds of thousands of patients, many waiting in severe pain for an operation. I can assure you that apart from COVID and preparing the NHS for winter, addressing this backlog is absolutely my top priority.

Now, I think it's fair to say that the vast majority of NHS staff have gone way beyond and above the call of duty in this past year. When it comes to consultants, they are contracted to carry out a certain number of sessions that they provide to the NHS, and they have to undertake that before they offer anything in terms of additional work outside of the NHS.

The Wales Audit Office report found that the level of private sector activity in NHS facilities is about 0.02 per cent of all activity, so it's a very low level anyway. I think what's important is that we recognise that long waits at the moment mean that some patients are making those really difficult decisions to go private, but I can assure you that all patients are being seen in an order of clinical priority.

Our priority at the moment is to get those who need the urgent care to be seen first. But, I think it is important that we put our measures in place, as we talked about earlier, to prepare the NHS to get us into a better place for the medium term, not just to address the immediate crisis that we're facing today.

Minister, the Bridgend Clinic is a private clinic located within the Princess of Wales Hospital. It is unique to Wales, and for the past 24 years it has worked in partnership with the NHS, with more than 50 consultants practising in both the clinic and the Princess of Wales Hospital, while profits are put back into the local NHS.

We all know that the NHS is an amazing institution, but we should not hide it from meaningful and beneficial partnerships that deliver for patients. Will the Minister examine the outcomes achieved by this partnership so that other health boards may consider the advantages of building capacity in this way? Thank you.

Thanks very much for that question, Altaf. I don't know enough about this particular partnership to comment on it, but I will make sure that I go and investigate further. I know that some of the people involved in the call that I was on on Saturday are involved in the Princess of Wales Hospital, so I will investigate further and see whether there is anything that we can learn from that. Thank you.

GP practices across Wales are providing a wide range of options for patients to access services through the use of digital technology. Clinical triage is a key tool to ensure patients receive the care they need, at the right time, from the right person.

I thank the Minister for that answer. Access to GP services is an increasing issue in Alyn and Deeside, and this has been highlighted in recent weeks—twice, actually—at St Mark's surgery in Connah's Quay, where there is clearly a shortage of doctors, and in Queensferry, where residents are seeing their practice being moved, or potentially being moved, to Connah's Quay, because the current building is not fit for purpose.

Minister, with this in mind, will you meet with the health board to address the issue at St Mark's and make sure they do have an adequate number of GPs? Will you also ask your officials to look into the potential of building a new purpose-built medical centre that serves Queensferry and the surrounding communities?

Diolch yn fawr, Jack. I know there have been some issues in particular with surgery at Connah's Quay in recent weeks. I think some of the issues that we saw outlined there, where, actually, a message went out that the practice was actually closed, and advising patients to call an alternative number, that should not have happened. The health board is very aware of that. I think we've got to remember, of course, that our clinicians and our services are built on the people who deliver them, and they are also susceptible to falling ill, and that's what happened in this particular case.

And I think it's important that we have a situation where of course we're looking at the infrastructure relating to surgeries around Wales. I've got to tell you that there's a huge amount of work to do in relation to upgrading surgeries around Wales. We have a commitment in our manifesto to create twenty-first century surgeries. We're hoping to do that on a kind of hub system so that we're working with local authorities and other partners to put that in place. It will be up to the local health board to determine the priority in which those should be set out. So, we will be in further discussions with them, but we are looking for how we can fulfil that commitment that was very clearly set out in our manifesto.

Well, I was copied in on a patient's e-mail to Betsi Cadwaladr University Health Board last week, complaining that a lack of permanent GPs at St Mark's surgery in Connah's Quay is, quote, 'now causing major problems as unable to book an appointment to see a doctor'. They tried to get through to the switchboard from 8 a.m. on 22, 23 and 24 June, and on each occasion, they were kept waiting for 45 minutes before being told that no appointments were left. On 28 June, a voicemail said the surgery was closed. Responding to me, the health board said the root of the problem was the unexpected sickness of two GPs due to be physically present and on duty on Monday, adding that this was the consequence of unplanned sickness, and this is now subject to the intervention of the area team to ensure this situation does not recur. However, this did not address the problem identified before 28 June, and similar problems are being raised by constituents who are patients at other practices.

What engagement are you therefore now having or planning with the relevant professional bodies, where it's now nine years since both the British Medical Association Cymru and the Royal College of General Practitioners Wales first launched campaigns warning members of a ticking time bomb, and seven years since the north Wales medical committee came to the Assembly, warning that general practice in north Wales was in crisis?

Well, thanks very much. Now, since the launch of our ‘Train. Work. Live.’ campaign, north Wales in particular has benefited from a higher number of appointments into GP training. So, last year saw 29 new trainees who were recruited to speciality training schemes in Bangor, in Dyffryn Clwyd and in Wrexham. So, I think that should demonstrate to you that, actually, there is a lot of work being done on this, specifically by Health Education and Improvement Wales.

The other issue, which you touch upon, is about access to GPs, and we did set out some standards that we announced back in March 2019, and there were a whole series of standards that GPs needed to respond to, if they were to get that enhanced payment that was due—and I have written to Members today to set out who received what and who achieved what in relation to meeting those standards. So, we do have measures and ways of trying to interact and engage, and we will be doing that in the next few weeks, with general medical services, to make sure that we can drive up access for our patients around the whole of Wales. Just to let you know that about 76 per cent of practices across Wales achieved all of the GMS in-hours access standards, and that compares to 65 per cent last year. But I'm very well aware that that suggests that 24 per cent didn't, and those are the ones we need to focus on.

Thank you, Luke. Delivering the actions set out in our dementia action plan 2018 to 2022 continues to be a priority for the Welsh Government. We continue to work with regional partnership boards and stakeholders to do this, and to identify areas where further progress is needed.

Thank you, Deputy Minister, and, as I'm sure you're aware, there are several different types of dementia in addition to Alzheimer's disease, which is the most common form, affecting around 75 per cent of people in Wales. Lewy body dementia is the second most common type of dementia in older people, a type that my grandmother lived with, but it's relatively unknown and has very different symptoms to Alzheimer's disease. What strategies are in place to ensure that the sub-types of dementia are accurately diagnosed and recorded by health boards to ensure that patients get the best possible treatment, and carers and families get the right support?

Thank you very much, Luke, for that supplementary. And you've raised a very important issue, because we too often talk about dementia as an all-encompassing condition, whereas, as you've correctly highlighted, it does cover a range of different conditions. It is absolutely vital that we ensure that people have an accurate diagnosis, and also that that accurate diagnosis is properly recorded. Last year, a Welsh health circular was issued, requiring memory assessment services and primary care services to accurately record someone's dementia diagnosis according to set READ codes that are issued. Also, a new all-Wales pathway of dementia standards has recently been issued, which reinforces the need to do that, and, in order to attract funding from the dementia action plan, it is required that organisations align with those standards. So, that will help drive that progress, but also there's further work ongoing to embed the need to properly record the diagnosis being taking forward. But I'm also very happy if you would like to write to me with more detail about your concerns, as I recognise this is something you feel strongly about. I'd be very happy to look further at this and to meet you to discuss it further. Thank you.

Our priority is to build on the impressive digital response to the COVID pandemic, and to lock in new ways of working that enabled us to use digital platforms to support our outstanding contact tracing and vaccine delivery services in Wales.

Thank you, Minister, for that answer. I'm sure that you know that, for many years now, IT workarounds have been devised by practitioners within the NHS, such as a bespoke app that two GPs in my constituency are developing with a local company. This particular app will enable patients to access their records, better medicate their own conditions and order repeat prescriptions, whilst also empowering the GPs to push out public health information. How are you, Minister, ensuring, though, that the NHS Wales Informatics Service has oversight of these kind of workarounds and is able to extrapolate best practice and then embed this into their 'once for Wales' approach?

Thanks very much, Vikki, and I know that some GPs have been incredibly innovative in the way that they've responded to the pandemic, and knowing that it's difficult to meet people face to face under some conditions, and therefore they have been really inventive, and it's great to hear that is happening in your constituency. I'm certainly very happy to pass on—if you could pass on that information to me, I'll make sure that that gets to Digital Health and Care Wales, who, of course, have now taken over from NWIS, and I know they work hard to identify new and emerging technologies that have the potential to improve health and care services. So, I'm very happy to look at that, and I'll be meeting with the head of Digital Health and Care Wales next week.

The delta variant continues to spread both in Bridgend and elsewhere in Wales, but Bridgend does currently have comparatively low rates of infection compared to a lot of other local authority areas in Wales. Our vaccination programme continues to offer the best means of combating the spread.

Diolch, Minister. During the election campaign, I met a lot of people who are very appreciative of the Welsh Government's handling of the pandemic, and particularly the First Minister's cautious approach to easing restrictions, as they are very scared and anxious about relaxing restrictions too quickly. The area I represent, Bridgend and Porthcawl, was one of the worst affected areas during the second wave of the pandemic, and that's an experience that we don't want to repeat. Many of the most vulnerable in our community are only just getting the confidence to go back out and about again, and when I met with staff at the Princess of Wales Hospital in Bridgend a few weeks ago, they too are very concerned about another wave of COVID cases. So, with that in mind, could you outline what the Welsh Government is doing to ensure as many people as possible are protected against this terrible virus and its many variants before we look to relax restrictions further?

