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The Assembly met at 13:30 with the Presiding Officer (Dame Rosemary Butler) in the Chair.
 
13:30
Y Llywydd / The Presiding OfficerBiography
Good afternoon. The National Assembly for Wales is now in session.
 
Questions to the First Minister
The Williams Commission
 
13:30
Llyr GruffyddBiography
1. Will the First Minister make a statement on the implications of the Williams Commission recommendations on public services in North Wales? OAQ(4)1437(FM)
 
13:30
Carwyn JonesBiographyThe First Minister
The commission published its report on 20 January, and I put on record my thanks to the commission for the work that it has undertaken. We all now want to consider its findings in detail.
 
13:30
Llyr GruffyddBiography
Thank you for that response. You said in an interview with the BBC yesterday in regard to the reorganisation of local government,
 
If you want to do this relatively quickly, you will have to retain the same number of councillors and then, in future, say that this is the time for a reduction in numbers.
 
Can you therefore confirm that it is the Welsh Government’s intention to reduce the number of councillors in the longer term?
 
13:31
Carwyn JonesBiographyThe First Minister
Yes, of course. It would be sensible to say that if there are fewer councils, there will be fewer councillors. I now wish to meet with other leaders in order to discuss the views of the various parties in the Assembly in order to progress with this as soon as possible.
 
13:31
Mark IsherwoodBiography
You may be aware that the Communities, Equality and Local Government Committee recently completed an inquiry into progress on local government collaboration. How do you respond to the evidence to that inquiry from Conwy council, on behalf of north Wales councils, that working across organisational and geographic boundaries could bring complexity and ambiguity that could generate confusion and weaken accountability, paralleled by Cardiff Business School, which said that you have hundreds of different cost curves all behaving differently and that there is no simple answer to the local government-sized conundrum?
 
13:32
Carwyn JonesBiographyThe First Minister
The Member makes the case for reorganisation, does he not, by saying that the evidence is not there that there is working across boundaries or that it is too complicated. What the Williams commission identifies is a need for change now and it identifies a need for change in order to benefit the public. It also identifies the problems that have arisen due to the lack of collaboration between many local authorities in Wales.
 
13:32
Aled RobertsBiography
First Minister, I am sure that the majority of people will be more concerned about the quality of services rather than boundaries. Some of the recommendations will create a situation where certain responsibilities, such as housing, mean that one council outsources the housing stock while another retains its stock. Is the timetable, in terms of making some sort of progress by Easter, a reasonable one given all of these implications?
 
13:33
Carwyn JonesBiographyThe First Minister
By Easter, I would like to be in a position where every party in the Assembly has a firm opinion. The process will not be complete by Easter, of course. The next step will be to consider in which way the change should happen. Following the process required in the Assembly means that it will not be possible to introduce a Bill in the Assembly this side of the Assembly elections. However, if there is consensus between the parties on moving things forward more quickly, then that is one option for consideration. There are practicalities that we have to consider, but, ultimately, what we are talking about is a system that will improve services for the people of Wales.
 
13:33
Y Llywydd / The Presiding OfficerBiography
Before we move to question 2, I am sure Members would like to join me in welcoming the delegation from our sister Parliament in Canada. We hope you will find this afternoon beneficial. [Applause.]
 
Energy Pricing
 
13:34
David ReesBiography
2. What discussions has the First Minister had with UK Government Ministers on energy pricing? OAQ(4)1440(FM)
 
13:34
Carwyn JonesBiographyThe First Minister
We have consistently raised with UK Government Ministers our concerns. I have personally raised concerns with Vince Cable, explaining to him the concerns that are passed on to me by our energy-intensive industries that the cost of energy for them is too high, and we remain concerned about the ability of the UK to remain competitive with energy costs as they are.
 
13:34
David ReesBiography
Thank you for that answer, First Minister. As you may be aware, the foundation industries, which include anchor companies such as Tata Steel, last week wrote to the UK Government asking for it to ensure that it created a level playing field for it to operate within. That included energy costs, so that companies can compete, as you say, effectively and efficiently in a global market. These companies bring huge investment into Wales and support our economy dramatically and employ many people. Do you agree with me that this UK Government has failed those companies and these employees by its failure to tackle the energy costs, and will you raise those issues with the Prime Minister, the next time that you meet him, so that he can change his approach to the funding and the costing of energy prices?
 
13:35
Carwyn JonesBiographyThe First Minister
I thank the Member for his comments. As I said, I have raised the issue with Vince Cable, and, if I remember, I have also raised the issue with the JMC. It is an issue that is of crucial importance to those industries that are important to the Welsh economy but which are high energy users, despite the fact that, like Tata, they have taken steps and have invested heavily in order to reduce the amount of energy they use. However, the nature of the business is such that they are bound to use a substantial amount of energy. I would urge the UK Government to address this position as quickly as possible in order to secure the future of our manufacturing industries.
 
13:35
Russell GeorgeBiography
One way to mitigate higher energy prices in the future is to improve the energy performance of new and existing buildings, both domestic and non-domestic. Why has the Government significantly reduced its building regulation targets for greenhouse gas emissions, which could go a long way to lowering energy prices?
 
13:36
Carwyn JonesBiographyThe First Minister
That has been done in order to assist the construction industry—and I thought that he might welcome that, actually—to improve its performance over the next few years. The Minister made it absolutely clear that he wanted to make sure that targets were reached within a reasonable time, but that they were not introduced so quickly as to stymie the recovery of the construction industry, which employs so many people in Wales.
 
13:36
Alun Ffred JonesBiography
Problems related to high electricity prices have been a concern for Tata Steel, and other industries, over many years. Would having a Government-owned company—possibly owned by the Welsh Government—to distribute electricity secure a better deal for taxpayers and for businesses?
 
13:36
Carwyn JonesBiographyThe First Minister
First, a question arises regarding European regulation. It would not be possible, of course, to subsidise any company. We would have to find some means of funding a company that would not break state aid law, and, of course, it would not be possible to establish any company that would work in a non-competitive way. If you want a competitive market, it is very important that all companies competing in that market do so on a level playing field. On whether it should be like that, that is, of course, another matter. However, any company would, first of all, have to raise its own money and, secondly, ensure that it did not work in a way that is contrary to European regulations.
 
Questions Without Notice from the Party Leaders.
 
13:37
Y Llywydd / The Presiding OfficerBiography
First this afternoon, we have the leader of the opposition, Andrew R.T. Davies.
 
13:37
Andrew R.T. DaviesBiographyThe Leader of the Opposition
Thank you, Presiding Officer. First Minister, you said recently that you were confident that the Welsh Ambulance Services NHS Trust has the resources that it needs. You are aware of the tragic incident of the death of Mr Pring from Flintshire, which was in the news last week. He died after waiting 42 minutes for an ambulance to arrive. The reason given for that was that there were no ambulances available to attend. We were told that there were six vehicles waiting at Wrexham Maelor Hospital, and that there were three at Ysbyty Glan Clwyd. The inquest also concluded that, if an ambulance had been available, the optimised prospects for his survival would have been greatly increased. When you hear of these types of events, do you believe that the Welsh ambulance service has the resources that it requires to stop events like this from happening?
 
13:38
Carwyn JonesBiographyThe First Minister
First of all, could I express my condolences to the family of Mr Pring and what happened to him? It is right to say that the coroner did not say that Mr Pring would have lived had the ambulance arrived; it is right to say that he would have had a better chance of living had the ambulance arrived in time—that much is true. However, that said, this was not a typical event in the history of the Welsh Ambulance Services NHS Trust, nor is it typical of its performance over the course of the last year. Nevertheless, it is important that it continues to improve—as it has done—in order to minimise events such as this occurring in the future.
 
13:39
Andrew R.T. DaviesBiography
First Minister, I asked you whether the Welsh ambulance service had the resources that it requires to try to stop events like this from happening. You will be aware that your own district general hospital—the Princess of Wales Hospital—last Thursday had, I am told, 11 ambulances waiting outside it. In the news last night, there was a similar type of event to the one that I mentioned, where a patient was unable to be discharged into the care of the Princess of Wales Hospital. That delay, potentially, could have affected the outcome of the patient’s ability to survive the incident that they were presenting for at the hospital. I ask you again, First Minister, given that I have cited two examples in very recent weeks: does the Welsh ambulance service have the resources to help mitigate and stop this type of event happening at our district general hospitals?
 
13:40
Carwyn JonesBiographyThe First Minister
The answer to that is ‘yes’, but could I just point the leader of the opposition to one aspect that certainly does affect ambulance response times? That, of course, is the time it takes to get through A&E. Part of the problem, if not much of the problem, is that A&E can become overloaded from time to time, and that is what delays the ambulances. So, the answer is to get more people through A&E in order to release ambulances more quickly. That, of course, is why, as a Government, we are so keen to ensure that we have a structure for the NHS that enables that to happen. It is not a question of ambulance resources. It is a question of ensuring that the hospitals are able to admit patients as quickly as possible, and that is why, of course, there have been proposals across Wales to look again at the structure of A&E.
 
13:41
Andrew R.T. DaviesBiography
I think that that is where we will disagree because I do not believe that, by shutting A&E departments, you will increase the life chances of people who are presenting at the ones that are to remain. Obviously, one of the key problems about people progressing through A&E has to do with being taken into the hospital environment, and the lack of beds and the loss of beds are one of the big obstacles to people being able to pass through A&E and, then, to ambulances, when they bring in new patients, being able to discharge them to A&E. We have the worst A&E waiting times in the United Kingdom, regrettably. What key actions are you going to be undertaking to see that there is improvement—and, I would suggest, immediate improvement—in our A&E times so that the events I have outlined previously at Wrexham Maelor and at your own district general hospital can cease to be an occurrence within the Welsh NHS and so that patients and families will not go through the trauma that those individuals’ families have gone through recently?
 
13:42
Carwyn JonesBiographyThe First Minister
Well, I disagree with him when he says that we have the worst A&E times. If he looks, for example, at Belfast, he will see that there have been enormous problems there, particularly around the Royal Victoria Hospital, where a state of emergency was effectively declared at one point. However, he makes the point about what we can do to increase the throughput of patients through A&E. He will know about the extra resource we have put into the NHS—£570 million—which will assist in that. However, there is no getting away from the fact that people also need to go to the right A&E department for the condition they have, and that means making sure that people go to the right A&E department in the first place and that the A&E departments are able to deal with them in terms of the experience they have, which is why reorganisation, of course, is something that is being taken forward across Wales.
 
Also, of course, there is a responsibility here as well on individuals. It is still the case, I believe, that people go to A&E when they do not need to. Speaking to A&E consultants in my own hospital in Bridgend, it counts for between a third and a half of the cases they see; these are people who should not be there in the first place because they have been to see the GP, the GP has said, ‘There is nothing wrong with you’, so they go to A&E. There is a level of discipline, I think, that people need to exert as well. I see nothing wrong in local health boards saying to people, ‘Look, do not come to A&E unless you really have to’. I think that is perfectly sensible advice. On top of that, in order to minimise tragic occurrences, such as the two occurrences in the past year, it is important that the resource is there, and I would argue that that is exactly what we have done.
 
13:43
Y Llywydd / The Presiding OfficerBiography
We now move to the leader of Plaid Cymru, Leanne Wood.
 
13:43
Leanne WoodBiographyThe Leader of Plaid Cymru
Diolch, Lywydd. First Minister, the Williams commission report has helped to shine a very concerning light on public services in this country. The commission confirmed that public service performance in places is poor and patchy, too complex and lacking in ambition. Do you accept this verdict on your leadership?
 
13:43
Carwyn JonesBiographyThe First Minister
Well, it does not talk about the Government, does it? I mean, it talks a little about the Government but it is concerned mainly with local government and other public services. The reality is that, if you look at the report, you will see that it talks about situations where some public service bodies see regulation and inspection as a burden or something to be resisted. The reality is that this is all about servicing the public, and the reality is that the present structure of local government, which is part of that report, will never be able to deliver the level of service that people expect.
 
13:44
Leanne WoodBiography
First Minister, you are in charge of public services in Wales, and what has been said about local government can equally be applied to our national health service. There are very real people being affected by poor public services. We have just heard about the heart-wrenching case of a patient from Flintshire, who lay for 40 minutes waiting for an ambulance while his wife watched him die. Surely you would agree, First Minister, that this is something that should never ever happen in our country.
 
13:45
Carwyn JonesBiographyThe First Minister
Indeed; I agree with that. However, in relation to the Williams commission, I would remind the leader of Plaid Cymru that her party did not come forward with the idea for a commission such as this, and did not consider that there was a need to look very carefully at the way in which the structure of public services was delivered in Wales. I await, with an open mind, her view on the Williams commission. I reiterate the point that I made earlier, which is that there needs to be change in Wales and there needs to be reorganisation of local government in Wales, so that we can take forward the Williams commission’s report. In order for that to happen, there needs to be a level of cross-party support within this Chamber. I want to talk to the other party leaders in order to establish how much of that is possible. This is a major change to local government. I would like to see this done on a basis that is as cross-party as possible. I extend that invitation to her.
 
13:45
Leanne WoodBiography
Thank you, First Minister. I am interested in reaching a consensus with you, but I would contend that you are not starting the process in the correct manner.
 
Going back to public services, this very morning, Betsi Cadwaladr University Local Health Board has postponed all non-urgent surgery. This is the second health board to do this. There is clearly a capacity issue that you have failed to get to grips with.
 
Rather than centralise and cut health services further, which will put further pressure on ambulances and on A&E departments, why do you not now back Plaid Cymru’s proposals to boost doctor recruitment? If you are against this, First Minister, can you tell us exactly what you are for?
 
13:46
Carwyn JonesBiographyThe First Minister
I would be in a better position, I am sure, to support Plaid Cymru if doctors themselves supported you, and they do not. If you look at what doctors say about the NHS in Wales, the vast majority of them will say that there needs to be change. Yet, you keep on opposing change all of the time. Doctors will say to you that the difficulty is throughput of patients; you cannot create a situation where there are more patients coming through a hospital. That does not happen unless you have a service that is more centralised. Unless you are prepared to ignore the Royal College of Surgeons and the advice of independent doctors, which is what your party is constantly trying to do, you cannot create the Shangri-La situation that you want. We want a sustainable health service that is based on the guidance that doctors themselves give. You want to ignore that guidance; where doctors say that a service is unsafe, you want to ignore that and pretend that it is not happening. That is not sustainable.
 
Coming back to the question that she asked about the Williams commission, I now look forward to working with Plaid Cymru and other parties with a view to getting consensus on the way that public services are delivered in Wales, in order to improve them for the people of Wales.
 
13:47
Y Llywydd / The Presiding OfficerBiography
Finally, I call the leader of the Welsh Liberal Democrats.
 
13:47
Kirsty WilliamsBiographyThe Leader of the Welsh Liberal Democrats
First Minister, in your programme for government, to which you are very fond of referring in this Chamber, you list a whole series of targets that you will use to measure NHS performance. On Sunday, you said that it is difficult to see what the justification is for them, and that there was no logic to them. If there is no logic to them, what on earth were you doing including them in your programme for government less than three years ago?
 
13:48
Carwyn JonesBiographyThe First Minister
They exist. If you look at the clinical reasoning for the targets, it is difficult to see where it comes from. That much is true. That is not coming from us; it is coming from doctors. When I went around Wales’s hospitals with the Minister for Health and Social Services in the summer, officials said the same thing to us. They said, ‘You have targets with regard to A&E. We have people who come here, they may spend 13 hours in A&E, but the alternative is that they spend three days in hospital. So, we keep them in for longer and the targets do not help.’ Clearly, we need to revisit the targets, but I am fully aware that revisiting the targets without actually reaching at least some of them will leave us open to the allegation that we are trying to stitch the figures up. I understand that. So, what I said on Sunday was that I would like to see us reach some of those targets and then consider carefully whether they need to be changed.
 
13:49
Kirsty WilliamsBiography
Let us look at one specific target. You promised, in your programme for government, that you would improve access and patient experience by ensuring rapid investigations and treatment. Are waits for scans and endoscopies no longer important, or is it the fact that the number of people waiting longer than eight weeks for diagnostic services has trebled in the last two years? Is that one that you are planning to meet or one that you are planning to ditch?
 
13:49
Carwyn JonesBiographyThe First Minister
It is true to say that there have been challenges, as I have said many times in this Chamber, over the past year or two. We are confident, however, that the extra resources—the £570 million—going into the NHS will help to meet some of those challenges.
 
13:49
Kirsty WilliamsBiography
First Minister, it is not just that target, is it? You do not routinely meet your Government’s ambulance response time targets, you do not meet your cancer targets, you do not meet your A&E targets, and the number of people waiting more than nine months for treatment has hit a new high. If you are saying that those things are not important any more in our NHS, how are you going to measure your Government’s performance in running the health service? I ask you again: which of those are you planning to meet and which are you planning to ditch?
 
13:50
Carwyn JonesBiographyThe First Minister
We plan to meet them all. I am not pretending that it is easy to do that. This is not a situation that is unique to Wales; England routinely misses its targets as well. The reality when it comes to cancer treatment times, for example, is that the situation is the same in Wales as it is in England. The reality is that the vast majority of people have prompt and effective clinical care. That is not to say that there cannot be improvement. It was the leader of the Liberal Democrats who suggested that we did not think that these figures were important; of course they are important. The performance of the NHS is important to all of us in the Chamber. That is why the Minister for health has outlined very carefully how he intends to see the health service improve in terms of the resources that he has put in. However, I emphasise that there cannot be improvement in the health service without structural change. One cannot happen without the other. To those parties—her party is not one of them, in fairness—that oppose all or any change in the NHS, despite, on occasions, independent panels of doctors saying that there has to be change, I have to say this: the NHS will not improve as long as those parties hold those positions.
 
13:51
Kirsty WilliamsBiography
We have never said that.
 
13:51
Carwyn JonesBiographyThe First Minister
No, you have not.
 
Welsh NHS
 
13:51
Darren MillarBiography
3. Will the First Minister make a statement on his priorities for the Welsh NHS in 2014? OAQ(4)1429(FM)
 
13:51
Carwyn JonesBiographyThe First Minister
A topical question. We continue to improve the quality, safety and sustainability of the NHS.
 
13:51
Darren MillarBiography
Thank you for that answer, First Minister. Do you agree that there is a developing crisis that is deepening in the Welsh NHS, particularly around emergency and unscheduled care? On 10 December, people were told not to go to Morriston Hospital’s A&E department unless they had a genuine emergency and they were told that they should not attend Withybush hospital unless it was absolutely necessary. Morriston and Princess of Wales hospitals had to cancel operations on 6 January, because of pressures on beds. We know that Wrexham Maelor was described as being logjammed on 8 January and we have heard just today about the cancellation of operations in north Wales. Your Minister for health has said that there is no crisis in the Welsh NHS, but do you agree that your record-breaking NHS budget cuts are not helping the situation, that you are cutting the NHS budget too far, too fast—to coin a phrase—and that it is now a matter of regret for you that you do not have a national comprehensive winter NHS plan, unlike the UK Government? What action are you taking to sort this problem out, once and for all?
 
13:53
Carwyn JonesBiographyThe First Minister
First, he talks about a winter plan; there is a winter plan and it is working. If you look at A&E figures in England, you will see that they are worse than ever. [Interruption.]
 
13:53
Y Llywydd / The Presiding OfficerBiography
Order, Darren Millar.
 
13:53
Carwyn JonesBiographyThe First Minister
Look at the newspapers for 11 January and you will see that things are far worse under his party’s stewardship, if you can use that word, in London. The reality is that he stands up in this Chamber and says that, where advice is given to people that they should not attend A&E unless there is an emergency, that advice is wrong. He seems to be suggesting that, according to the Conservatives, A&E departments are extended GP surgeries. I stand by that advice: people should not be going to A&E unless there is a genuine emergency. [Interruption.]
 
13:53
Y Llywydd / The Presiding OfficerBiography
Darren Millar, will you let the First Minister answer? I am sorry, First Minister; I cannot hear what you are saying, because Darren Millar keeps repeating things.
 
13:53
Carwyn JonesBiographyThe First Minister
I cannot hear him either, but there it is, Presiding Officer.
 
The reality is that it is quite right that people should not attend A&E unless it is a genuine emergency. He may think that they are extended GP surgeries, but they are not. We have put extra resources into the NHS. This compares with his party, which has cut the NHS by £20 billion in England, except they call those cuts ‘efficiencies’—if they call them efficiencies, they are not really cuts, are they? That is the reality of Conservative rule. We see A&E departments struggling in England. In Wales, we approach this with honesty, we understand the challenges, we put more resources in and we have an NHS that properly benefits the people of Wales, not one that is being hammered by billions of pounds of cuts, as is done by the Conservatives in London.
 
13:54
Elin JonesBiography
First Minister, one reason that ambulances queue outside A&E is that there is a lack of beds on wards. That is often because beds are blocked as a result of a lack of provision in the community. With the exception of Powys, yesterday, the Williams commission did not recommend the amalgamation of health services and social services, which is disappointing in my view. How will you, therefore, in 2014, direct health boards and local authorities to amalgamate services and budgets at grass-roots level to a much greater degree than at present?
 
13:55
Carwyn JonesBiographyThe First Minister
That is a very strong message. It is extremely important that they collaborate as closely as possible. In talking about social services, we are talking about care services—we are not talking about adoption, for example. The message has been conveyed to local health boards and to local councils, that it is extremely important to collaborate in order to ensure that the citizen is given the best service possible.
 
13:55
William PowellBiography
First Minister, last term I raised with you the urgent fire safety requirements that had to be put in place at Bronllys Hospital’s pain management centre. I am pleased to say that, since your intervention towards the end of the autumn, the work is now in hand. However, my question for you today, particularly in the context of your Minister for health’s statement last week with regard to the NHS concentrating more on the areas where we can deliver good rather than, potentially, deliver harm, is: would it not be prudent to consider investing further in that recognised centre of excellence, particularly as it would, on a spend-to-save basis, potentially reduce the burden of costs for expensive and ever-escalating drug bills for pain relief?
 
13:56
Carwyn JonesBiographyThe First Minister
These are matters for the local health board, of course. I am sure that it will want to invest in such a way that services are delivered better and efficiently. I am glad to hear that, following your question in the Assembly Chamber, work seems to be beginning, at least, at Bronllys Hospital.
 
Welsh High Street
 
13:57
Suzy DaviesBiography
First Minister, Cooke & Arkwright reported last week that many small businesses in Wales are paying double the business rate that they should be paying—
 
13:57
Y Llywydd / The Presiding OfficerBiography
That does not match the question that I have on my paper.
 
13:57
Suzy DaviesBiography
I am so sorry. It was my mistake.
 
4. What actions will the Welsh Government be taking to support the Welsh high street in 2014? OAQ(4)1434(FM)
 
13:57
Carwyn JonesBiographyThe First Minister
It is very sporting of the Member to give me the supplementary question before the main question. [Laughter.]
 
13:57
Suzy DaviesBiography
I am sure that I am not the first.
 
13:57
Carwyn JonesBiographyThe First Minister
Our vibrant and viable places framework demonstrates a clear emphasis on the regeneration of town centres in Wales. This will be supported by further action, including business improvement district support, a town-centre loan fund, action on business rates—Members will be aware, of course, of the cap—and a high street support campaign launched this autumn.
 
13:57
Suzy DaviesBiography
At the risk of repeating myself, I welcome the 2% cap in the business rates that you have just mentioned, but your own high street strategy is now some seven months late. In the meantime, how about adopting some of the Welsh Conservative policies that were announced in the vision for the high street?
 
13:58
Carwyn JonesBiographyThe First Minister
I think that there is some common ground here. We all want to see the high streets thrive. That is why we announced the pilot town-centre loan scheme, which has been brought forward to assist local partners in pilot areas to bring their own town centres back to life. Officials are also working with a small task and finish group regarding the campaign that I have mentioned in support for our high streets, which will be launched this autumn. The Minister announced business rate relief schemes, which will benefit town centres by encouraging construction and speculative developments, and support long-term empty premises back into use. Of course, the business rates cap will help that.
 
13:58
Rhodri Glyn ThomasBiography
First Minister, I am pleased that you acknowledge that there is a crisis facing many high streets in Wales at present. One thing that impacts upon the image of the high street is empty shops. Would you consider working with local authorities to see how empty shops could be filled, possibly by businesses that cannot afford a shop window on the high street at present?
 
The second point is parking. Do you believe that there is scope to be creative with parking—offering an hour or two of free parking during the day so that those spaces cannot be taken by office workers?
 