Well, thanks very much, Sarah, and can I assure you that there is not going to be any big liberation day here in Wales when it comes to COVID, not when rates are increasing at the rate they are? It really defies belief to look at what's happening in England, when you see the rates increasing at the rate they are. Our decisions will be based on science, they'll be based on evidence, and we are very pleased to see the number of people in Wales who have taken the opportunity to have the vaccine, and we know now that there is definitely a weakening when we see the relationship between contracting the virus and having the vaccine and hospitalisations and deaths. So, that's the good news.

The other good news is that, actually, adults have been taking up this opportunity. There's still an issue with younger people, which is why we have set up walk-in centres, which were set up across Wales last weekend. But I think we have also got to be realistic and get to a place to understand that we are going to have to live with COVID; it's not going to disappear. But we will need to do that in a cautious way, understanding that there will always be vulnerable people within our communities and we need to be sensitive to them as well, whilst, of course, understanding the other harms that people are experiencing. In particular, there are economic harms, mental health harms and social harms that we also have to bear in mind. So, next week, we as a Government will be setting out our next steps in terms of the virus and our route-map in Wales.

I thank the Minister. We will now suspend proceedings to allow changeovers in the Chamber.

Item 3 is topical questions. Janet Finch-Saunders.

I welcome feedback from the Welsh Local Government Association. We certainly need to ensure our bodies, including NRW, are best placed to achieve our significant environmental ambitions. We're starting with the review of the delivery of flood risk management functions, to which the Welsh Government committed in the national flood strategy.

Thank you. I wouldn't have exactly called it 'welcome feedback'. I was shocked, and I'm sure those employees on the front line were shocked also, working for NRW, that all of Wales's 22 local authorities have now called for a review. The letter sent by the leader of the WLGA had scathing comments on it, Minister, such as,

'when dealing with events at a local level there can still be tensions over decisions and choices'.

And a number of leaders suggested that not all is well. Local authorities are calling for you to question how well the functions undertaken by NRW are being performed, and if there might be an alternative, more effective model of working. We believe there most certainly is. As we said in 2018, the quango should be split up. It has simply gone from crisis to crisis.

The timber deal scandal lost the Welsh taxpayer at least £1 million. Despite compiling an evidence-based report at a cost of £45,000 to the taxpayer, NRW ignored the advice and banned game shooting on public land. The Climate Change, Environment and Rural Affairs Committee, at their inquiry into the February flooding, found that NRW's role and services were stretched beyond capacity, and only around half the 70 additional staff needed—and that was according to the chief executive and the 'February 2020 Floods in Wales: Flood Incident Management Review'—only 30 had been appointed.

The recent section 19 report by Rhondda Cynon Taf County Borough Council found that flooding at Pentre was caused by wooded debris washing off the mountainside and blocking a local culvert. They very robustly pointed the finger at NRW. Another failing. In Aberconwy, local landowners were forced to carry out works to the Tan Lan embankment, after NRW would not pay. They were quoting £150,000 for this work to be done, and my constituents have managed to have the work done for £15,000. And our community request for dredging of the afon Conwy, protection of Gwydir Castle, and removal of the large build-up of shale around Llanrwst bridge, remain unaddressed.

I am not alone in having no confidence whatsoever in NRW's ability to respond effectively to flood events, and, as such, have made clear that we should have a national flood agency for Wales, 100 per cent focused on flooding. Do you agree on that?

NRW and Welsh Government should pay compensation to the residents affected in Rhondda. Are you looking into the possibility of doing so? And, do you agree with me that you should respond to Councillor Andrew Morgan's letter by committing to review how NRW might be better modelled going forward?

The number of complaints coming into my mailbag now about NRW, and the lack of trust that the public have in this organisation now, is becoming quite concerning. Will you please listen to the words of those 22 local authority leaders, who have their own local intelligence and know what works for them and what doesn't? And will you look, please, Minister, once and for all, at restructuring NRW? Thank you. Diolch, Dirprwy Lywydd.

Thank you for that, Janet Finch-Saunders. I'm not sure which of your very many questions you wanted me to focus on, so I will just focus on the ones that I think are the most important. First of all, I've already had a meeting with NRW's leadership team, in which I've been extremely clear about my expectations for their future resource management, management in general, and their relationships with public authorities across Wales in a team Wales approach.

We're already conducting a review of the flood management arrangements, as I have said. We have a large number of regulatory arrangements coming back from Europe, and I've already asked for a review of the structure and delivery of those new regulatory powers to be arranged. We also need to be mindful of NRW's capacity to look at all of these reviews at the same time as delivering their vital services on the ground.

I've asked all flood management authorities to review their processes as we approach the next winter. We've already conducted two emergency exercises to ensure that everybody knows who should be doing what in the event of extreme flooding or other weather events during the next winter. And I am, of course, in close liaison with the local government association, with whom I have an excellent relationship, via my good friend and colleague Rebecca Evans's good offices as local government Minister, to continue a robust discussion with them and with NRW.

I need to declare an interest in this issue, as I live in the community of Pentre, and was personally affected by the 2020 floods.

Minister, as you're aware, I have my own anxieties and frustrations with NRW. Over 200 properties and businesses flooded in the Rhondda last year. Immediate action was taken by Welsh Government, Welsh Water and RCT council to put right the culvert and drainage systems. Clear dialogue has been provided to residents throughout. Sadly, this can't be said of NRW. Flood-affected residents frankly feel ignored by NRW and feel that the public body lacks accountability. I share these views.

The behaviour of NRW following the release of RCT council's section 19 report into the Pentre floods was appalling. Refusing to take any responsibility for the dreadful events of last year is insulting, given the fact there's clear photo and video evidence of wooded debris from NRW land blocking the culvert above Pentre. Public bodies should willingly co-operate with other public bodies for the benefit of residents. We've seen anything but from NRW in the Rhondda. It's for these reasons that I believe NRW needs an urgent review, and I'd appreciate a meeting with the Minister to further discuss this for the benefit of the flood-affected residents and businesses.

Thank you, Buffy, for those comments and remarks. I've certainly already welcomed Rhondda Cynon Taf's section 19 report in relation to the 2020 flooding in Pentre, and my sympathies go to all of the residents, including yourself, who suffered from the flooding in that extreme weather event last year.

There are clearly some very concerning findings, and lessons clearly need to be learned following those devastating floods. Both NRW and RCT have acknowledged this in their respective reports, and I know they are working together to address recommendations to improve the level of flood protection provided to the community. I can't comment on the individual issues around compensation and so on for obvious reasons. I am more than happy to meet with you and the local authority leaders, and, in fact, I believe we have such a meeting immediately following this topical question. So, I'll be very delighted to take part in that meeting and consider further what we can do.

I am very keen to consider the feedback from local authority leaders, other delivery partners, and the public in the context of the lessons we need to learn. We also need to make absolutely certain that all flood risk management authorities work together to develop a plan of action for the Pentre community and for the other communities across Wales, to provide clarity on the action they have taken since the floods in 2020 and to provide reassurance that we will not see recurrences of that in the forthcoming winter.

However, as you know, we have declared a climate and nature emergency in the Senedd because of our changing climate and the necessary need to protect against extreme weather events becoming much more common. So, I understand and accept the urgency of the remarks that you've made and we certainly will be working with NRW and all of the relevant flood risk management authorities to ensure that we have those robust emergency plans in place, and that we've taken all the necessary steps to do everything we can do to be as ready as possible for the forthcoming winter.

It is right that questions are asked of NRW and I raised this very issue yesterday in the Senedd, but I am concerned by the tone of the comments made today. At the end of the day, I think we need to remember that Natural Resources Wales are a Welsh Government sponsored body. In their own review and report into the floods, they stated that they have been underfunded and this has been on record for a number of years, and, as Janet Finch-Saunders referenced, they need an additional 60 to 70 members of staff, which they still don't have.

So, therefore, can I ask that we don't make a scapegoat of Natural Resources Wales solely on this, but that it is time now that we have that full independent inquiry into the floods? Because as the rest of the section 19 report will be published, the fault won't just lie with Natural Resources Wales—questions will be asked of Welsh Government; questions will be asked of local authorities; questions will be asked of Dŵr Cymru Welsh Water. There are a number of organisations with responsibility for flooding and it's a very complex picture, and there are different reasons. Even in the section 19 report, there is some fault directed towards RCT council in terms of the drains in Pentre as well, so not solely focused on NRW.

Can we please, given this public fallout and given all of these concerns raised, have that independent inquiry into the floods, so that people get justice and the answers they deserve, and we tackle flooding for the future once and for all, rather than commissioning review after review and rather than tackling the root cause and getting to grips with this issue as a matter of urgency?

Well, thank you very much, Heledd, for those remarks. I certainly agree with the remarks in which you praised the action of the many staff in NRW who worked above and beyond the call of duty during the flooding. And I want to add my thanks to those staff, including the staff who work specifically on these particular issues. There were staff from across the public sector working very hard both in the run-up to the flood events and indeed in the crisis afterwards—well above and beyond the call of duty, and I certainly add my thanks to them for doing so.

As I said, we are already in the process of reviewing the flood management arrangements. We've already reviewed that with a number of public bodies and I have already met with the NRW leadership team in order to discuss my requirements going forward for their liaison as part of our team Wales approach, exactly as you outlined.

As I've already explained several times in the Senedd to you, I don't agree with your call for an independent inquiry. I think that just diverts resources away from the issue at hand. I appreciate that you don't agree with that, but I'm afraid I don't agree with you on that point. We will be working very hard with NRW and all other partners across Wales to ensure that we have all the lessons learned in place and that we have the right resources available in the right place for the forthcoming winter.