13:59
Carwyn JonesBiographyThe First Minister
That is a matter for local authorities, of course. In terms of pop-up businesses, I think that it is possible for local authorities to work with businesses to consider whether or not it would be possible, for example, to secure a month for a business without having to pay rates or any type of interest just to see whether it can be sustainable. Then, if it is sustainable, it would have to pay. It would provide an opportunity for some people who may not want to start a business by being tied into some sort of contract, to see whether there is a market for what they want to sell. One of the problems that we have to consider—and I was thinking about this issue this morning—is that the high street has to rethink the way that it works because of the fact that most high street customers are at work when those shops are open. They close at 5.30 p.m.. Well, for most people, including most of us in this Chamber, there is very little shopping going on during the week during those hours, so people tend to go to shops that are open later. So, we also have to consider, in my opinion, the opening hours of our high street stores in order to draw people in during the evenings, and not only during the daytime.
 
Reduce Smoking
 
14:00
Lindsay WhittleBiography
5. What evidence do you have that the Welsh Government’s approach to reducing smoking in cars carrying children is having any positive impact? OAQ(4)1430(FM)
 
14:00
Carwyn JonesBiographyThe First Minister
Recent research has shown an increase in people reporting that smoking was not allowed in their main car. We have also commissioned studies of primary and secondary school age children’s exposure to second-hand smoke in cars. The results of that research will be available later this year.
 
14:01
Lindsay WhittleBiography
I thank you, First Minister, for answering my question. It is well known that 80% of the public want smoking in cars carrying children to be banned, yet 22% of adults still smoke when children are in their cars. Eminent medics tell us that this form of passive smoking leads to asthma, chest infections, ear problems and even cot deaths. While we have been waiting for the past two years, children have been suffering. I know that some Conservatives have opposed this with shouts about personal freedom. Is it not time, First Minister, to put the right of children to good health above so-called personal freedoms and ban smoking in cars in which children are passengers?
 
14:01
Carwyn JonesBiographyThe First Minister
That option, of course, is available to us, when that research becomes available in the summer. We have always said that, if the voluntary approach does not work, we will look to legislate.
 
14:02
William GrahamBiography
The First Minister will be aware that, every year in Wales, around 14,500 young people, aged 11 to 15, are introduced to smoking, very often through peer pressure. First Minister, you have given one answer already, but do you not think that you should look at this once again? I appreciate that you want to see the evidence, but most people would like this ban to be in place. Could you reconsider bringing legislation forward to outlaw smoking in cars with children in them?
 
14:02
Carwyn JonesBiographyThe First Minister
I think that we need to get the results of the research to provide the evidence base. We all know anecdotally what the situation is, but that much is important. The point I would make is this: yes, of course people—adults, that is—have a freedom to do as they wish in their own cars, but when there are children in the car, the children cannot get out of the car and they cannot make their own decisions. That personal freedom of adults to impose their smoking on children is not something that I would look to support as being in any way a freedom that does not impinge on the rights of others. That is exactly what smoking in cars with children in them does.
 
Bronglais Hospital
 
14:03
Simon ThomasBiography
6. What plans does the First Minister have to re-establish colo-rectal surgery services at Bronglais Hospital? OAQ(4)1444(FM)
 
14:03
Carwyn JonesBiographyThe First Minister
I know that the health board attempted to do this and somebody was offered the post in June of last year, but, they declined the post. Since then, unfortunately, the royal college has said that it would not support having a specialist consultant there at present, because it does not believe that the model at the hospital is adequate as regards national standards.
 
14:03
Simon ThomasBiography
Those are the reasons why such treatment is not available at Bronglais currently, but there has been no answer to the question as to when such a service will be available. Do you expect the current situation, which was supposed to be temporary nine months ago, to continue over the next year? That is unfortunately the story with Hywel Dda: temporary measures are introduced and then they become permanent. There were 300 people at a public meeting in Aberystwyth 10 days ago—including three Assembly Members—and they voted unanimously to re-establish this treatment. When will we see this treatment re-established at Bronglais hospital, please?
 
14:04
Carwyn JonesBiographyThe First Minister
At present, the college says that there is not a sufficient number of patients to ensure that the service is safe. At the moment as I understand it, as regards cancer, two to three people a month are affected by this situation. One problem that existed at Bronglais was the fact that there were doctors available to undertake the surgery, but they did not undertake laparoscopies. Due to that fact, they could not train anyone else. Once those doctors left, there was no-one left. So, there was a problem because the way in which they undertook surgery at Bronglais did not match with the most modern ways of doing things. There was nothing wrong with the way that they were doing it; I am not criticising the quality of the surgery there, but it was not the same as the practice found at other hospitals in Wales. As a result, there was a problem: no-one could come in as a junior doctor, because they could not receive the training that they required. If the college changes its mind and changes the standards, it will be possible to reconsider this. However, nobody can appoint a doctor in a hospital where the doctors themselves say that it would not be safe to do so. That is the problem at present.
 
14:05
Rebecca EvansBiography
As Simon Thomas has said, the recent meeting in Aberystwyth focused very much on colorectal surgery, and of the 300 people who were at the meeting, none were from the health board. Do you join me in encouraging the health board to up its game in terms of engaging with and listening to people across Hywel Dda?
 
14:06
Carwyn JonesBiographyThe First Minister
I think that it is essential that all health boards are as accessible as possible to the people that they serve. I would urge all health boards to do that. I would say that the health board, I understand, has said to those who organised the meeting that it is more than happy to answer any written questions that are sent to it as a result of that meeting. I understand that no such questions have yet been sent, though.
 
14:06
Darren MillarBiography
First Minister, I too share the concerns that have been expressed by Members, both about the lack of engagement by the health board and the challenges that this decision presents to patients. One of those challenges is of course the transport costs to get to the other, alternative centres for their treatment. I wonder what engagement the Welsh Government has had with the health board to ensure that it is supporting patients who need support with finance towards those transport costs to make sure that they can access the treatment that they need.
 
14:06
Carwyn JonesBiographyThe First Minister
I would expect the local health board to assist people where it can, but the reality of the situation is that where you have the royal colleges saying that the establishment of a particular service would not be safe, no politician, surely—rationally—would then try to establish that service. It is unfortunate. It is nothing to do with money. A lot of it is to do with the throughput of patients. You cannot increase, physically, the number of patients going through a particular department unless you centralise the service in that regard. It has been an unfortunate scenario that has unfolded in Bronglais. I do reiterate the fact that the number of patients affected is small. For those affected, of course, it is an issue—I understand that—but we are talking about two to three patients a month.
 
New Work Connections
 
14:07
Rhun ap IorwerthBiography
7. Will the First Minister make a statement on the New Work Connections initiative? OAQ(4)1432(FM)
 
14:07
Carwyn JonesBiographyThe First Minister
Supported by £9 million from the European social fund, the £17 million New Work Connections project is helping disadvantaged people in north-west Wales to find employment and access training opportunities.
 
14:07
Rhun ap IorwerthBiography
New Work Connections will be coming to an end at the end of February. It has been extremely important in assisting disadvantaged people with finding a pathway back to work. We still do not know what will replace it. Does the First Minister accept that that gap between New Work Connections and whatever will replace it could be detrimental from the point of view of finding employment for the most disadvantaged people? Will you make a commitment to announce plans for a new scheme as soon as possible?
 
14:08
Carwyn JonesBiographyThe First Minister
I understand that the local authorities themselves are looking at proposals to ensure that individuals can continue with the project, and they are looking to see how they can put other resources in place outwith this programme. Having said that, we want to ensure that the plans for the European funds for 2014 to 2020 have been considered and permitted by the European Commission by May of this year.
 
14:09
Antoinette SandbachBiography
First Minister, of course you will be aware of the Working Links programme that runs concurrently with the New Work Connections programme, so when this programme ends, it will be possible for people who have been on the New Work Connections initiative to go to seek assistance and help from Working Links. Have you been working with the UK Government to see how it might be able to assist in that regard? The Working Links programme has the same objectives of getting people back into work and providing training for them and support, particularly when they may have particular needs or problems that need to be addressed.
 
14:09
Carwyn JonesBiographyThe First Minister
The Minister has been active in terms of working with the UK Government on this, and I understand that there has been a recent meeting with a view to looking to resolve the situation.
 
Enterprise Zones
 
14:10
Nick RamsayBiography
8. Will the first Minister provide an update on the progress of Enterprise Zones? OAQ(4)1431(FM)
 
14:10
Carwyn JonesBiographyThe First Minister
A progress update was published in the autumn term. We have also published performance indicators and targets, against which we will report further progress in May of this year and on an annual basis thereafter.
 
14:10
Nick RamsayBiography
I am sure that you are aware of the Finance Committee’s report into enterprise zones, which was published in December last year, which alluded to what I can only describe as an air of mystery surrounding where we are at the moment with enterprise zones in Wales. One of the concerns in the report is that,
 
‘it is difficult to be 100% clear about what influence these strategic objectives have’,
 
because the Welsh Government has hitherto failed to make those objectives public, despite having them in the Welsh Government’s files, so to speak. Will you agree with the Finance Committee, First Minister, that recommendation 1 of that report should be fulfilled and that all non-commercially sensitive information relating to the objectives of the zones should now be published so that scrutiny can run its course?
 
14:11
Carwyn JonesBiographyThe First Minister
There is no mystery surrounding the success of our enterprise zones: we have already assisted over 60 new and growing SMEs with their business rates. That is nearly £4.5 million committed in support. Some 2,000 jobs have been created across the enterprise zones, which contrasts with his party’s stewardship of enterprise zones in England, where the target was 54,000 jobs by 2015 and it seems now that 11% of those 54,000 jobs will be delivered. The National Audit Office has hammered the UK Government recently over its stewardship of enterprise zones. In order to help keep track of progress, Members will be aware that, over the next year, we will be publishing performance indicators and targets for 2014-15. We look forward to publishing the first report against those indicators in the spring of this year. We are more than happy to be scrutinised on the success of the Welsh enterprise zones, compared to the abject failure of those across the border.
 
14:12
Yr Arglwydd / Lord Elis-ThomasBiography
As one who has the privilege of representing the Snowdonia enterprise zone, I see no mystery at all surrounding these proposals and I warmly welcome the developments that are taking place. Will the First Minister agree, following the publication of the excellent report by Sir Paul Williams and his fellow commissioners, that it is now crucial that local government, including planning authorities and national parks, see their way clear to co-operate with the Welsh Government’s objectives when important issues on consents for developments come before them?
 
14:12
Carwyn JonesBiographyThe First Minister
It is exceptionally important that that happens. Some of the major applications fall under a number of local authorities at times. I know from experience that it is not easy to get them to collaborate in order to give a response to any developer. Also, experience demonstrates that local planning authorities in Wales are able to deal with routine applications, but once a major application is submitted, they struggle because they do not have enough planners and they do not have the capacity in the bodies to deal with the major ones. It is important that we have a planning structure that can deliver very swiftly and also considers in detail what leadership is given by the Welsh Government.
 
14:13
Eluned ParrottBiography
First Minister, you have told me repeatedly in this Chamber that the primary purpose of enterprise zones is to create new private sector jobs. However, the KPIs published by your Government suggest that you will publish an aggregate of jobs, created jobs, safeguarded jobs and assisted jobs, and it will not specify that they are private sector jobs that we are talking about. It is still your intention that enterprise zones are there to create private sector jobs?
 
14:14
Carwyn JonesBiographyThe First Minister
They are; of course, they are. That is why we have chosen not just those areas that are easier than others to pull in investment— Deeside being one such area—but we also looked at areas such as Snowdonia, which historically has been difficult to attract investment into. We do not try to look for the easier areas. We want to make sure that enterprise zones are spread out across the whole of Wales. Enterprise zones are there to do exactly what it says on the tin, namely, to promote enterprise.
 
Commonwealth Games
 
14:14
Lynne NeagleBiography
9. Will the First Minister provide an update on proposals to host the Commonwealth Games in Wales? OAQ(4)1436(FM)
 
14:14
Carwyn JonesBiographyThe First Minister
Since December 2012 we have been working with Cardiff, Sport Wales and the Commonwealth Games Council on preliminary investigations to establish whether a bid should be mounted and what the implications would be.
 
14:14
Lynne NeagleBiography
I believe that hosting the games in 2026 could be a huge boost for the country, putting Wales at the centre of world attention for the duration of the games and underlining our growing reputation for organising and hosting global sporting events. First Minister, what is your assessment of the economic benefits that the games would bring to Wales and the sporting legacy that it would leave? Would you ensure that, hardwired into any bid, is a commitment to ensure that places such as Torfaen share fully in the benefits of this potentially fantastic showcase for Wales?
 