Just to remind everyone that NRW is a great deal more than just a flood defences authority. They employ 1,900 staff and have a budget of £180 million. This is not a small, under-resourced organisation and I do think the public of Wales need to understand that in the light of the comments being made today.

Thank you, Minister.

The next item is the 90-second statements. Huw Irranca-Davies.

Thank you, Dirprwy Lywydd. This weekend, I took my first steps on Prostate Cymru's The Big Walk 2021 as part of Carol Vorderman's celebrity team. Now, I think I speak for everyone in this Chamber when I expressed my shock as being thought of as a celebrity at all, despite having the honour to represent the people of Ogmore for many years. But the really important people in this are the many, many people taking part in The Big Walk 2021 right across Wales, walking 26 miles over the month of July, in many little strolls or big treks, raising funds to aid the research and to support all of the families facing the impact that a prostate cancer diagnosis brings and raising awareness too, and often doing it because they themselves or someone they know and love has had that diagnosis.

One in eight men—that's one in eight—will suffer with prostate health, and for those with a family history, it's a one in three chance. So, people can still register to walk 26 miles over the month of July, and to do a mile a day or do it all at once, whatever suits them. Whilst we might not be able to all walk together again this year, due to COVID restrictions, we can be together in spirit every single step of the way. So, go to prostatecymru.com to find out more, and even sign yourself up. Then, stride out, experience the beautiful walks we have here in Wales, and help us secure in Wales the best care, support and medical attention for those battling the most commonly diagnosed cancer in the UK. My thanks to all at Prostate Cymru for all the work they do, and to the walkers and sponsors who are putting their best foot forward to save the males in Wales.

The eleventh of July 2021 marks the twenty-sixth anniversary of the Srebrenica genocide, in which over 8,000 Bosnian Muslim men and boys were murdered in the worst atrocity on European soil since the second world war. Today, I join hundreds of others across the country to pledge to ensure that we never forget about that genocide. This year's Srebrenica Memorial Day theme is rebuilding lives. In albeit very different ways, the COVID pandemic has brought loss and difficulties to millions, shattering individuals and communities who are now looking to rebuild their lives. As we move forward to rebuild our communities in the wake of many health and economic challenges, which people with divisive agendas are all too keen to exploit, we will remember the spirit of genocide survivors who, despite the horrendous hatred and destruction they were subjected to themselves, have been rebuilding their lives with dignity, humanity and without calling for retribution or promoting division or hatred. This is all the more remarkable and inspiring given what they went through. I therefore reaffirm the commitment to working towards the elimination of discrimination, rejecting hatred and intolerance and helping to build a safer, stronger and more cohesive society here in Wales. Thank you.

The next item is the motions to agree committee membership. There are 12 motions under this item, which will be discussed together. I call on a member of the Business Committee to move the motions formally—Darren Millar.

I move.

Thank you. If there are no objections, I propose that the votes on the motions to elect Members to committees are grouped. The proposal is to agree the motions. Does any Member object? No. Therefore, the motions are agreed under Standing Order 12.36.

Item 5, Member Debate under Standing Order 11.21(iv) on small businesses and tourism. I call on Hefin David to move the motion.

Thank you, Deputy Presiding Officer. Excellent Welsh, by the way.

So is yours.

I don't know whether I'm delighted or disappointed that I see from the voting advice from the whips that the Welsh Government is voting in favour of our motion today. I think I'd probably be a bit worried if they changed their minds at the end of the debate. The aim of the debate today is to hear Members' views. I want to try and open this up and hear Members' views on this key issue as we talk about rebuilding and recovering from the pandemic. I'd be interested to hear Members' views from across the Chamber, so I haven't written a closing speech; I'm going to try and summarise the key things that are said through the debate.

What I'd like to focus on in opening, though, is particularly the role of small businesses in supply chains, and the role that they can play in recovery. I'd like to look at the role and nature of the foundational tourism sector, and particularly some of the less-remembered parts of that. You can imagine where they are, given that I've tabled this debate. I want to thank everyone who signed up to it as well. I'd like to look at the consequences of easing restrictions, which I think is topical given what's happened this week in the UK, and what will happen next week from the Welsh Government when they announce on Wednesday, and the implications of a tourism levy I would like to consider.

On the nature and the role of the small business, I think we often misunderstand the role of small businesses. They aren't engines of employment. In fact, the number of small businesses relative to population size is fairly static over time. I think we've got something like 6 million small businesses in the UK at this point in time—heading towards 6 million—and of those, the vast majority of them, more than half, employ fewer than 10 people. So, we cannot expect small businesses to be this engine of employment. I hear people say small businesses are the lifeblood of the economy, but, actually, they are a fairly foundational part of the economy. They exist, but they don't provide an engine of rapid growth. They provide stability. They used to say in the 1970s that if every small business takes on an extra employee, the unemployment problem would be solved. Well, if that was going to happen, it would have happened by now, and it just isn't going to happen. But neither is employment the sole objective, because we know about in-work poverty too.

I think one of the key things that small businesses have is social capital. It's one of the key options they've got when it comes to the alternative to employment. Social capital is key because that is where the creative spark happens, when people interact. That's where businesses that are sustainable are created. When people have interactions with their family and friends, that's called bonding social capital. That's when small businesses find their feet and find their foundation. But the growth of small businesses happens through bridging social capital. That's when we talk to other small businesses, other networks. My concern about the pandemic is that it has shrunk networks right down in a way that will take a long time to rebuild. So, rebuilding those business networks over time is really, really important. I would like to see that as a key part of the Welsh Government's economic strategy, not only creating business but creating business networks. I think if businesses are to grow and succeed, that will be absolutely key.

It won't just be the SMEs on their own in the tourism sector itself that will enable us to recover; we aren't naive enough to think that that is simply going to be enough. We need to see the tourism sector play a part in the recovery, and a bigger role than it did pre pandemic. I think that is important. We often think of tourism as being the seaside in Wales, the Brecon Beacons, Yr Wyddfa, Snowdonia. We see those as the key tourism areas. But you will know that the south Wales Valleys—and I can that see the Minister, Dawn Bowden, will agree—have a huge amount to offer. Our community in Caerphilly borough has a huge amount to offer, and I think it's underplayed as a tourism venue. We talk about day trips to Caerphilly castle, but it's so much more than that. There is so much more that Caerphilly has to offer. I met the Minister at Caerphilly castle—when was it, three weeks ago—and we were welcoming £5 million of Welsh Government investment that Cadw is going to put into Caerphilly castle to transform the castle as a venue next year. But what we also want to see is the streetscapes improved, we want to see the tourism trail improved, because those social networks that small businesses rely on are also dependent upon the society in which they operate. Therefore, it's not just about improving one venue, but improving the environment as a whole.

I welcome this debate today and the opportunity to talk about the role of small businesses in sustaining local economies. As the Member for Caerphilly has said, small businesses are at the heart of our villages and towns, and in areas like my own constituency, those small businesses are part of a dominant tourism and hospitality sector. Unfortunately, the pandemic hit many of those businesses hard, and while some were able to weather the storm, others were not so fortunate. I appreciate that the Welsh Government has provided support to businesses, and that support has been gratefully received by businesses in Pembrokeshire. However, for many, this funding did not go far enough to cover the loss of revenue throughout the pandemic. I'm also aware that many businesses fell through the cracks and were unable to access support quickly, threatening the sustainability of their businesses.

During the pandemic, I hosted a series of virtual local tourism forums, along with my local MP, to hear from businesses about the challenges that they were facing, and they made it pretty clear that what they needed most from the Welsh Government was support and, indeed, clarity. Many felt like the Welsh Government simply wasn't listening to them and that Government policies and regulations were being made without a thought for the impact they would have on smaller businesses.

Now, today's motion calls on the Welsh Government to work with the small business and tourism sectors to integrate both sectors into its economic strategy and COVID-19 recovery plans, and it's vital that the Welsh Government does just that. Our economic strategy needs to focus on sustaining and developing our tourism industry as one of the nationally significant foundations of our economy. We are rich in heritage, language, seascapes, countryside, sports and castles, and with so many businesses reliant on tourism, we should never underestimate how important it is for us in Wales. Those businesses that are part of our tourism sector are heavily reliant on other industries, such as hospitality, farming and food production as well as the development of town centres, particularly in rural and coastal areas. We can't underestimate the importance of road developments, public transport links and investment in those town centres to maintain and keep these attractive to visitors.

I agree with stakeholders like the Federation of Small Businesses that Ministers need to work with industry to establish what a recovery from the pandemic looks like and how the future will be shaped, not just as a response to COVID, but because all our futures are dependent on a strong economy underpinned by small businesses as the lifeblood of our communities.

Now, the motion recognises the Welsh Government's push for people to holiday in Wales this year and support our domestic tourism sector. As the Welsh Government focuses on promoting staycations within Wales, it's vital that Ministers work with representatives of the small business and tourism community to promote Wales as a sustainable tourism destination all year round. To fully recognise the potential of our tourism offer, there has to be collaboration with the sector. Unfortunately, instead of that, the Welsh Government's programme for government outlined plans to consult on legislation permitting local authorities to raise a tourism levy, despite the detrimental impact that that tax will have on the sector. Now, the Member for Caerphilly, at the outset of this debate, asked us to express a view on a possible tourism tax. Well, he probably won't be surprised to hear that I oppose a tourism tax; it's something that businesses in Pembrokeshire are against and I agree with them that this could have a devastating impact on the sector at a time when it's trying to stabilise following the pandemic.

The point has already been made in this debate that when we think of the tourism industry, we tend to focus mainly on our coastlines, our mountains and our national parks. However, Wales is blessed with so many beautiful hidden places, perhaps; jewels that shimmer under the surface and deserve to attract more visitors.

We've already also heard in this debate about how vital it is to help the tourism industry—a sector that's facing three winters, as the FSB has reminded us. A quarter of the businesses in this sector in Wales lost over 80 per cent of their normal revenue in 2020, so it's clear that we need a strategy to aid the recovery of these businesses.

But, I would like to see part of that strategy focusing on helping small businesses in regions such as the south east, which is trying to attract visitors to our delightful and vibrant communities; a strategy that helps hostels that provide services to those who walk or cycle along the Taff trail; a strategy that assists the restaurants and tea rooms that overlook our glorious castles and scenery, and that supports the groups that celebrate our industrial heritage—this point has already been made by Hefin—with the pitheads, the viaducts, and the majestic masonry that was once so glorious.

I would like to see that strategy clarify how it will work with local groups and with small businesses that are embedded in their communities, that promote awareness of Welsh traditions and that use local supply chains and local produce. We have an opportunity here to showcase more local produce and to support so many small supply chains that have suffered so much as a result of Brexit and the pandemic.

Any discussion on post-COVID recovery should find ways to empower our communities—perhaps through a levy; yes, we have to consider that—and to foster ethical tourism, which doesn't just use our scenery as a backdrop only for events that could be happening anywhere. This is tourism that does not exacerbate our climate and nature emergencies.

For the benefit of employers and our communities, I very much hope that the strategy stemming from all of this reflects the points that I have raised. More people will be going on holiday closer to home this year, and they are likely to encounter the most magnificent aspects of our glorious nation anew. Let us find a way of ensuring that people can always feel that same sense of wonder when they visit us in Wales, and that they can learn about our fascinating stories.

Thank you, Hefin, for proposing this debate. Inspired by you, I'd like to tell you about the wonders available in Cardiff Central; for example, the treasures available for free at our national museum in Cathays Park, much of it there thanks to the ingenuity, love of art and entrepreneurial attitude of the Davies sisters. Their extraordinary collection of impressionist paintings, bequeathed to the nation, is one of the most important collections of impressionists outside London.

Cardiff castle is free to enter for residents of Cardiff. Bute park contains wonderful herbaceous borders, as well as a fantastic bike and walking route along the Taff, all the way to Caerphilly castle.

So, it is most unfortunate that many families who live a mere bus ride away from these wonderful attractions never visit them. It is one of the definitions of poverty that people never leave the confines of their own communities. I know that the national museum is doing a lot of work to broaden the number and diversity of their visitors to both the national museum and the prize-winning St Fagans, and its other assets. But, many people still don't know how to get there, and we have to recognise that people living in poverty are restrained by the cost of public transport for a family day out.

According to the most recent Office for National Statistics figures, about a quarter of all households across Britain cannot afford one week's annual holiday, and the figure for Wales alone is likely to be higher because the level of deprivation is higher in Wales. So, we need to bear that in mind, this year of all years, when there are such opportunities for the Welsh tourism business, to ensure that we are endeavouring to do the maximum possible, so that everybody gets some sort of a holiday after what has been the most challenging 16 months that all of us have ever experienced.

I agree, absolutely: we need sustainable all-round tourism so that greater numbers of people who are not locked into school holidays can enjoy Wales's many sites of outstanding natural beauty, which are with us all year round. Edwards Coaches, I know, do a fantastic job of getting people who don't have the means of transport to go places on their own, and that's a really valuable service valued by many, particularly older people who don't wish to go places by car. But if we all go to Barry Island when the sun shines, all we'll get is a traffic jam. So, it's really important that we support people like Natural Resources Wales, Snowdonia National Park and Brecon Beacons National Park, to ensure that we are encouraging people to go to the lesser-known places and everybody's not trying to go up Snowdon, and we've seen some of the appalling sights that happened in Easter last year.

Thank you, Mr Hefin David, for submitting today's debate. As we all know, and has been outlined already, the tourism industry is vital to Wales's economic prosperity. For me in north Wales and for the region I represent, it employs around 40,000 people, contributes around £3.5 billion a year to the local economy and, as such, it's really welcome, the cross-party focus and support for the sector here this afternoon.

It is worth reflecting that the pressures in this sector from the COVID-19 pandemic haven't gone away and they are still there. I mean, it was this time last year when there were real pressures in the sector. And we're talking about nearly 100 per cent of businesses within the tourism and hospitality sector having to close for a prolonged period of time, with around 80 per cent of staff being furloughed. So, whilst it's been mentioned, the positives around seeing a boom here this summer, that is off the back of a very, very difficult time for the sector, and that can't be dismissed quickly. And, as the motion states, now is the time for Welsh Government to work with representatives of the small business and tourism community to promote Wales as a tourism destination all year round. Because holidaying abroad, as we know, is unclear at the moment and not easy to achieve, I suppose. It's a big opportunity now to make Wales a destination, and, as we know, once you go somewhere on holiday, you're very likely to repeat going there. So, attracting a new audience, a new group of customers into Wales, is a huge opportunity over this summer and years to come.

On the year-round point—and I thank the Member for including that within the motion today—because I think that's one of the key strategic items that should be explored, because that is what's going to make the sector and industry more sustainable throughout Wales. And, indeed, Members have taken the opportunity to mention some of the tourism businesses in their patch, and I'll mention a couple that I went to recently. It was really good to see the Penderyn whisky distillery open up in Llandudno, which I'm sure Members would appreciate a visit to from time to time, but that is an indoor attraction in a seaside resort, which actually allows an all-year-round visitor attraction. Similarly, Surf Snowdonia or Adventure Parc Snowdonia down the Conwy valley—I had the privilege of opening their new hotel, the Hilton hotel, there, alongside their indoor adrenaline activities. It's an all-year-round experience, which will make that business and the whole sector more sustainable. So, I think that's a real key point that the Member has brought forward today, and I welcome and appreciate the Government support for those businesses as well.

The other part that is worth mentioning—and I certainly welcome Welsh Government's support on, in collaboration with the UK Government—is work on the economic ambition board in north Wales, because, within that, for example, there's a tourism academy proposed to be built. The skills needed in the tourism sector are really important, because, if we upskill that sector, we'll create better jobs and better quality tourism attractions, which then, in turn, creates a stronger economy for that sector. So, I think they're the two big strategic areas that I would ask the Member, in his furious note taking, to put under the strategic section.

Can I begin by thanking Hefin David for bringing this important debate to the Senedd today? And I know a number of Members have used it to highlight wonderful tourism destinations in their constituencies and regions; you'll be pleased to know I won't be doing that. I will not even mention Aberavon seafront in an attempt to curry favour with the Dirprwy Lywydd in my region. [Laughter.] Wouldn't dream of it.

In particular, the tourism and hospitality industry has been one of the worst hit since the pandemic struck, and I'd like to welcome the unprecedented levels of support given to the industry by both Welsh and UK Governments. Tourism and hospitality are arguably the sectors of our economy that have suffered the most over the last 18 months or so, having either severe differences or adaptations placed upon the sector, or being forced to closed entirely. The mere fact that some of them are still standing and operating today is testament to the resilience of those small business owners, their staff and the sector as a whole, and, as has already been discussed, we know how important the hospitality sector is to the Welsh economy.

Pre pandemic, the sector employed, either directly or indirectly, some 174,000 people, and added around £3.6 billion to Wales's GVA. This makes hospitality one of the largest employers in Wales, accounting for around 10 per cent of the national workforce. We also know that this is a sector that has disproportionately benefited from the UK Government's furlough scheme. But the most recent Wales tourism barometer highlighted the welcome news that some 69 per cent of operators are in some way confident they can run their business profitably for the remainder of the year, but that confidence isn't consistent across the sector. So, despite the economy starting to reopen, some businesses are still struggling as a consequence of continued restrictions. For example, the majority—62 per cent—of businesses in the tourism sector are operating at less than full capacity, had fewer visitors than normal, and whilst about 40 per cent of businesses that had taken advance bookings into 2021 have more than normal at this point of the year, this promise is not shared amongst all sectors. So, amongst serviced accommodation, only 60 per cent of available capacity has been booked, compared to 90 per cent in the self-catering sector.

So, this summer, above all summers, should be the summer of the staycation in the UK and across Wales, and, while I share Hefin David's optimism for the sector in 2021, it's a summer of opportunity and challenges for the sector, because there are sectors still struggling with visitor numbers. Pubs and cafes operated with 63 per cent fewer visitors than usual during the May half term, and activity providers operated at 82 per cent fewer visitors than usual.

I call on the Minister for Economy, Vaughan Gething.

Thank you, Deputy Presiding Officer, and I want to thank Members for their contributions and for the opportunity to respond, and thank Hefin David for bringing the subject today, and I think he should be pleased and positive that the Government will vote in favour of the motion. [Interruption.] I know. [Laughter.]

Since the beginning of the pandemic, our aim has been and continues to be to support individuals, businesses and communities, and that's informed both our emergency response, but also our approach to economic recovery. The Welsh Government has recognised the fundamental role of Welsh small and medium-sized enterprises and the foundational economy and its impact on the well-being of the nation long before the COVID crisis. There are large parts of this sector that could not be shut down, as they provide the infrastructure of everyday life and serve essential, daily household needs.

The new programme for government commits us to build on our approach to improving and supporting the foundational economy, so we will continue to provide support for businesses through Business Wales and to develop a backing local firms fund to help support local businesses, and to see that carried through in different areas of Government activity—in particular, how we look to deliver procurement spend.