14:15
Carwyn JonesBiographyThe First Minister
We are undertaking an analysis of the benefits and costs. Part of that will be informed by the experience that we see in Glasgow later on this year. I have to say that it is a very expensive undertaking—there is no question about that. The figures that we are talking about run into the hundreds of millions of pounds. A rigorous analysis of any benefits would have to be undertaken even if the funds could be secured to host the games. Those are the challenges that we face; the aspiration is still there, but much work needs to be done.
 
14:16
Mohammad AsgharBiography
First Minister, the Commonwealth Games have the potential to project Cardiff on a global scale and bring real jobs and investment to this city and to Wales also. Will the First Minister confirm his support for the bid and will he advise us how many meetings his Government’s major events unit has had with the officials of Cardiff Council and other bodies with the aim of bringing the Commonwealth Games to Wales in 2026?
 
14:16
Carwyn JonesBiographyThe First Minister
There have been many meetings. I have had many meetings over this issue as well. The issue will be further informed following an analysis of Glasgow. As I say, the aspiration remains to look to host the Commonwealth Games, but it is an exceptionally expensive undertaking. There would have to be very clear and demonstrable benefits to Cardiff and the surrounding area—well, not just the surrounding area, but the whole of Wales, actually, because it would be a Commonwealth Games for the whole of Wales—before even considering the next step of understanding where the money might come from, which, again, is not an easy question to answer.
 
14:17
Bethan JenkinsBiography
First Minister, of course I would welcome any bid, particularly if there were an opportunity to contest in our own colours as a nation, but I agree with what Lynne Neagle had to say in terms of the legacy of the games, because we have seen with the Olympic Games that we have not actually benefited a great deal from the legacy of the Olympic Games that took place in England. So, we do need to realise how Wales could actually benefit, particularly as local councils are closing sports facilities or privatising them. The Government must ensure that we, as Assembly Members, understand fully how the people of Wales, and young people in Wales, will benefit from any games coming to this country.
 
14:17
Carwyn JonesBiographyThe First Minister
That is right and that, of course, is why we are considering what the benefits and costs would be. By the autumn of this year, I would say, we will then be in a position to consider the challenges and the benefits.
 
14:18
Urgent Question: The Commission on Public Service Governance and Delivery Recommendations
Y Llywydd / The Presiding OfficerBiography
Thank you, First Minister. I have accepted two urgent questions. On the first urgent question, I ask Janet Finch-Saunders whether she would like to ask the question she submitted.
 
14:18
Janet Finch-SaundersBiography
Will the First Minister make a statement on the implications for local authorities and public service providers in Wales of the recommendations proposed by the Commission on Public Service Governance and Delivery? EAQ(4)0373(LG)
 
14:18
Carwyn JonesBiographyThe First Minister
I refer the Member to the answers that I gave in relation to question 1.
 
14:18
Janet Finch-SaundersBiography
First Minister, ahead of the publication of this report, and following many pre-emptive statements by yourself, there are predictions now of some 15,000 front line staff that are now in limbo, waiting for news on what reorganisation will mean for them. Furthermore, the estimated costs of reorganisation have been somewhat wide ranging, from £500 million by senior figures in Welsh Labour to £200 million from the Welsh Local Government Association, to £100 million by the commission itself. This is a staggering gulf in estimates, First Minister. Now, I know the report—
 
14:19
Y Llywydd / The Presiding OfficerBiography
Are you coming to a question? Immediately, please.
 
14:19
Janet Finch-SaundersBiography
[Continues.]—was only released yesterday. What considerations have you given—[Interruption.]
 
14:19
Y Llywydd / The Presiding OfficerBiography
Order, order. Carry on.
 
14:19
Janet Finch-SaundersBiography
First Minister, what considerations have you given to showing strong leadership by undertaking a full cost-benefit analysis in order to obtain a definitive cost to the taxpayers of reorganisation and to alleviate the concerns of our front-line staff?
 
14:19
Carwyn JonesBiographyThe First Minister
I accept the costings of the Williams commission of £100 million. I see no need to conduct another exercise in terms of a cost-benefit analysis. I do intend that this should move forward as quickly as possible. I urge all those in the Chamber, the leaders, to consult their parties. I look forward, of course, to looking to gain as much cross-party support as possible. I will not, as her leader said in his press conference this morning, be in a position where the ball is in my lap and I should not therefore sit on it. I am not a gymnast. [Laughter.] I intend to take this forward as quickly as possible and I look forward to hearing the views of other parties.
 
Janet Finch-Saunders rose—
 
14:20
Y Llywydd / The Presiding OfficerBiography
Sorry, you have had your question. I call on Rhodri Glyn Thomas.
 
14:20
Rhodri Glyn ThomasBiography
First Minister, I am very pleased to hear you say that you are going to respond positively and swiftly to the Williams commission, because, if that does not happen, councils will be looking to see what partnerships they can form in considering the options that have been proposed by Williams. We need firm and definite leadership on this. Are you confident that you can work to the timetable that the Williams commission has set for you?
 
14:20
Carwyn JonesBiographyThe First Minister
Yes. I want to be in a position by Easter where, in terms of my own party, we have a firm position. In terms of the other parties, I very much hope that the other parties can also express their views. I am not saying that everyone will have the same view, of course, but it is very important that this is progressed now. It is important that we bear in mind, in terms of the Williams commission, that there were, not representatives of, but members of, each party on the commission. I understand that they were not party nominees, but the commission was broad-ranging in terms of its membership. It is now important that parties consider their stance on the commission so that we can progress with this issue.
 
14:21
Peter BlackBiography
May I first of all confirm, First Minister, that there was no member from the Welsh Liberal Democrats on that commission? Secondly, in relation to the commission’s report, you have indicated already that you wish to consult with other parties and get a consensus as soon as possible. What plans do you have to achieve consensus among stakeholders and other people around the country? How will the consultation process on taking this forward pan out?
 
14:21
Carwyn JonesBiographyThe First Minister
First of all, I had not realised that the Liberal Democrat had resigned from the commission. However, it was a wide commission, whatever happened. In terms of consultation, the first step, to my mind, is for the party leaders to talk about this over the next few weeks, to look to get to an established position by Easter. Then, of course, there will need to be some debate as to what process this should be taken through—whether it should be taken through the established legislative process, which means that this would not happen before the Assembly elections, or whether there is a feeling in the Chamber—and this is not something that the Government should push, to my mind, without acceptance elsewhere—that this should be taken through a speedier process, with, of course, the permission of the Presiding Officer. That much is important. Those are matters yet to be dealt with.
 
Then, at the appropriate time, a Bill would be introduced. There would be consultation on the White Paper and on the draft Bill itself. That would then give an opportunity to stakeholders to comment on the principle and then the detail of not just the reorganisation of local government—‘merger’ is a better word, I think—but all of the proposals included in the Williams report.
 
14:23
Angela BurnsBiography
First Minister, the report is silent on democratic accountability. You have just talked about producing White Papers, but will you also be producing a White Paper on how we will be able to elect people to whatever the new councils will be? For example, if Dyfed were to come back, there would be 176 councillors, which is obviously unworkable. Also, what impact will this have on the current legislative programme, which has a lot of work on boundary-orientated organisations, such as the six safeguarding boards in the Social Services and Well-being (Wales) Bill? What work are you doing to see how this might impact on the legislative programme?
 
14:23
Carwyn JonesBiographyThe First Minister
We are confident that this can be dealt with in the legislative programme, should it be the will of the Assembly that it should happen this side of the election. The boundary commission has indicated that it would be able to complete any work on new boundaries by 2016. That is ambitious, but it is something that, I understand, it has indicated to us. Initially, there was a debate as to whether you keep the same number of councillors and then reduce them at the following election, but that introduces a new option, as far as we are concerned.
 
I do not think that the report was silent about accountability. It was far from silent about scrutiny. It talked about the lack of scrutiny that exists in many levels of government and, indeed, in some bodies. It was particularly scathing—I think that is the right word—in terms of the attitude of some public service delivery bodies in regarding inspection almost as an impertinence and not something to be used to improve services. It talks a great deal about the need to improve scrutiny, particularly in authorities where it is suggested that officers have been running them with little scrutiny from members. It also talks, of course, about the need for a leadership academy and further training with regard to scrutiny. That much is important. If we look to reorganise the way public services are delivered, if there is an appetite to merge councils, as I believe there is, then, of course, those issues mentioned in the commission about scrutiny will be equally as important.
 
14:25
Y Llywydd / The Presiding OfficerBiography
Thank you, First Minister.
 
14:25
Urgent Question: Betsi Cadwaladr University Local Health Board
Y Llywydd / The Presiding OfficerBiography
I call on Antoinette Sandbach to ask the second urgent question.
 
Antoinette SandbachBiography
Will the Minister make a statement on the suspension of non-urgent elective surgery in the Betsi Cadwaladr University Health Board area? EAQ(4)0384(HSS)
 
Will the Minister make a statement on the suspension of non-elective surgery in the Betsi Cadwaladr University Health Board area?
 
14:25
Mark DrakefordBiographyThe Minister for Health and Social Services
There is no suspension of non-elective surgery in the Betsi Cadwaladr University Local Health Board area. Indeed, it is precisely in order to strengthen its capacity to go on providing emergency non-elective treatments that the LHB has announced a temporary suspension of some non-urgent elective surgery during this week.
 
14:26
Antoinette SandbachBiography
Minister, it is clear that there is a suspension of some non-urgent surgery currently in place at Betsi, as announced today. Patients in the Betsi Cadwaladr—
 
14:26
Y Llywydd / The Presiding OfficerBiography
I have asked the Minister to reply to an urgent question. It would be helpful if Members listened.
 
14:26
Antoinette SandbachBiography
Patients in the Betsi Cadwaladr University Local Health Board area currently have among the highest waiting times in the whole of Wales. The health board area has the highest number of patients waiting for over 26 weeks and up to 36 weeks for surgery and the highest number of patients waiting over 36 weeks for treatment. In relation to the current announcement, Minister, it cites issues with out-of-hours care and problems of capacity at the health board. Have you thought about announcing extra funding in order to fund a winter care plan—the UK Government has put £500 million into funding a winter care plan—because, clearly, the pressures within the health board are such that it is not able to cope at this time?
 
14:27
Mark DrakefordBiography
It is the case that Betsi Cadwaladr Local University Health Board has experienced particularly high levels of emergency call on its services during the post-Christmas period. It is in order to be able to deal with that effectively that it is temporarily suspending some non-urgent treatments. I regret that, and so does the clinical director in his note to staff and patients. However, it is not an issue to do with funding. It is an issue to do with the pressures that have come on the system, coupled with norovirus, which has led to the closure of wards in north Wales. This is a sensible way of the local health board prioritising the demands that are placed on it in order to make sure that those whose needs are the most urgent are guaranteed to get the treatment that they need.
 
14:28
Llyr GruffyddBiography
Last year, Hywel Dda Local Health Board, of course, decided to postpone elective surgery to concentrate on the expected surge in urgent cases due to winter pressure. Now, it seems that Betsi Cadwaladr, temporarily, perhaps, has followed suit. Will you tell us, Minister, whether elective surgery, or urgent elective surgery, if you prefer, is now something our NHS regards as requiring a winter break?
 
14:28
Mark DrakefordBiography
I do not think that it is possible for Members here to play this both ways. Before Christmas, Members on the bench opposite week after week criticised Hywel Dda Local Health Board for taking the view that, knowing that pressures would come on the system, it should take decisions in advance in order to provide scheduled care in a way that would allow it to meet winter pressures. When Betsi Cadwaladr takes the opposite tactic, and tries to sustain its levels of non-elective surgery, then they wish to criticise the health board for doing it that way as well. It is unavoidable that, if a healthcare system comes under severe pressure from urgent need—very often, of the most frail, elderly people with complex comorbidities who then end up having to stay in hospital for extended periods of time—in order to make sure that those people get the care and treatment that they need, some less urgent treatment has to be suspended for a temporary period. It is regrettable, but it is sensible and it is proportionate.
 
14:30
Aled RobertsBiography
Minister, I think that the point that we are trying to make is that, last Thursday, we were told that there were 4,330 patients in the Betsi Cadwaladr area who had waited more than 36 weeks for treatment. The statement by the clinical director today does not say ‘some’ elective surgery. It states that all non-elective surgery on its three main district general hospital sites, excluding cancer surgery, are suspended for a week.
 
It will be looking at the situation again on Thursday. There is no guarantee in the statement that the situation will not extend beyond next Monday. The fear that we have in north Wales is whether we are looking at a situation where the NHS in north Wales only operates for part of the year for non-urgent cases.
 
14:30
Mark DrakefordBiography
The statement that the Member quotes from is clear that the suspension of non-urgent elected surgery does not include cancer surgery, elective ophthalmology or orthopaedic surgery, which will continue at Abergele, and that this is suspended until Monday of next week. The board will review its position on 23 January and I have instructed my officials to have daily contact with members of the Betsi Cadwaladr University Local Health Board in order to ensure that the planned surgery that it has had to temporarily suspend is resumed as soon as possible.
 
14:31
Darren MillarBiography
Do you accept that the huge reduction in bed numbers over the past decade will have contributed to this problem because there is insufficient bed capacity in some of our hospitals in north Wales, and that, in spite of the plans that were put in place for this winter, the ability to flex those beds has not been sufficient to address the problem and pressures in the A&E departments? Can you tell us what action the Welsh Government has taken to assess whether people who are waiting for operations are themselves, as a result of those waits, putting even greater pressure on our emergency departments because of complications associated with their problems? That is something that, anecdotally, we are told is a problem. I wonder what evidence base you have either to dismiss those suggestions, or indeed to support them, and given that evidence, what action you intend to take.
 
14:32
Mark DrakefordBiography
I disagree with the first proposition that the Member made, but agree with two of the other points that he went on to make. I disagree with the basic proposition that the solution to problems in the health service is more beds. That proposition has been investigated many times and was found not to be the answer. He went on to ask about flexing bed capacity in the short term, during the winter period. I agree with him that more needs to be done in different parts of the Welsh NHS to learn from one another as to what has happened during this winter in being able to open up what is called surge capacity. It is possible that Betsi Cadwaladr has not been able to open planned surge capacity beds sufficiently quickly to deal with some of the pressures it faced over the past week.
 
The issue of whether people who have planned operations cancelled then go on to provide additional pressure into the unscheduled care system is a matter that has been raised in the past, and is one that my officials continue to investigate along with members of local health boards in Wales.
 
14:33
Business Statement and Announcement
Lesley GriffithsBiographyThe Minister for Local Government and Government Business
I have three changes to report to this week’s business. The Business Committee has agreed to schedule a motion to elect Members to Assembly Committees immediately after this business statement. I have postponed my oral statement on local government performance: Blaenau Gwent County Borough Council, and, finally, no questions have been tabled for answer by the Assembly Commission, so tomorrow’s agenda has been amended accordingly. Business for the next three weeks is as shown on the business statement and announcements, which can be found among the agenda papers that are available to Members electronically.
 
14:34
William GrahamBiography
I am grateful to the leader of the house for her statement today. I ask her to ask the Minister for Economy, Science and Transport to make a statement on measures to be taken by the Welsh Government on the present problems and wide-ranging difficulties facing the M4 motorway around Newport. This is obviously before the relief road is built. I note the Minister is in her place today and ask her to bring forward a statement on what is happening at the moment. She will know that delays over the last two days not only show that the southern distributor road is completely inadequate, but that even the most modest improvements would prove to be an impractical solution. Yesterday, the traffic lights failure on junction 28 resulted in 8 miles of traffic, and, today, two lorries crashed in the Brynglas tunnels, most unfortunately, causing terrible delays for all.
 
14:35
Lesley GriffithsBiography
The Minister for Economy, Science and Transport is happy to make a statement.
 
14:35
Rebecca EvansBiography
Yesterday, I was pleased to host what I hope will be the first of many ‘The Guardian’ round-table events here in Wales. We discussed, in quite some depth, malnutrition and nutritional care. In the light of that, I wish to ask for two statements, the first on how the Welsh Government is tackling malnutrition, in the context of austerity, and the second on how nutritional care is being delivered in hospitals and in social care settings, as well as to people who receive their care in the community.
 
14:35
Lesley GriffithsBiography
I am sure that the Minister for Health and Social Services discusses both those topics with health boards regularly. Obviously, it is up to health board to make sure that they have those services within their service for the local population. However, I am sure that the Minister will be happy to make a statement, if he has anything further to add.
 
14:36
Alun Ffred JonesBiography
I would like to have a debate but I will accept a statement from the Minister for Health and Social Services on the care of mental health patients in north Wales. A little before Christmas, the Glan Clwyd Hospital mental health unit was closed completely, because the service was not safe. By now, there is civil war between the staff of the Hergest unit at Ysbyty Gwynedd and the local health board, with public rowing, and a threat once again that part of the unit will be closed. This is a key service for the most vulnerable within our community, and it is in total chaos. As a representative of the area, I should have an explanation from the Government about what is happening, and about how I can ensure my electors that this service is safe.
 
14:37
Lesley GriffithsBiography
As you say, mental health services are very important for some of the most vulnerable people in our society. As a local Assembly Member up in north Wales, I know that we are being kept informed of the action that is being taken by Betsi Cadwaladr University Local Health Board in relation to this issue. I know that the Minister’s officials are working with the health board to rectify the difficulties, and I am sure that we will be updated in due course.
 
14:37
William PowellBiography
Minister, you have no doubt seen the coverage of the recent movements of train rolling stock through the town of Barmouth, given the recent difficulties that were caused by the inclement weather on the Cambrian line. I wonder whether you could liaise with your colleague the Minister for Economy, Science and Transport to keep this house updated on progress. Yesterday, we had information from Network Rail that stated that it may take until at least May to have the service fully restored. I think that it is vital that this house is kept abreast of developments in that area, particularly given the importance of the vital tourist sector in that part of Wales.
 
14:38
Lesley GriffithsBiography
Thank you for that question. The Minister for Economy, Science and Transport has indeed kept us updated, as she wrote to all Assembly Members on 10 January with an update on the impact of the storm damage on transport services, which included the Cambrian coast railway line. Her officials continue to work closely with Network Rail, and the Minister will be happy to provide a statement, as appropriate.
 
14:38
Mark IsherwoodBiography
I call for a single statement on ambulance and hospital emergency department services in north Wales, following the comments by the coroner for north Wales east and central only yesterday. The chief executives of the Welsh Ambulance Services NHS Trust and Betsi Cadwaladr University Local Health Board have said that they have made a number of improvements since the tragic death from heart failure of Mr Pring from Mynydd Isa, Flintshire in March 2013, while waiting 48 minutes for ambulances to arrive, after his wife called for them. However, the coroner for north Wales east and central said only yesterday that unacceptable ambulance delays led to Mr Pring’s death, and that he intends to make reports to the ambulance trust and to the health board advising them of his concerns, and that, unless action is taken, circumstances creating a risk of other deaths will continue to exist. That was stated only yesterday. I would be grateful if you could comment on that, bearing in mind the two Wales Audit Office reports—the first found that the NHS in Wales was the only one of the four UK nations to have suffered a real-term cut in funding, and the second report, produced jointly with Healthcare Inspectorate Wales, found that major corporate governance failings at Betsi Cadwaladr, something that our casework had been warning us of for many years.
 
14:39
Lesley GriffithsBiography
We are very aware of this tragic incident. The Wales Ambulance Services NHS Trust has submitted a summary of its investigation findings, and action that it has identified that requires to be taken on issues addressed by that investigation. For instance, there is going to be the ongoing implementation of the north Wales unscheduled care integrated action plan. It confirms that the ambulance trust and the Betsi Cadwaladr University Local Health Board are working together to address the issues that have arisen from hospital handover delays.
 
14:40
Simon ThomasBiography
Minister, I do not apologise for returning to the issue raised by William Powell; the Cambrian line is very important in terms of the connections between north and south Wales—it is one of the few public transport links that we have. It is currently important for taking children to school, and closing parts of the line has disrupted that. It is also important in the longer term because of tourism. People will be starting to plan and book their holidays, and although the hope is that it will reopen in May, there is no certainty of that. So, I would like to ask the Government to make a statement to tell the Assembly what is being done. There is an emergency conference on 7 February in Porthmadog to discuss this, and I very much hope that Welsh Government officials will be in attendance. In the light of that, I ask the Minister to make a statement in the Chamber on what is being done, and that he also states what the Government will do to ensure long-term defences against storms, particularly on our coastline. We do not want to find ourselves in a situation of this happening again. If there is investment now to reopen the Cambrian line, we must ensure that that is robust enough to keep that line open for the future.
 
14:41
Lesley GriffithsBiography
You will have heard my earlier answer to William Powell. The Minister will be very happy to make a statement when she feels that she has something to update us on. Her officials are working very closely with Network Rail, and they are trying to ensure that this work is done as soon as possible. The point you raise about tourism is very important.
 
In relation to your second point about coastal defences, you will be aware that the Minister for Natural Resources and Food is having a review of coastal defences, and it is very important that that is done as quickly as possible.
 
14:42
Antoinette SandbachBiography
Leader of the house, there are a number of opportunities for young people to go abroad to gain valuable experience on programmes run by the European Union, such as the Erasmus programme, and programmes offered by institutions such as the educational programmes run by CERN for summer students and university students. A cross-party group visited CERN yesterday, and we saw the Alpha project run by Swansea University looking into antimatter. Could we have a statement from the Minister for Education and Skills about the number of opportunities that have been taken up by Welsh students, particularly in the school system, to access the educational programmes available for schools and summer schools, and also in the university system? That will allow us to see how many young people in Wales are taking advantage of exceptional programmes that can provide them with the entry on their curriculum vitae that allows them to stand out when they are looking for employment, and allows them to gain invaluable technical expertise that could help ensure that we can take advantage of changes that will happen at CERN in 2020, for example, to ensure that we have that expertise in Wales and can make the most of it. It would be really good to know how many people have taken up those opportunities in the last five years, and whether more can be done to encourage them to do so.
 
14:44
Lesley GriffithsBiography
I am aware that there are several schemes—you referred to Erasmus—that encourage young people’s participation. I am not sure whether the information that you are requesting will be held centrally by the Welsh Government, but I will ask the Minister for Education and Skills, if he has that information, to make it available to all Assembly Members.
 
14:44
Andrew R.T. DaviesBiography
Leader of the house, I wish to put two points to you today. The Presiding Officer very kindly allowed an urgent question on the Williams commission report yesterday, and I note that the Government has tabled a debate for next week. It is normal custom for the Government to make a statement so that questions can be put to the Government Minister—in this case, the First Minister—as to the Government’s intention and the way to take it forward, including, maybe, some of the flaws—or not, as the case may be—in that piece of work that is up for scrutiny in the statement. I am interested to know why the Government has chosen not to bring a formal statement forward. I thought that, just in the questioning on the urgent question, there were some very valid points from across the Chamber that might not be able to be explored via a debate.
 
The second point is that I was hoping to receive a statement from the Minister for health in relation to selective internal radiation therapy. I have engaged with the Minister in relation to this treatment, which is currently available in other parts of the United Kingdom, but not, regrettably, in Wales. The Minister has indicated that the health service in Wales is proceeding towards making this treatment available, but when I have spoken to clinicians who are experts in this field in Velindre, they seem to be unaware of the progress that has been made. Indeed, they do not seem to have been consulted as to its implementation here in Wales. So, I would be grateful if a statement could be forthcoming from the Minister for health on the time frame for making this treatment available to Welsh patients, and, importantly, on the discussions that are ongoing with the clinical consultants who are dealing with this matter on a day-to-day basis and who, ultimately, will bring this treatment forward in the NHS.
 
14:46
Lesley GriffithsBiography
Thank you for those two questions. In relation to the Williams commission report, we have, as you say, timetabled a debate for next Tuesday, which will be led by the First Minister. In relation to a statement and questions, I will be answering questions tomorrow. I think that I have five tabled questions on the Williams report, so you can ask me questions in relation to that.
 
In relation to selective internal radiation therapy, the Minister for Health and Social Services has asked officials to examine the viability of joining the Commissioning through Evaluation programme in order for certain patients in Wales to benefit from that therapy. That work is in its early stages, but I am sure that the Minister—you mentioned that you were in correspondence with him—will keep you updated.
 
14:47
Y Llywydd / The Presiding OfficerBiography
Thank you, Minister.
 
Motions to Elect Members to Committees
Motion NDM5408 Rosemary Butler
 
To propose that the National Assembly for Wales, in accordance with Standing Order 17.14, elects Alun Ffred Jones (Plaid Cymru) as a member of the Finance Committee in place of Simon Thomas (Plaid Cymru).
 
Motion NDM5409 Rosemary Butler
 
To propose that the National Assembly for Wales, in accordance with Standing Order 17.14, elects Alun Ffred Jones (Plaid Cymru) as a member of the Public Accounts Committee in place of Jocelyn Davies (Plaid Cymru).
 