Now, I have always been clear in understanding that small and medium-sized businesses are a hugely important sector within the Welsh economy, and I recognise Hefin David's regular comment that we should not refer to them as the lifeblood of the Welsh economy, and the figures that he's regularly quoted over a period of time, and newer Members will get used to that. But they're not only important in their number, they're also critical to the way that our economy and local communities operate, and I should just say lots of conversation here has been about small and medium-sized businesses in villages and towns. That's important, but I can say, as someone who represents a large part of the capital city, they're a hugely important part of life within our cities as well. It's a relevant part of everyday life.

Now, we've regularly talked about the fact that, since the start of the pandemic, the Welsh Government has provided more than £2.5 billion of support for businesses, and that's deliberately been designed to complement the support provided by the UK Government. With that support, we've been able to safeguard hundreds of thousands of jobs right across our economy, and I'm proud of what the Welsh Government has done over the course of devolution, but particularly when we really have been tested like no other time before over the last 18 months or so.

Now, as we look towards economic recovery, we now have to consider how we make our services, including the support we provide through Business Wales, sharper and more tailored to the needs of firms and companies the length and breadth of Wales. And we certainly need to ensure that our businesses are prepared and supported as we continue the journey of having left the European Union and emerge from the COVID pandemic. There is a particular need, including for small and medium-sized businesses, to look at businesses that import and export and how we support them with the very real challenges in the friction in trade that has now been introduced.

Our relationship with the business community through the pandemic has been vital, together with trade unions, and the provision of a strong social partnership. And I'm proud of the fact that we will build on that, moving forward, within this term. And like my predecessor before me, I do value the opportunity to regularly engage with our social partners, and we do listen to the concerns and share early Welsh Government thinking. We do hear from time to time that people aren't listened to or are ignored, and yet we have regular contact and engagement with representative groups within those sectors. But, of course, that means that we can't talk to every single individual business. But, whenever I talk to business organisations, they themselves say that relationships with the Government and with broader partners have never been as good, because of the way the pandemic has forced us together. Now that, coupled with the proactive fair work agenda of this Government, I think demonstrates how far ahead of the pack we are in our partnership thinking.

Now, much of this debate has obviously focused on tourism and hospitality businesses and the role they play in our current economic picture and the future. And we don't underestimate how challenging the pandemic has been for this sector and how it continues to be a real challenge, even now. That's why over £54 million in support to date has been provided to help firms survive. It's also why, with the help of the sector, the Welsh Government, with Visit Wales, has developed a tourism and hospitality recovery plan.

Now, I recognise that many people, as has been said today, are looking forward to a holiday after the past year and—bearing in mind what Jenny Rathbone has said—that many people can't afford to physically go away. With the continuing uncertainties that have been talked about with foreign travel, we have said and made it clear that this is the year to take a holiday at home and to enjoy what Wales has to offer—in the coast, the country and in our towns and cities too.

Now, we do recognise and we've often talked about the caution that's still needed with the Delta variant despite our successful vaccination programme, but we have now moved away from what we were talking about previously, about 'Visit Wales. Later'; we now have a proactive approach in wanting people to come on holiday in Wales, but to do so safely. That's why we've asked people to take part in the Addo campaign, to be responsible tourists in any and every part of Wales that they visit. And I would encourage again people to support local businesses who have been hit hard by the pandemic and to think about the choices that each of us make.

No Members have indicated that they wish to make an intervention. I therefore call on Hefin David to reply to the debate.

It's a good job I know the Minister well enough not to be offended by some of the jibes he made in his speech just then. I'll come to the things he said in a second, but I just wanted to make a comment about Delyth Jewell's contribution, because I think we were born in the same hospital, we went to school in the same town and I currently live in the place where she grew up, and also, you may have noticed, we also contested the same seat at the Senedd election. So, you can understand why we've also got the same views when it comes to tourism in our community here about South Wales East—about South Wales East, but Caerphilly as well—and she's talked about 80 per cent of normal revenue being lost during the pandemic. The concern I've got, I think, was reflecting what I said, that there is a danger that that cost is being passed on to the consumer in the immediate period ahead and that might have a detrimental effect when we talk about year-round delivery. So, there is a concern there. And I'm not blaming anyone, by the way; it's a natural market mechanism that you would expect that to happen, and I think as a social democrat, I would expect the Government to intervene when that market mechanism is not working, and I think that is the challenge. I don't think the Minister quite got to that in his speech, but I think that is the challenge, that we could see a detrimental consequence in the autumn of 2021 and 2022, and I think that was recognised by Delyth Jewell.

And then if I come to the statements made by the three Conservatives, Paul Davies, Sam Rowlands and Tom Giffard, it was really good to hear, and I'd say to Sam and Tom as well what excellent contributions you are making as new Members, and I know from experience how difficult it is, particularly the first time, to get up and speak. It gets easier with time, but I can see that you've taken to it very, very well.

One of the things that I don't think was answered by the Conservatives, though, was why the opposition to a tourism levy is so strong. So, Paul Davies said in his contribution that he thinks it could have a devastating impact, but I don't think he explained why, because there are models around the world where a tourism levy actually works, and I think the Government and I'd say the Minister's response was fairly light—I think he'd agree himself—was fairly light in his response, and that was perhaps because you said that a consultation is ongoing and it will be flexible in its introduction. So, I think that's still being formulated, and I suspect therefore there is still a bridge to be built between outright opposition and the introduction, and I'd like to see how that bridge is going to be built and resolved.

And just to come to Sam Rowlands's comments. Three things, he said: a road map for the summer—I completely understand that; review social distance measures, and supporting recruitment. Perhaps one day we'll hear a bit more, soon, about supporting recruitment, but particularly about reviewing social distancing measures, I highlighted in my speech the possible counter-consequences that we haven't fully understood yet, that if you remove social distancing measures completely and people don't feel safe in those venues, they're just as likely to stay away. So, I think we must find a balance there between the clinical advice and the safety and that economic situation and living with COVID. And I'll be honest with you, I don't think the UK Government's got it right, and the Welsh Government will find out next week whether they are getting it right or not, and I think that announcement next Wednesday is important.

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

We'll now suspend proceedings to allow changeovers in the Chamber. If you're leaving the Chamber, please do so promptly. The bell will be rung two minutes before proceedings restart. Any Members who are arriving after a changeover should wait until then before entering the Chamber.

[Inaudible.]—the Welsh Conservatives debate on the road network. I call on Natasha Asghar to move the motion. Natasha Asghar.

Thank you, Presiding Officer. In the film Back to the Future, Doc Brown says to Marty McFly, 'Roads? Where we're going, we don't need roads.' Listening to those words, he could have easily been talking about Wales today. It's a sad fact that they reflect the attitude of the Welsh Government, and, in particular, the Deputy Minister for Climate Change. However, Wales does still need roads to function for commuting and transportation of goods. Ultimately, the Welsh economy still very much depends on roads.

As the Federation of Small Businesses reported in 2019, 86 per cent of those companies surveyed put investment in road infrastructure as quite or very important, making this their most important transport priority. However, successive Welsh Labour Governments have failed to address the issue of rising congestion in Wales, through a combination of apathy and incompetence. Between 2000 and 2019, the road network only increased by 2.8 per cent, despite the fact that the volume of road traffic increased by 29.5 per cent over the same period. There is no denying that some road infrastructure projects have been delivered late or over budget. Others, such as the M4 relief road, have been promised and then cancelled. Their failure to address rising congestion, as well as the poor standards of public transport, is having major health and environmental impacts on the people of Wales.

Wales has some of the worst air quality in the UK. I have mentioned on a few occasions since I've been here that Cardiff and Port Talbot both have higher PM10 levels than either Birmingham or Manchester, and that's just simply unacceptable. Congestion on Welsh roads is a major factor in this. Stop-start traffic not only emits more greenhouse gases than free-flowing traffic, it also causes more particulate pollution to be emitted. A constant flow of traffic will reduce the amount of particulate matter released by brake and tyre wear, as well as reducing the carbon dioxide that the acceleration of cars produces.

The Welsh Government declared a climate change emergency in 2019. However, they are not providing the infrastructure to ensure that electric vehicles are a valid alternative to those that run on fossil fuels. Wales is very much lagging behind much of the United Kingdom when it comes to fast charging points for electric vehicles. While Scotland has 7.5 rapid charging points per 100,000 people, Wales only has 1.8 per 100,000. Their failure to address climate change has resorted to knee-jerk reactions such as the freezing of road building projects rather than improving public transport and easing congestion on Welsh roads.

A decision that halts plans for a new road scheme in Flintshire was described by Labour MP Mark Tami as very disappointing. Forcing people out of cars without providing adequate public transport as an alternative is just simply unworkable. The number of local bus journeys in Wales has fallen from 100 million a year in 2016-17 to 89 million in 2019-20. With 80 per cent of bus users not having access to a car, the Welsh Labour Government needs to reverse this trend in order to tackle climate change and encourage commuters to ultimately not use their cars. But this must be done properly and not by living in an idealist world, with money thrown at something with little or no result.

As I said in the debate on bus services two weeks ago, the bus services support grant has not been increased in Wales since its inception six years ago. Funding per passenger for bus services is inadequate and compares poorly with that provided for rail passengers. The freeze on new road-building projects may have been welcomed by Greta Thunberg, who we all admire for her strong beliefs and dedication to campaigning against climate change. I recognise that she is a fantastic role model for women and young people and she holds passionate beliefs, but I represent the views of those who live in Wales, those who have to use our substandard roads, and those who cannot rely on public transport, especially in rural areas.