Motion NDM5410 Rosemary Butler
 
To propose that the National Assembly for Wales, in accordance with Standing Order 17.14, elects Dafydd Elis-Thomas (Plaid Cymru) as a member of the Enterprise and Business Committee in place of Alun Ffred Jones (Plaid Cymru).
 
Motion NDM5411 Rosemary Butler
 
To propose that the National Assembly for Wales, in accordance with Standing Order 17.14, elects Jocelyn Davies (Plaid Cymru) as a member of the Committee for the Scrutiny of the First Minister in place of Elin Jones (Plaid Cymru).
 
14:47
Elin JonesBiography
I move the motions.
 
14:47
Y Llywydd / The Presiding OfficerBiography
I propose that the votes on the motions are grouped. Does any Member object? There are no objections. The proposal is to agree the motions. Does any Member object? There are no objections, therefore the motions are agreed in accordance with Standing Order 12.36.
 
Motions agreed in accordance with Standing Order 12.36.
 
14:47
Statement: Hywel Dda Service Change Plans
Mark DrakefordBiographyThe Minister for Health and Social Services
I am now in a position to make my determination in respect of the proposed level 2 neonatal unit at Glangwili General Hospital, Carmarthen. Welsh Ministers were asked to make a determination on objections raised by the local community health council to proposals for this unit contained in the Hywel Dda health board’s service change plan, ’Your Health, Your Future’.
 
In my statement to this Chamber on 24 September, I explained that the expert panel set up to advise me had asked for a further piece of work from the health board on its plans for local obstetric and midwifery services before it could provide final advice on neonatal services for the Hywel Dda area. That additional work was submitted just before Christmas and shared with the local community health council. Also in December, I decided to ask the expert scrutiny panel to reconvene in order to consider these plans. The panel received assistance in this task from Mr Simon Emery, a consultant obstetrician and Wales representative of the Royal College of Obstetricians and Gynaecologists.
 
Following a series of meetings in the Hywel Dda area, the scrutiny panel has now provided me with its final, subsidiary report and recommendations. The panel is clear that this subsidiary report should be read in the context of its original detailed report, and not as a separate entity. Llywydd, let me therefore begin by reminding Members of some key conclusions from the expert panel’s report of September 2013, in which it said of Hywel Dda that attempting to go on providing
 
‘neonatal special care facilities across all health boards hospitals is neither safe nor sustainable. Even if funds were available to establish teams of specialists at every site where babies are born it is unlikely that there would be sufficient numbers of skilled, trained staff available to recruit, and even if recruitment were possible, their skills will be inevitably, rapidly compromised through lack of sufficient patient throughput.’
 
The panel was clear that the needs of pregnant women and their babies could be safely accommodated without a neonatal unit presence, provided that this was accompanied by emergency cover, staff trained in newborn resuscitation and stabilisation and with clearly defined pathways for in utero and postnatal transfers. The scrutiny panel, following its further work, has concluded that it has not been presented with any additional evidence that leads it to question its original support for the health board’s proposals to develop a level 2 neonatal unit at Glangwili. Indeed, the panel expressly endorses the health board’s intention to move to midwife-led units across the Hywel Dda region. This it sees as vital to the way Hywel Dda neonatal services should develop and improve in future.
 
However, there are a number of important provisos relating to the way ahead that the panel has also set out. First, mindful of the issues raised by local communities and the strength of feeling when changes are made to obstetric, midwifery and neonatal services, the panel feels that it is essential that, until the midwife-led units are fully established, the health board should put in place a robust safety-net arrangement to provide midwives with the skilled assistance they might need in the event of an unexpected emergency. Until the new service model is fully in place, therefore, a suitable level of consultant obstetric support will remain in place in Withybush. It is the LHB’s intention that, during this period, a stratified service, supported by an obstetric rota, will also continue at Bronglais, with high-risk mothers, as now, being transferred to Glangwili hospital for their babies to be delivered.
 
Secondly, in order to help mitigate local public anxiety over additional travelling times and for efficient transfer arrangements, the supplementary report recommends that robust emergency transfer arrangements should be put in place by the health board until its new emergency medical retrieval system and the improved Cymru inter-hospital neonatal transfer service become fully operational. I can tell the Chamber this afternoon that detailed work will now go on, involving my officials and local health boards, to accelerate the introduction of a new round-the-clock emergency retrieval service for Wales, deploying specialised medical staff. The planning for that service will include the capacity to transfer sick babies and mothers in labour.
 
Thirdly and finally, the panel is clear that the midwife-led units must be developed in strict accordance with the guidance provided by ‘Neonatal Support for Stand Alone Midwife Led Units; a Framework for practice’. The combined effect of these provisos leads the panel to recommend a phased introduction of the new service model. I expect the local community health council to assist the health board with the preparatory work to develop pathways and clinical protocols. The panel recommends, and I agree, that this work should start without delay.
 
An essential factor in any maternity model of care is that the mother should be able to make a clinically informed decision on the place of birth. That is what the panel’s recommendations produce and promote. For mothers in the Hywel Dda health board area, these changes will mean that the majority of maternity services, including pregnancy day assessment and pre and postnatal care, will continue to be provided locally by their GPs and hospital, as they are now, and that the majority of women, if they choose do to so, can safely have their deliveries at their local midwife-led unit. These are important developments for the people in the Hywel Dda area. In a further assurance measure, I will commission, through the health board, an independent evaluation of the impact of the revised neonatal services on newborn outcomes and patient experiences in 12 months’ time.
 
Llywydd, I have provided a summary of the expert panel’s advice and recommendations to me in this matter. I am immensely grateful to them each of them individually—Dr David Salter, Professor Neena Modi, Mr Jim Wardrope and Mr Simon Emery—for working tirelessly on this over the holiday period and for undertaking a challenging itinerary of visits to the Hywel Dda area. I am satisfied that the scrutiny panel has conducted a comprehensive examination of the proposals, has reviewed all relevant information and has supplemented that information with meetings with the CHC, the LHB and with local clinicians.
 
I have very carefully considered the expert clinical advice provided, as set out in both their original and subsidiary reports and so now determine this matter on behalf of Welsh Ministers. I endorse the new service model as set out in the panel’s report. I also make it a requirement that implementation of that model is predicated on meeting the provisos identified by the panel and set out in this statement.
 
Llywydd, all change in health services is challenging and gives rise to very strong feelings. The panel’s recommendations are expressly based on what it says provides the best outcomes and experience for mother and baby, and its conclusion is that the new service model will provide an improved service for Hywel Dda mothers and babies. That is the basis on which it has secured my endorsement.
 
14:57
Paul DaviesBiography
May I thank the Minister for his statement this afternoon? However, I rise to respond to this announcement with a heavy heart. Today, I believe, is a bleak day for the people of Pembrokeshire who have tirelessly campaigned and fought to protect vital lifesaving services at Withybush hospital, because the Minister has made it absolutely clear that it is his intention to close the special care baby unit in due course. The decision to close this unit will, I believe, undoubtedly put lives at risk in my constituency, and that now lies squarely on this Government’s shoulders.
 
It seems to me that this decision has been taken without considering a number of crucial factors affecting us in Pembrokeshire. I put it to the Minister that geographical considerations have not been taken fully into account. I note in his statement that detailed work is now going on with the air ambulance service to accelerate the introduction of a new round-the-clock emergency retrieval service. Surely, this work should have been undertaken before a decision like this was made, to ensure that it is safe and sustainable in the future. Perhaps the Minister can tell us why this work has not been done before now.
 
Quite frankly, I do not see how the decision to site the new level 2 neonatal unit at Glangwili hospital meets recommendation 13 of the Assembly’s Children and Young People Committee’s report on the provision of neonatal care in Wales, which states that the Welsh Government needs to
 
‘ensure that local health boards take transport transfer times into account when assessing service reconfiguration plans’.
 
Perhaps the Minister can explain exactly how closing the special care baby unit at Withybush hospital meets this specific recommendation.
 
The constituency that I represent has challenging transport links and, therefore, travelling any distance to obtain emergency treatment will certainly lessen survival chances. The Welsh Institute for Health and Social Care analysis states quite clearly that outcomes improve significantly if patients receive the right care and treatment within the first golden hour of falling ill or being injured. However, for patients in rural areas such as Pembrokeshire, it is highly unlikely that they will receive the right care and treatment within the first hour of falling ill if critical services are not based locally. Quite simply, Minister, that could mean the difference between life and death for the people whom I represent.
 
Given the work currently being undertaken by the local health board and the fact that he intends to commission an independent evaluation of this decision in 12 months’ time, can he confirm that, if these new services are proved to be unsafe, he will reconsider his position?
 
There is also a question about the sustainability of other services at Withybush hospital and the knock-on effect that removing the special care baby unit will have. In recent years, we have seen services already disappear from Withybush hospital—for example, orthodontics and histopathology have already transferred from Pembrokeshire. Can the Minister, therefore, provide cast-iron guarantees this afternoon that there will be no knock-on effects on paediatrics and A&E services following the closure of this unit? The Minister must surely recognise that establishing a new level 2 neonatal unit at Glangwili hospital could take staff away from the paediatrics department at Withybush hospital, which could make this department unsustainable in the future. Paediatrics is absolutely essential to a district general hospital, given that 25% of admissions to an accident and emergency department are children. If the paediatrics department is taken away, children will be unable to be admitted to accident and emergency, which, in turn, could make that facility unsustainable in the future. Therefore, what plans does the Minister have in place to protect these services in the wake of the closure of the special care baby unit? If the Minister cannot guarantee that other core services, such as paediatric and A&E services, are not downgraded, can he confirm that, before further changes take place, another comprehensive consultation process will be undertaken?
 
Given today’s decision, can the Minister also reassure us that the closure of this unit will not affect the recruitment of staff and professionals to manage other services at the hospital? There could well be an impact on recruitment, because doctors and other professionals might well see this decision as a signal to downgrade other services, so clinicians might feel disinclined to join a hospital that they believe does not have a future. Given that the new level 2 neonatal unit will cost an estimated £12 million, surely it could be more beneficial to patients and, indeed, more cost-effective to maintain and improve current services at existing sites rather than centralising these services at one site.
 
The Minister, his predecessor and the First Minister have all talked about the need for safe and sustainable services and said that change should be clinically led. However, the Children’s Commissioner for Wales, in recent correspondence with me, has claimed that these decisions are primarily of a financial nature. Can the Minister clarify whether the children’s commissioner is right? Is the decision to close the special care baby unit at Withybush primarily of a financial nature?
 
In closing, the Minister made it clear at the end of last year that change was coming to Withybush. However, the change that he has announced today could be dangerous and unsafe for the people of Pembrokeshire and will put lives at risk.
 
15:03
Mark DrakefordBiography
Let me begin, as I did the last time that we debated this matter, by recognising the way in which the local Member represents the strong views of people who live in this part of Wales and the respect that I have for the way that he does that.
 
I will take his last point first. Of course the panel directly considered the issue of whether lives would be put at risk and whether the proposals that it was putting to me were likely to endanger the lives of patients. Of course it looked at that, and it would not have made the recommendations that it has made had it thought that that was going to be the outcome.
 
May I take a moment to reflect on the experience that we have in Wales, in Powys, where exactly this sort of model has been in operation now since 2001? Over the last few years, 2,549 babies have been born in Powys using midwifery-led services. Of course, there are occasions when a woman will have opted to give birth in a midwifery-led unit and things, in an unexpected way, turn into an emergency. That has happened in fewer than 4% of those cases. Every one of those cases then requires that woman to be taken, in an emergency—and in Powys’s case, lengthy distances—to the hospital where she will get the care that she needs. In not a single one of those cases has there been a risk to the life of the child or the mother. We have the experience in Wales. We know that it can be done. Of course, I would not be coming to this Assembly if I thought that the proposals that I was endorsing really did put lives at risk in any way. I give the Member an assurance that, should it be the case that, at the 12-month point, an independent review demonstrates that the new service model is—to use his word—‘unsafe’, any sensible person would, of course, want to revisit that model.
 
I do not know whether there is anything that I can say to the Member on the slippery slope theory: that this change will lead to another change, and yet another, and will end up with nothing being left in place. However, I can say to him that I am confident that Withybush hospital will continue to serve its local population; it will continue to have a secure and significant place in the health services that are provided in that part of Wales. It was only last week that I made an announcement of further capital investment in services at that hospital. I think that the recruitment of staff will be made easier for these services as a result of this announcement. It was only last week that we held a debate here where it was suggested around the Chamber that uncertainty was leading to difficulties in recruitment. I am providing certainty for the future of these services today.
 