We have all seen the news reports, and I have had countless messages from people all across Wales—north, south, east and west—expressing their anger and dismay at the Deputy Minister’s announcement. This Government plans to spend £75 million on active travel, nearly £29 million on public transport and £9 million for zero-emission charging infrastructure. This is commendable, but how about the roads that we already have here and now? We need a programme of improvements to our road network and not a moratorium. When I became a Member of this Senedd I searched for a document—any document—to give me some indication as to the Welsh Government's strategy for transport. To my amazement, after searching high and low and asking numerous people, I found numerous reports from different people and organisations, but nothing specific from the Welsh Government about their long-term plans. There is nothing in writing about the upgrading the A55, one of the most important roads in the United Kingdom, which, ultimately, is there to provide a vital link for the population of north Wales, and between the busy port of Holyhead and key arterial roads like the M6 and the rest of the United Kingdom.

I'm very pleased to take part in this important debate today. Of course, in the part of Wales that I represent, we've been having a debate over the balance between roads, public transport and active travel for quite some time, in terms of the congestion on the M4 around Newport and many other roads besides. We now have the work of the Burns commission and the delivery unit in place to take forward necessary improvements.

Personally, I think that if we can make for a much better public transport system and offer through the work of the Burns commission, then we will relieve these congestion problems on the roads around Newport. It won't be easy, that's for sure—it never is, in terms of behavioural change and modal shift in transport—but the challenges of climate change and the environment, I think, make it crystal clear that there is no alternative but to make that shift. The work of the Burns commission will be important in enabling us to do that in this part of south-east Wales.

I'm very pleased that the Welsh Government has now removed the protected route for the M4 relief road, because I know that is crucial in terms of the protection that the Gwent levels need and for sustainable development on those Gwent levels. I'm very pleased to be chairing a working group that's looking at how we take forward community development, environmental protection and biodiversity on those very precious levels. Some really good work has been done by the Living Levels partnership, and that will have a legacy for the future. It has really built a good base of community activity on the levels, working with the local authorities, Natural Resources Wales and business. That will stand us in good stead as we take forward the work that will produce the sustainable legacy that will be so important for the future.

Of course, it's not just the Gwent levels that are crucial in terms of what we need to see in terms of challenging the damage that's been done to our climate and our environment. Lots of local issues have come to the fore in terms of air pollution, and that's so crucial to public health. We need, again, to see that modal shift if we are going to really improve the quality of our air for health and environmental benefit around Newport. That's why I am very, very pleased that the Welsh Government has committed the funding that it has to active travel, because that's a really important part of the overall equation, in terms of improving air quality and meeting these challenges of modal shift.

I know that many aspects of Welsh Government policy are driving in the right direction around this. One aspect of that is the default 20 mph speed limit for our inner urban roads, because, again, that will enable us to get traffic off the road, to improve road safety, to get more people cycling and walking, and, indeed, more children playing outside their homes and more elderly people walking. Because they can do that with greater safety, it then really creates greater community engagement and community spirit for the benefit of everyone.

I'm pleased to be part of this debate today. I know it's a debate that many people may not want us to have, certainly some, perhaps, colleagues opposite in the Chamber, but it is an important one. I'll focus, probably, on point 2 more of the motion, and that's the Welsh Government's decision to pause all new road improvement schemes. I think there's a great fear that 'pause' is a false word; it's actually 'stopping', and that's the great concern: will some of these things be re-ignited when further assessed?

I do feel that the Government is possibly shooting itself in the foot here by pulling away from future infrastructure investment, which is needed so importantly to underpin their own aspirations around climate change. It makes no sense to take away the infrastructure, as Natasha shared, which will enable us to move to a different way of travelling in the future, with more electric and alternative-fuelled vehicles. I think an example of where investment into new roads is justified was also mentioned—that's Chepstow bypass. Many people will know that the Hardwick Hill element of the A48, as it travels up through Chepstow, is probably now one of the most polluted roads in the whole of Wales, and that's driven by many vehicles accessing the motorway from Gloucestershire. It's a terrible, terrible situation there that needs to be dealt with. An investment into a bypass would actually help the green agenda, would turn Chepstow into a place that could become a green town. So, we shouldn't pull the plug on things like that, which is a new project, and I'm pleased with the support the Welsh Government has provided in that regard to date. Don't let some of this thinking stop progress on those key areas.

Indeed, I could argue the same to the M4. I know that debate's getting worn out in many people's views, but it is crucially important. I've been sitting on that most weeks now, as I come here, and even at a 50 mph speed limit, it is still getting quite congested. In fact, I'm seeing levels of traffic moving to the levels of pre COVID. Indeed, I've even been in the tunnels moving slowly and I'm breathing the fumes within those tunnels in my own car. Heck knows what would happen if we were stopped in those tunnels. You know, again, this is where infrastructure, investment in infrastructure, can enable these things to happen. Everybody agrees with the need for enhanced public service or investment in active travel. I, indeed, ride an electric bike; I would love to be able to cycle lots of places, but the reality is, we are years away from being able to replace highways with alternative modes of travel. And, indeed, these things could sit alongside each other, but we really just have to be thinking very carefully about how we're going to move forward.

There is a touch of the Jekyll and Hyde about this motion, isn't there? On the one hand, I agree entirely with the points about air pollution, the need for more investment in public transport infrastructure, improving electric vehicle charge points and working with bus operators—they're all really important issues. Then, the second and third parts of the motion seem to undercut the first, talking about building the M4 relief road, come what may. Even as Wales prioritises public transport, active travel, electric vehicles, we will still need roads, Llywydd, but why doesn't the motion talk about priority lanes? Why doesn't it mention schemes to adapt roads for buses and trams and electric vehicles and for electric-only highways? This debate could have sparked a discussion about devolving road tax and fuel duty, of devolving the HGV levy so that we could create a replacement eco levy based on road use, local public transport options and emissions. And why doesn't the motion mention low-emission zones in our cities, integrating the network of active travel and public transport, or propose ideas about cycle ways in commuter areas? The Conservatives could have taken this opportunity to advance ideas for facing the crises of the twenty-first century, instead of lumbering us with ideas from the twentieth.

But the first part of the motion, Llywydd, raises vital concerns about air pollution—that's what I want to focus on. When people talk about roads, or any major infrastructure project, it's normally cloaked in language about powering the future, the journey to tomorrow, but our collective obsession with concrete means that children are the collateral damage. Congestion is said to clog the arteries of our nation, but it also chokes the lungs of our children. It traps us in a future of smog and tarmac. It isn't just an inconvenience, it is a slow-motion killer. Asthma UK and the British Lung Foundation are working with many of us on a campaign to introduce a clean air Act in Wales. The reason we want that Act is because children who grow up near the most polluted streets are five times more likely to have poor lung development. We're living in a time of pandemic, when a respiratory virus has nearly ground the earth to a halt, so we shouldn't ignore that notion. Even short-term exposure can worsen conditions like childhood asthma and chronic obstructive pulmonary disease. Long-term exposure to nitrogen dioxide is linked to chronic respiratory morbidity—chronic morbidity. They're not terms we should just be bandying about as though they're acceptable or normal, they should fill us all with shame. Nearly 10 per cent of all children who live in Wales are thought to have asthma, and for everyone who lives within 50m of a major road, the risk of developing lung cancer increases by up to 10 per cent.

Gareth Davies. There you go.

Can you hear me now?

Yes. Carry on.

Thank you very much, Llywydd. As a Member of this Parliament representing a north Wales constituency, I know only too well the failings of our transport network. I use that term very loosely, because it's not so much of a network, it's more of a collection of routes. My constituents can travel to Manchester or London easier and quicker than they can get to their own capital city down here in Cardiff. This is not only due to the lack of decent road links, but also a lack of reliable public transport. Businesses in south Wales described the M4 around Newport as a foot on the windpipe of the Welsh economy. For us, up here in north Wales, the A55 has the same effect. For nearly a quarter of a century, Welsh Governments have failed to address the issues, which has led to a rise in congestion. You have failed to ensure people can get around Wales to travel for work or leisure, and have failed to tackle the lack of reliable alternatives to the private vehicle. Without improvements to the A55 to boost capacity and increase linkages across this route, my constituency and the whole of north Wales will continue to be held back economically.

And I regret that this Government has become anti road. We won't address the issues of climate or air quality by scrapping infrastructure improvements. I support the stance taken by Labour parliamentarians Mark Tami and Jack Sargeant, who have condemned the delays to the red route, That decision not only impacts Alyn and Deeside, but affects all constituencies along the A55 corridor, and it adds to the congestion. That, in turn, adds to an increase in greenhouse gas emissions and has a severe impact on air quality. Stop-start traffic emits more particulate matter. Until my constituents have a clean, reliable alternative to the car, they will continue to rely upon personal vehicles to get from A to B, and unless you are proposing to rip up all roads, that'll mean more and more of them sitting in stop-start traffic. Unless we can ensure our road infrastructure can meet the demands placed upon it, our air quality and emissions will continue to deteriorate. The alternative is overcrowded and unreliable public transport. You can't force modal shift if there are no alternative modes of transport.

What we need to accept is the fact that the car is not going to disappear, so we have to make the car greener. It's really regrettable that the Welsh Government have failed to prepare to move to zero-emission vehicles. We have fewer electric charging points across Wales than Wandsworth and Westminster councils put together. Only 60 of our charging points are fast chargers. We have an even worse record when it comes to hydrogen buses or electric trains. We want people to use public transport, of course, yet in my part of the nation, that transport still uses the dirtiest of fossil fuels, diesel. It's time to stop blaming the motorists for the failings of the Welsh Government. Diolch yn fawr iawn.