Finally, on the issue of the financial matter, financial considerations played no part in the panel’s deliberations. It was looking to see what safe and secure service for mothers and babies in this part of Wales could be provided for in the future.
 
15:08
Rebecca EvansBiography
Minister, I think that most people accept the evidence, which suggests that standalone midwife-led units for low-risk women are safe. We saw that in the recent maternity clinical reference group’s position paper on midwife-led care, and the Cochrane Library review, which found that maternity care delivers better outcomes for those low-risk women under a midwife. What really frightens people about these proposals are those rare cases where a woman who has been identified as not at risk suddenly develops unexpected complications. So, according to the evidence, Minister, how often would you expect women to find themselves in that situation, under the new system? What solid reassurance can you offer them about their safety and that of their baby?
 
The panel refers to a safety net. What does that really mean, in practical terms? It also talks about ‘phased implementation’. What would the timescales and milestones be for that phased implementation? Also, what really needs to be in place before any change at all takes place?
 
You referred to looking to Powys for lessons. What have you learned about how geographical challenges are dealt with in Powys, and how does that impact on how the emergency retrieval service might work in Pembrokeshire?
 
I note your response to the questions on the impact on other services at Withybush hospital. I just seek your reassurance and your guarantee, Minister, that you have had no evidence to suggest that these proposals might negatively impact specifically on A&E, because that is an issue that has been drawn to my attention many times.
 
I must also ask you about the impact of the proposals on Glangwili hospital. Specifically, are you satisfied that Glangwili has the expertise for a level 2 unit, or are we looking at another difficult and protracted round of recruitment? Does the hospital even have the physical capacity to deliver anything more than it already does? I cannot see that there is much spare physical space in the hospital, or much room for it to expand. The expert panel refers to the need to for additional labour ward, theatre, antenatal and postnatal capacity. Are you sure that there is the capacity there to do that? In your previous statement, you said that you would expect the level 2 unit to comply with all modern standards, including parental accommodation. Is that still your intention? What investment would be needed to make that happen, and what would the timescales be? The neonatal services at Morriston would also impact on services at Glangwili. Is there a danger that Morriston might make a level 2 unit at Glangwili unsustainable in the long term?
 
Finally, Minister, how do you respond to concerns about the impact that these proposals might have on an already stretched ambulance service?
 
15:11
Mark DrakefordBiography
I will take some of those questions in order. Rebecca Evans is absolutely right to point to the very recent Cochrane Collaboration review of maternity-led services. Not only did it conclude that midwifery-led services had advantages over other forms of provision, but it also concluded that the risk level of births in midwifery-led units could be raised safely and successfully. So, there is more scope within these units for more births to be conducted in the future.
 
The Member asked me about the safety net that the panel set out. I have already mentioned two aspects of it. At Withybush, while the midwifery-led unit is being established and matured, a level of consultant obstetric cover will remain in place. I expect that to be there for at least the next 12 months. It will provide the safety net to make sure that, should midwives come across cases that, in those early establishing days, they do not have the confidence or competence to deal with, there will be consultant obstetric cover available to them. At Bronglais, the existing provision will continue during this safety-net period, and certainly into the period during which the piece of work that has been set in hand to look at the future of services across that middle part of north Wales will have a chance to consider this issue and to report on its work.
 
What have we learned from Powys? Well, we have learned some of the things that I mentioned earlier. There, fewer than 4% of births that are intended to be carried out in a midwifery-led unit end up in an emergency transfer to a hospital setting. What have we learned in terms of those transfers? We have learned that they can be carried out successfully, because they are carried out successfully every week of the year, and in some challenging terrain as well. This can be done. This will require additional expertise at Glangwili. The panel was in favour of Glangwili because it believes that recruitment there will be more successful. It will require physical capacity at Glangwili as well. I expect the level 2 unit to be built to modern standards. There is money in the Welsh Government capital programme next year set aside against exactly this development. Regarding Morriston, it is possible that, in the future, there will be further developments in other parts of Wales. The panel draws attention to this. It says that we will need to keep the whole of these services under review as patterns of service change in the future. However, we have to attend to the here-and-now needs of the population of Hywel Dda, and that is what today’s decision does.
 
15:14
Simon ThomasBiography
I would like to thank the Minister for his statement today. I begin by accepting this it is not his intention or that of the panel to establish a system that would, in any way, endanger the lives of expectant mothers in west Wales. I also accept what he has said about regimes that are midwifery led, and how successful they can be. I also accept his fundamental point that the purpose of all of this work is to ensure that mothers can make a decision as to where to have their children on the basis of full clinical information, full clinical advice and, I will add to that, equal access to services also.
 
Having said that, he will know full well that many people, particularly in Pembrokeshire, will be exceptionally disappointed with his decision and will feel very angry about it. One of the reasons for that is not the content of what he has said, but the context, because so many statements made by the health board in the past have been proven to be false, and have not come to fruition. Many people in the Hywel Dda area now have a lack of trust in the clinical leadership of the current health board because of the way that it runs its services, for example, the case that I was asking the First Minister about earlier, where it cuts a service temporarily and then, a year later, that service is not re-established. That is the context as to why people are so uncertain and lack confidence in what the Minister has said today.
 
I really want to ask some more detailed questions, not so much on the statement that the Minister has made today, but on the accompanying material that he sent to us, and particularly the letter from the panel to the Minister, which I think has some worrying caveats in setting out its recommendation that this issue should be taken ahead. There is a long list of some dozen extremely important points that are not yet in place for this service to be safe. These are what you describe, Minister, as the safety net. I want to put it to you that, before we venture down this road, we have to be absolutely certain that this safety net is not only in place, but is robust and able to deal with the changes coming forward.
 
Let me put a couple of these to you if I may. First of all, there is the concern, very clearly expressed at the top of the letter, at the lack of contingency planning for emergencies. There is no more explanation of that, but it is a shocking statement in itself, and I really need to ask you: have you satisfied yourself that that contingency planning is now in place?
 
The second is around what you said, and have already referred to, about the transfer of patients, and particularly the air ambulance. When we undertook the Children and Young People Committee review of this, we had quite a bit of evidence to say that air ambulances were not in fact very good at transferring either mothers in labour or neonates. Have things changed? Do we now have an air ambulance system that can do this, day and night, in all weathers and at all times? I did not think that we did. Your decision seems to be predicated on that happening, yet the letter suggests that there need to be improvements in the transport system before it can happen.
 
Third is a point that you have already referred to, but I want to come back to it because I do not accept your response to Rebecca Evans: the fact that developments are happening in Morriston that may impact on the decision to place this new unit in Glangwili. Let us accept that we need a unit in Hywel Dda, for a start, as recommended by the Children and Young People Committee, but why Glangwili? If Morriston is going to develop, that will undermine Glangwili, particularly as regards recruitment, I would suggest. If you say that recruitment is better in Glangwili than it can be at Withybush, then the inference is that it will be even better in Morriston than it can be at Glangwili. You said that we have to make decisions for here and now, and that is for the future, but according to the letter you have received from the panel, there have been no meaningful discussions between Hywel Dda and Abertawe Bro Morgannwg. How on earth did we get to a situation where we are planning nationally, surely, for neonates, level 2 and other levels of concern, and there have been no such meaningful discussions? You are taking a decision on the basis of something that the two health boards have not discussed, and I think that is quite shocking.
 
The final point that I wanted to raise on what is contained in the letter—there are many more points, but I do not have the time—is the reference to the work of the obstetricians, who the letter says must be there to support and not interfere with midwives. That is quite a strong statement. It is even stronger when you go on to read that that support is not there. The panel does not find that support there. There are all kinds of implications about the relationship between midwives, obstetrics and so forth that it is probably beyond my pay scale to go into, but it is not there now, and the panel says that it has to be there before we can move to this system. On what basis are you taking the decision today without being absolutely sure that these healthcare professionals are working in a much more joined-up way?
 
My final question is about something you said in your statement. You said that the majority of women can safely choose to have their deliveries at their local midwife-led unit. If we look specifically at Withybush, the letter to you states that the midwives themselves make the assessment that the number of deliveries at Withybush will fall from 1,200 a year to 350 under the new arrangements. That is not a majority in any way, shape of form. Making statements like that, Minister, which are not borne out in the evidence, is what leads people to have a lack of faith in the decisions made on their behalf.
 
15:20
Mark DrakefordBiography
I will start by thanking Simon Thomas for his initial comments and what he said about midwives. I agree entirely. I will return at the end of my contribution to what he said about providing options for mothers in this area. I recognise that there is a major piece of work to be done by the health board to rebuild its relationship with local communities. I have asked the Welsh NHS Confederation to assist the health board in that particular endeavour.
 
I turn to the panel’s letter. I will say, to begin with, that it was my decision to publish the letter alongside the report. The panel did not write the letter to me necessarily for publication, as it did its public work in the report itself, but I felt that it was important for people to see the whole picture. I would rather that we were able to debate and discuss here the things that the letter said, rather than for people to feel in some way that information had been kept from anybody.
 
I will respond to some of the points that Simon Thomas raised on that letter. It is because of the panel’s concerns about contingency planning for emergencies that it put such an emphasis in its report on the need for safety-net arrangements. It says, and I have said this afternoon, that having those arrangements in place is a pre-condition of this plan going ahead. I have tried to outline some of the practical measures that are already being agreed to make that contingency planning real.
 
As for the emergency retrieval service, we will be in discussions with the air ambulance service. There is more to do to explore with it the part that it might be willing and able to play. It already has a helicopter capable of flying day and night, around the clock. There are developments that mean that more can be done in terms of transporting very small and sick babies, and mothers in labour, by an air ambulance service. We have not concluded those discussions. I did not imply that, I do not think, in my statement. What I said was that those discussions are going ahead and going ahead on an accelerated basis.
 
I cannot wait for developments that may happen six or seven years hence. There is an immense frustration among clinicians in the Welsh NHS at the way in which reasons are always found to delay a decision and not to take things head on. I said when I became Minister for health that I thought it was my responsibility in my first year to try to bring the three major reconfiguration exercises in Wales to a conclusion. I understand that there will be many people in Pembrokeshire who are anxious at the decision, but I believe that a decision is better for them than continuing uncertainty and years more of arguing, wrangling, claims and counter claims, and difficulties in recruiting staff—as Plaid Cymru focused on last week—when that uncertainty undermines the confidence of potential recruits in the future of a service. There have to be meaningful discussions between health boards and that will happen.
 
I will move to the final point because it was an important one. I was careful in what I said in my statement not to mislead people in any way. What I said was that midwife-led units are capable, according to NICE guidance and other expert advice, of accommodating between 50% and 60% of births, but the fundamental point is the one that Simon Thomas made, which is about mothers’ choice. The figures in the letter tell you what midwives in Withybush think that mothers will choose when that service is up there to begin with and that is less than half—only a third of women in Cardiff choose to use the well-established midwifery service that is available to potential mothers in Cardiff. More of them choose to use the other service. However, the figures show, and that is what I said in my statement, that between 50% and 60% of births can be safely accommodated in midwifery-led units. It is my belief that as these units become established, gain reputation and show what they can do, the figure in that letter will grow.
 
15:25
Kirsty WilliamsBiography
Regardless of what the Minister says today and what academia and experts may say, I believe that the decision will be a bitter blow to the local population. While I agree that midwife-led units offer a very good service, it is clear from the letter that a majority of mothers who have previously delivered their babies in Withybush will now have to travel to deliver their babies. That is not only because they are high risk, but—you are right, Minister—because of the very real choices that mothers make. I do not want to pull rank with the Minister, but, believe me, the availability of a full range of pain relief is something that weighs very heavily on an expectant mother’s mind.
 
It is simply counterintuitive to tell people that to travel further away for a service will give them a better service, because all of their instincts tell them something completely different. As we have just heard, the scrutiny group’s letter—and I welcome the fact that the Minister has taken a very positive decision to make that letter available—raises a number of concerns for me about the robustness of how the Hywel Dda board has developed its plans, especially with regard to emergencies, and indeed its ability to deliver on its proposals. Far from being reassured that these changes will lead to a better service, I am sure that many parents-to-be in Pembrokeshire, when they read this letter, will not be reassured and will feel let down.
 