'Our house is on fire.' That's what Greta Thunberg said. We have a climate emergency, and when we have an emergency, just as we've had with COVID, there are things we can carry on with, and there are some things we have to give up. And this is a bit of a schizophrenic motion, if you don't mind me saying. Whilst I agree with some things in it—I agree about increased electrical charging points, and I agree that we need to be looking at our bus infrastructure. We cannot hear from the Conservatives that one week you're supporting biodiversity and wanting to tackle the climate emergency, and then, on the other hand, you want to build more roads. It just does not make sense at all. We have to give up something, and where we need to go is thinking we come out of our vehicles and we do invest in better public transport. Bus speeds are declining faster than any other mode of transportation. Figures from Stagecoach show a 13 per cent decline in bus speed between 1995 and 2015, resulting in the requirement for an additional six buses per service.

Electric vehicles are great, and we want that, but they're going to replace fuel vehicles, they're not going to be an addition, and, therefore, we don't need new roads. We have to absolutely invest in electric vehicles.

This is what Andrew R.T. Davies said last year in your Conservative conference:

'I passionately believe environmental principles are instinctively Conservative principles, and as advocates of individual responsibility, they go to the very heart of what we believe in.'

I implore you, if you really believe in climate change, if you really believe in biodiversity, then building new roads does not fit with that. So, no more new roads in Wales, and I don't want to build new roads, I want to build bridges. I want to build bridges across this Chamber so that we can all work together to really tackle the climate emergency. Thank you. Diolch yn fawr iawn.

Well, today my Welsh Conservative colleagues and I are calling for many things—they're very sensible options—but, from my perspective, for urgent upgrades to be made to the A55. This is a key arterial route that not only supports the sixth largest roll-on, roll-off port in the UK at Holyhead but also brings goods and trade to my beautiful constituency of Aberconwy.

The issue of poor road conditions and underinvestment in north Wales is, sadly, nothing new. Throughout the fifth Senedd, I campaigned relentlessly to see my local country routes improved and speed limits reduced from 60 mph to protect our rural communities. This would have a beneficial impact of making roads safer, prolonging good road conditions and encouraging active travel. And thank you to Conwy County Borough Council for listening to some calls, and we've now got those areas where some measures have been put in. There's more to do, however.

But whilst the First Minister advised me that the guidance 'Setting local speed limits in Wales' was to be reviewed from the summer of 2020 onwards, this has not yet come to pass. So, I'm clear that a change from the present reactive strategy towards enforcing proactive policy must still be made. We can no longer wait for accidents to happen before the necessary changes to speed limits are made. So, I would welcome a commitment from the Deputy Minister today that such a speed limit review will be undertaken.

Now, whilst it is most concerning that this Welsh Labour administration has decided to put the brakes on all new road-building projects, perhaps this will provide an opportunity for Government officials to review the planning stages for all roadworks. At present, works to the A5 near Capel Curig and the A470 through the Conwy valley are causing major and considerable disruption as we head into the summer tourism season. After 15 months of serious challenge to their businesses, this is the very last thing they need.

Now, our debate rightly highlights that Wales has some of the worst air quality in the UK, with recent research finding that Cardiff and Port Talbot have higher PM10 levels than either Birmingham or Manchester. As well as underlining the need for a clean air Act, this fact also points to a need to support cleaner modes of transport. However, we're still, here in Wales, lagging behind much of the UK when it comes to fast charging points, with only 60 of the 990 Welsh charging points being rapid charging points. And with more than 500,000 electric cars now travelling on our roads, we require an urgent course correction.

Whilst I welcome the recent funding announcement from Ofgem, which will help Llandudno railway station to meet its EV commitments by looping in a 1,000 kVA transformer to deliver 600 kW of charging stations, the Welsh Government do need to do more to support long-term change. So, I do call on the Minister to outline how she will be working with our housing associations and local authorities to increase EV on-street charging provision for those households without access to a driveway.

The Deputy Minister for Climate Change to contribute—Lee Waters.

Diolch yn fawr iawn, Llywydd, and I thank Members for their contributions. I was particularly pleased to hear Janet Finch-Saunders say at the conclusion there that, in the sixth Senedd, it's time for us to reset the discussion, and I was very encouraged two weeks ago when I heard Janet Finch-Saunders say that the publication of the Climate Change Committee report

'is a serious wake-up call for Wales',

and I was also encouraged when I heard her say a week ago that

'rhetoric must now be met with bold and decisive action'

when she called for us to declare a nature emergency.

I've been reading about this thing called cognitive dissonance, which is a psychological concept where two actions or ideas are not psychologically consistent with each other, and that's what I've heard in the Chamber this afternoon from the Conservatives. We've had two weeks of hot air proclaiming their green credentials in calling for bold action on climate change, in tackling the biodiversity and nature crisis, and speech after speech with the same old rubbish of the same old policies that have led us to the situation that we're in today. [Interruption.] There is a contradiction between calling for different actions to achieve different outcomes and then calling for us to keep investing money in projects that embed carbon in them, and, through increasing traffic, generate existing carbon not just for us, but for the future generations they're saying to stand up for.

Now, clearly, looking at their faces, there is incomprehension at what I'm saying, and this is—[Interruption.] If we are genuine about resetting the conversation in this Senedd, which we must if we're going to reach the Climate Change Committee targets of doubling the amount of emissions reductions in the next 10 years that we've achieved over the last whole 30 years, we have to do it across this Chamber. It's no good giving speeches for easy headlines, but when it comes to the first action we have to do to put that rhetoric into action we turn instead to these glib contributions about doing the same thing, and decrying us for letting down motorists and letting down people. This is just bunkum, and I'm afraid the Conservatives need to confront this, as do all parties in this Chamber. There are contradictions on all sides here. The general reaction to my announcement of pausing road-building schemes has been: 'We agree with the principle, except for the road scheme in our constituency.' And I can understand that as a constituency Member myself, and there are road schemes in my constituency that have strong support, and it is a difficult political message to say to people, 'We need to pause and reflect.'

Now, I do understand the concerns that there are, and I want to put on the record that the roads review that we have announced does not mean we're ending road investment in Wales. The review will consider how we can move away from spending money on projects that encourage more people to drive and spend more money on maintaining our roads and investing in real alternatives that give people a meaningful choice. And that's the important word: a choice. This isn't about ramming anything down anyone's throat or forcing people to do anything; it's about giving people a realistic alternative, which we can't do when we keep pouring investment into schemes that generate additional carbon emissions. And I'll be publishing the panel members and the terms of reference shortly, where further details will be available. For now, I can add that, with regard to individual schemes, the review panel will be developing its own review criteria and making an initial report to Ministers within three months of its appointment on the road investment projects in scope of the review.

Samuel Kurtz to reply to the debate.

Diolch, Llywydd. In summing up this debate, I first of all want to thank all my colleagues for the important and interesting contributions that they've made, and commend my colleague from south-east Wales for leading this debate. I thank the Deputy Minister for his response.

An effective, co-ordinated and integrated transport infrastructure is what the people of Wales not only deserve, but what they need to reach their potential. A criticism often levelled at the Welsh Government is that too much attention is focused on urban Wales, leaving rural Wales behind, and I feel this is especially true when it comes to transport. We've seen today that a lack of transport infrastructure is a concern that attacks us here in north Wales, south Wales, mid Wales, and me in west Wales too.

As mentioned, the Deputy Minister a fortnight ago brought forward a statement to the Senedd pausing a number of road projects, bringing disappointment to many communities across Wales. I agree with my colleague Peter Fox—when I hear 'pause', I believe it a byword for 'cancelled', and should these projects actually get the green light and go ahead, then they'll inevitably be delayed.

However, I was pleased to receive reassurance about the long-awaited upgrade to the A40 at Llanddewi Velfrey, and that this will go ahead. This is a scheme that has been discussed for a number of years, and has been beset by countless delays. I look forward to finding out when the diggers have broken the ground on this project and it being fully completed. Obviously, I and the business community would rather see the A40 dualled all the way to Fishguard port, something that I know my colleague Paul Davies in Preseli Pembrokeshire has long called for and championed. But these current upgrades on the A40 will alleviate some of the pinchpoints on this route brought about by transcontinental HGVs, caravans, agricultural vehicles and other slow-moving traffic travelling on a single carriageway.

I do need to express some concerns over the letter that was sent by the future generations commissioner to the Deputy Minister and received by all Members, which not only welcomed the pausing of the aforementioned projects, but also called for further consideration to be given to reconsidering projects that were given the go-ahead. Deputy Minister, enough uncertainty is already about—please do not allow more to be created.

The car isn't going anywhere, but what is changing is the way that it is powered, and this is a point that my colleague Delyth Jewell and Gareth Davies both made in their contributions. We are on a journey, as the whole of the United Kingdom, of removing our reliance on fossil fuels, but we need to ensure that all four corners of Wales are supported on this journey. We still have a long way to go, and the Welsh Government need to ensure that the same focus is applied to ensuring that rural areas have the same access to electrical vehicle charging infrastructure as they do in main urban areas. And in terms of the clean air Act that Delyth Jewell mentioned and the Deputy Minister mentioned, there is support from all corners of this Chamber and, Deputy Minister, you will be pushing at an open door should the Welsh Government bring forward that clean air Bill.

The proposal is to agree the motion without amendment. Does any Member object? [Objection.]

Yes, there is an objection.

And therefore I defer voting on this item until voting time.

Therefore, in accordance with Standing Order 12.18, we will suspend the meeting to prepare for voting time.

That brings us to voting time, and the only vote this afternoon is the vote on the Welsh Conservatives' debate on the road network. And I call for a vote on the motion tabled in the name of Darren Millar. Open the vote. Close the vote. In favour 15, no abstentions and 40 against, and therefore the motion is not agreed.

That concludes voting time, but we have one remaining item of business.

That item is the short debate, and the short debate is to be presented today by Peredur Owen Griffiths. And I call on him to speak to the topic that he has chosen.

Diolch yn fawr, Llywydd, and just to let Members know that I've agreed to a request from Sioned Williams to make a short contribution at the end of this debate.

Over the past few weeks, I've been getting to know the different aspects of my portfolio. I'm the spokesperson for communities and older people. As you might expect, a large part of this covers social care. For those of you that know me, it'll come as no surprise that I've been talking to the people that I meet about different aspects of my portfolio. Indeed, when I visited my dentist, it came as no surprise that dentistry and oral health came up, in particular oral health in care homes.

During our conversation, my dentist talked about some of his long-standing patients, some of whom he’s seen move into care homes. Under his care, his patients had maintained healthy teeth and gums for many years, until they moved into a care home. He's been shocked to see how many of his patients have had a dramatic decline in their oral health since moving into a care home. I then mentioned this conversation to a friend of mine. They echoed the experience. Their father had dementia and had to move into a care home. When he stopped eating they assumed it was because of the dementia, but actually it was toothache. His oral health had declined dramatically after moving into a care home.

Now, staff in care homes are working their socks off—I don’t think there’s many here who would deny this—but, inevitably, things move down the priority list. Indeed, dental care, for many of us over the last 18 months, has taken a back seat due to the need for social distancing, and I’m sure care homes, who have been especially vulnerable to infection during the pandemic, have been mindful of this.

By its nature, dental care is one of the most difficult health services to restore during a pandemic. The written statement issued by the Government last week acknowledged this matter, and I don't think there will be many people who disagree with assertions such as, and I quote,

'During a respiratory virus pandemic, dentistry has been one of the most complex areas of primary care delivery to scale back, provide and recover.'

This is due in part because so many of its procedures generate aerosols, and also the proximity of the dentist to their patient in dental care delivery. This has led to many dentists only fulfilling requests for emergency treatment, so check-ups have had to be put on hold for the time being. I fear that this is especially the case in care homes.

To get to the crux of this debate, we must rewind the clock back to 2014, when the Older People’s Commissioner for Wales published a report called 'A Place to Call Home?'. This was a review into the quality of care that older people receive in care homes. The report found that dental care was lacking in many areas and many care homes. In establishing its conclusions, the report used evidence from the British Dental Association, which highlighted that there are high levels of unmet dental need in care home residents, and with many only receiving dental care when they develop a problem.

Pressure such as this thankfully led to the last Government's Gwên am Byth oral health programme in 2015, which aimed to improve oral hygiene and mouth care for older people living in care homes, through the development of a consistent all-Wales approach. It aimed to plug the shortfalls in dental care for older people in a care homes, by ensuring that an up-to-date mouth care policy is in place; by training staff in mouth care; and by keeping a register of that training. It also aims to ensure that residents have regular mouth care assessments that lead to an individual care plan, and that they are referred to a dental team if necessary.

In 2019, it was announced that funding for this programme was to be doubled to £0.5 million a year to ensure that the programme was rolled out fully in all care homes in Wales during 2020-21. This was obviously welcome. Good dental care is crucial to so many aspects of health. In the last few years, there has been mounting evidence that gum disease may be linked to dementia. Even for people with dentures, good oral hygiene is vital, as bad practice can lead to aspiration pneumonia. But, since the update we received from the previous health Minister on 23 December 2019, we have had no further updates or Government statements on the matter.

I'm pleased to make a brief contribution to this important debate. The General Dental Council notes that, because of the pandemic, which has exacerbated health inequalities, that older people and those considered clinically vulnerable face increasing challenges in accessing all sorts of dental care, and it's clear that some care home residents fall into that category. And I believe, even before the pandemic, that there was a need for an additional focus on this area in order to tackle the inequality in dental provision across the generations.

The aim of the Welsh Government in this area is laudable, and I welcome the guidance on ensuring that individuals are supported to care for their teeth, and that appropriate oral healthcare is available and that oral health is monitored. But the key question for us is how do we track this. It appears that a lack of up-to-date research in Wales is a problem, and I would be grateful to hear what plans the Welsh Government has to track the aims of Gwên am Byth. How can you know if Government guidance is being implemented? Thank you.

I call on the Minister for Health and Social Services to reply to the debate—Eluned Morgan.

Thank you, Dirprwy Lywydd. I'd like to start by thanking the Member for raising this important issue of dental services for people in care homes. As Members will know, the aim of the Gwên am Byth programme, introduced in 2015, which has already been referred to this afternoon, is to improve oral health and oral care for older people living in care homes by developing a consistent approach across the whole of Wales. Now, the programme tackles health inequalities by ensuring that some of the most vulnerable people have fair and appropriate access to oral healthcare. We know that the oral health of many of those people does deteriorate when they move into care homes, very often as a result of a decline in their general health and the fact that they hadn’t been as mobile in previous years, including those living with dementia.

Gwên am Byth runs alongside 'A Healthier Wales', as the response of dental and oral health services. The principles of the programme do ask care homes to ensure the following things: the first is that there is an up-to-date oral health policy in place; second, that staff are trained in oral health; third, that residents get regular assessments of oral care and health; fourth, that the assessment leads to an individual care plan, with the aim of maintaining good oral health; and, fifth, that residents are referred to a dental team, where necessary.

Our experience following the first five years of the programme has demonstrated that securing improved oral health for people in care homes is complex and challenging. Over half of care homes now participate in the Gwên am Byth programme, and almost 8,000 residents participate. We have had positive feedback from the care home staff and residents, carers and community dental services that provide the programme. As a result of the progress made, in 2019 my predecessor announced that funding would be doubled to £0.5 million, and I am pleased that Peredur noted that in his contribution. Thank you for that.

The programme is now a key part of the Care Home Cymru programme, which is funded by the Welsh Government and provided by Improvement Cymru and Public Health Wales. Integrating with Improvement Cymru has strengthened Gwên am Byth further, making it an integral part of the national work undertaken in Wales to improve oral health among adults.

We don't have many debates these days that don't refer to the huge impact of COVID on the provision of public services, including general dental services and oral health programmes for people across Wales of all generations. Last week, as you noted, I shared a written statement with Members outlining the gradual progress made in dental services, and it confirmed that the contract reform that we anticipate will be delayed until April 2022. And, whilst COVID-19 continues to cause concern in terms of public health, dental teams do need to maintain the appropriate virus containment systems.

So, we know that the return of services will continue to be gradual, and we recognise that people across Wales have not had the regular check-ups that they've been used to. However, the service has adapted to prioritise urgent care, and I would like to take the opportunity to thank dental teams and health boards for their commitment and dedication during the last 15 months to maintain access to essential dental services for those in the population experiencing pain and problems. And, yes, that does include people who are in care homes.

Now, we know that this has been a very challenging time, and we recognise the impact that COVID-19 has had on individual members of the dental team and on the profession as a whole. As the risks of COVID-19 reduce, more treatments will be able to be provided. Now, we need dental practices to continue to follow strict infection control measures, including social distancing, to protect practice staff, patients and the wider community. Practices are encouraged to see patients using suitable recall periods, determined by their patients' needs and risk.

Now, given the need to shield vulnerable residents in care homes, active face-to-face engagement during the initial phase of the pandemic was paused. The majority of dental care professionals were unable to directly access care home staff and residents for face-to-face contacts at the time, which is what you've noted. However, many local community dental teams remained in contact with the care homes by e-mail and phone call contact. The Care Home Cwtch—a peer support network for care home managers—was set up by Care Home Cymru and PHW to help assist care home managers during and beyond the pandemic. Now, this platform provides the opportunity for Gwên am Byth leads to integrate with care home staff to deliver oral health and hygiene information and skills-building sessions.

Infection control and isolation in care homes is much more difficult than in the controlled clinical environment of a hospital or a dental clinic. People receiving social care often have underlying conditions that make them more at risk of infection and death from COVID-19. Some people require physical help with aspects of daily living, such as eating, washing and mouth care, making complete isolation very difficult for them. Now, this has added further complexity to the provision of the programme during the pandemic.

The need for face-to-face contact in care homes is under regular review, and local teams will be guided by service providers on the level of activity in each care home. Gwên am Byth teams have maintained regular contact with care homes throughout the pandemic, whilst monitoring and managing emergent needs where appropriate. This has ensured an approach that prioritised urgent needs, as well as the wider provision of dental services in Wales. And I'm incredibly grateful to the community dental services across Wales for the efforts they've made to ensure care home residents can access the advice and interventions where appropriate throughout the pandemic.

Now, just as much as the challenges and complexity of providing dental services, I fully recognise the impact that COVID-19 has presented in care homes. And it's highlighted that care homes have different levels of workforce experience or resources to be able to fully engage in the Gwên am Byth programme. It's commendable that many care homes have already fully engaged with the programme and are achieving excellence in mouth care standards. However, our aim prior to the pandemic remains: we expect to see the programme available in and offered to all care homes for older people in Wales.

Thank you, Minister, and that brings today's proceedings to a close.