The Minister has been very kind to highlight the issue of Powys and the fact that, in Powys, we have had a midwife-led service since 2001. It is true; it is a very good service and it serves the women of my constituency very well indeed. The number of emergency transfers is limited and I am not aware of a single case where an emergency transfer has resulted in a tragic outcome. However, the Minister has been slightly cute, Presiding Officer, because the situation was slightly different in Powys. At the previous units, at Brecon, for instance, babies were not delivered by obstetricians; they were delivered by GPs who had an interest in obstetrics, who were carrying out caesarean operations with one GP doing the surgery and one doing the anaesthesia. I am sure that all of us can agree that, in hindsight, it was the right decision to move to a midwife-led service.
 
The Minister was asked earlier about the lessons that we can learn. What is absolutely crucial, and what we learnt in Powys, is that midwives who have been operating under supervision—either, in the case of Brecon, under the supervision of GPs, or, in this case, under the supervision of obstetricians—have done their midwifery skills in a different way. They will require a great deal of training, support and reassurance as they use their midwifery skills in a different way. That takes a lot of time and resource to give the midwives the confidence that they will need in order to move to a very different system, where they will be professionally autonomous in terms of making those decisions and will not be doing so under the guidance of obstetricians. I too am very concerned to hear that the relationships that currently exist are not positive ones. I would like to hear what the Minister and the health board are going to do about that.
 
With regard to retrieval systems, with all due respect, Minister, we have been hearing for years about the need to improve retrieval systems. Every time we discuss the issue of neonates and neonatal services, the Government says that it is working really hard to develop a really first-class retrieval system, and every time we debate this subject, which we have done over many years in this Chamber, the Minister says, ‘Oh, we need to do more’. When do you think that you as a Government will be able to say definitively that we have a robust retrieval system? We have talked about it for years and years and we never seem to get there.
 
I am particularly concerned about the role of the air ambulance in this. It does an amazing job and I know that the Government gives money to that service in terms of paying for salaries. However, those ambulances stay in the air because of the tin-rattling and the charitable efforts of communities the length and breadth of Wales. Surely, if we are asking them to take on this kind of role, we should re-examine the relationship between the air ambulance service, the Welsh ambulance service, and the Welsh Government. I would be grateful to hear the Minister’s views on that.
 
The Minister says that capital money will be available next year for the development of the new tier 2 services in Carmarthenshire and the whole letter raises concerns about Hywel Dda’s prospective timetable of moving to this system by 1 August of this year. Could you tell us definitively when you expect these new services to be in place? Finally, the letter also says that there is an assumption that the three MLUs can be developed and made fully operational safely at the same time. Could you give us a hierarchy of when these services will be delivered and can you once again clarify to us what that statement means for services at Bronglais hospital above and beyond those that can be delivered by midwives?
 
15:31
Mark DrakefordBiography
I fully accept what the Member said at the outset and certainly bow to her greater expertise in the way that women actually make decisions in these sorts of areas. The panel’s advice to me in its September report was that only 10% of women needed a level 2 service, but we know, and those are the figures partly reflected in the letter, that women will choose differently from what is perhaps strictly necessary clinically. We must plan on the basis of what women will choose and what women will want. Women in this part of Wales will have all the different tiers of service in a stratified service available to them. Choices will, I believe, change over time as people come to see the service that they have there on the ground.
 
It may be counterintuitive to say to people that you sometimes get a better service by travelling further, but, even if it is counterintuitive, we know very well that that can be true. I am not going to repeat what is by now the hackneyed story of the footballer who dies on the football pitch and is then driven past three hospitals in order to get to the one that actually saves his life. However, that is a true example, and sometimes going further will be better. Part of what the panel has done, I firmly believe, is to introduce a greater degree of robustness into the plan that Hywel Dda first put forward, which is why I am so grateful to it for the work that it has done. That is why I have said in my decision today to the health board that, while I give it the go-ahead for the new service model, that go-ahead is predicated on it delivering on the requirements that the panel has set out.
 
While the transition in Powys may have been different, when I look back at the Brecon midwife service and its establishment at the beginning of the last decade, I am not necessarily remembering that it was that much easier. Of course, Kirsty Williams is absolutely right that midwives need to have the new skills that they will need to carry out these new jobs. I know that one of the things that the panel was most impressed by when it went to Withybush was the determination, skills, the enthusiasm and commitment of the midwives that it met there. It does point to some relationship issues that exist between different groups of staff and I believe that, by making this decision today and drawing this to a conclusion and making sure people know what they have to face in the future, some of those relationship difficulties will now have to move on and improve.
 
The capital is there for next year, and we will deploy it as those plans are confirmed. The panel was clear that there is a path here and a staged implementation of this plan; not all midwifery-led units can happen at the same time.
 
Finally, as far as Bronglais is concerned, I will simply say what I have said in answers already: Bronglais will remain a stratified service, supported by an obstetric rota, and mothers who are considered to be at high risk will be transferred to Glangwili hospital to deliver their babies, as happens now.
 
15:35
Y Llywydd / The Presiding OfficerBiography
Thank you. I do understand that this is a very important statement, of particular geographical reference. The Minister gave a very detailed presentation originally, and we have had four very detailed sets of questioning, and four very detailed replies. I still have some speakers, and I am just going to ask you now to ask new questions. If you do not ask new questions, I will cut you off, because I hope to get through everyone, and we are already 20 minutes over the allotted time. I call on Angela Burns.
 
15:36
Angela BurnsBiography
Thank you, Presiding Officer. Minister, trust and safety are the two most important things for any new mother and any new child. We need to have trust that we have good, safe systems in place. So, my question to you is actually very simple; I had a whole list of questions, but those have been asked by everyone else, and I thank Members for those questions, and I thank you for your answers, Minister.
 
My question is really simple. Minister, I would like your undertaking that you—and I mean you personally—will keep a watching brief on this over the next few years to come. Why do I ask you this? It is because Hywel Dda has three traits that are unpleasant and that are highly evidenced. The first is that it has a tendency to shut things and then put the solution in afterwards. Although you, your report, and your statement, say that alternatives will be put into place, that safety nets will be put into place, and that transportation arrangements will be put into place, I would like my constituents to know that the Minister for health of Wales is actually keeping an eye on this.
 
The second reason is that Hywel Dda has proven itself to be quite incapable of recruiting people and implementing positions and process. It has taken four years to take an oncologist on board, and that person is still not in place. Again, so much of this is predicated on those other things being put in place, Minister, and I would like you to keep that watching brief on behalf of the constituents.
 
The third and final reason is that the trust has been woefully poor at maintaining an honest and transparent communications strategy. If we are to convince all those people who stand outside Withybush Hospital on Saturdays and Sundays protesting—because people love their hospital, have trust in the hospital, and know that it is safe for them—it is going to take quite something to persuade them elsewhere. So, in order for them to believe all of this that we have talked about today, they need to have a really excellent communications programme that is very clear to them. Minister, I think that that will only happen if it is driven from the very top of Welsh Government, and I would ask that you keep that on board.
 
I have one last comment, Presiding Officer. The slippery slope argument—the local health board has already started talking to the CHC about the future of paediatrics. That is why people worry about—
 
15:38
Y Llywydd / The Presiding OfficerBiography
That is not an issue for this afternoon. I call the Minister.
 
15:38
Mark DrakefordBiography
On trust and safety, I think that the announcement that I have made this afternoon is predicated on a safe service being provided, and that is something that I think that I have been able to do. Angela Burns is right about trust. Trust is something that the health board does have to work hard at to rebuild with its local population. By chance, I have myself a long and current family relationship with Haverfordwest; I am a freeman of Haverfordwest—
 
15:39
Kirsty WilliamsBiography
Then we know what is wrong with it. [Laughter.]
 
15:39
Mark DrakefordBiography
Can it be rescinded? [Laughter.]
 
Of course I will keep an eye on this—I will do more than keep an eye; I will take a close personal interest in the way that all of this develops while I am the Minister for health. I give that undertaking.
 
15:39
Joyce WatsonBiography
The first thing that I want to say is that I live in Haverfordwest. I understand the concerns that people have out there, and the real anxiety and fear, quite frankly, behind any decision to change.
 
You have been asked several times today, Minister, about planned care, and you have answered by saying that that will undoubtedly put pressure on Glangwili, but, even with all the very best planning in the world, you can never anticipate the emergency that happens. That was the situation that I found myself in when I was having my son. Within 15 minutes, he was born. Had he not been born, I doubt very much that he would be here now for me to tell you that story. I also doubt very much that I would have been here looking as healthy as I do. So, given my own personal experience, which I do not usually bring to the Chamber—in fact, I do not think that I have ever done so before—I have to ask you a question, which I know you will give an honest answer to, because I have no doubt that it is what you will do: are you happy, Minister, that the plans that are here will satisfy a situation like the one that I have just described, in all cases?
 
15:41
Mark DrakefordBiography
I recognise very strongly the way in which the Member understands and represents the views of people who live in Haverfordwest, and I have been able to be at Withybush hospital with Joyce Watson in the past summer to look at services there. What I say is this: the best advice available to me says that the decision that I have made today will provide a long-term safe service for mothers in west Wales, it will provide a service that they can rely on and a service that will last. It has to be built up and the safety of it has to be paramount. That is why there are conditions in this. However, I very firmly believe that the package that we have put on the table in this statement today will be one that does everything that the Member has asked of me.
 
15:42
Elin JonesBiography
Thank you, Minister, for the statement. The statement, and your decision today, states that, in the long term, you would wish to see midwife-led services only at Bronglais hospital. That is different from the recommendation of the health board for a consultation in west Wales just some months ago, and, indeed, is very different from what you told me last September in the Chamber. When you announced this work, I asked you whether Bronglais would be considered as part of this review and you stated very clearly that you would not open up the issue of Bronglais:
 
‘The issue of services at Bronglais hospital has not been referred to me by the community health council because it has reached an agreement with the local health board... Nothing in what I have said today should be taken as casting any doubt on that agreement for opening up an issue that has not been referred to me for consideration’.
 
Yet, today, you are telling us that you are stating that there will be a midwifery-led service in Bronglais, which is different. It will be a shock to the local community to hear you saying this on the floor of the Chamber today without there being a specific consultation with local people on this kind of service. I ask you to explain why you have taken such a far-reaching step in relation to the service in Bronglais. I have heard what you have said about the timing of that service, and I know that you intend to wait until the independent report provides you with further advice. However, this will be a shock to the community. The distances in the context of Bronglais are so much greater than the distances in the context of almost any other community in Wales. Therefore, the people in the Bronglais area deserve a further statement from you, I would say, on exactly what sort of service they can expect in the short term, as well as the long-term service, for that area.
 
15:44
Mark DrakefordBiography
I thank Elin Jones for raising that important set of issues, and I recognise and accept that the advice that the panel has given to me has altered in that respect between its original report and what it has said in its subsidiary report. Back in September, it made no observations about any change at Bronglais. However, you will recall that what it said it needed before it could give the go-ahead to the new service model was further information and assurance from the local health board about the wider pattern of maternity care services. In that wider pattern and the extra information that the LHB has provided it is the LHB that has said to the panel that it sees, in the longer term, a midwifery-led service at Bronglais. That is what I reported in my statement because the panel endorses the health board’s position. However, because it is a departure from what was said here in September, I have tried to be clear this afternoon. I really hope—there is no need for the local population to be alarmed at what the statement says because what I am trying to be as clear as I can about is this: for the foreseeable future the service at Bronglais will be exactly the same service that is there now. No changes will be made in this service at Bronglais until the independent piece of work that is being commissioned, looking at services across the top of that mid part of Wales, has reported. Its report will cast a further reflection on these services and their future. It may be that in the future the local health board’s plan, as endorsed by the panel, will come to fruition at Bronglais. However, we are not at that point today. In the safety-net period of 12 months and beyond I believe that the current service at Bronglais will continue and there will be a whole new set of important work done that will provide a new context in which that longer-term future to which the Member referred will be shaped.
 
15:46
Y Llywydd / The Presiding OfficerBiography
Russell George has indicated that his questions have been asked. Therefore, thank you, Minister.
 
15:47
Statement: Local Government Performance—Blaenau Gwent County Borough Council
Y Llywydd / The Presiding OfficerBiography
This item has been postponed.
 
15:47
Statement: Improving the Energy Performance of Buildings in Wales
Carl SargeantBiographyThe Minister for Housing and Regeneration
In July and September last year, I published written statements concerning the stimulation of house building in Wales and proposed changes to the 2010 building regulations. Both statements outlined details of my plans to improve the energy efficiency of all buildings in Wales. The decisions contained within these statements were arrived at following an extensive consultation and engagement process that concluded at the end of 2013. I am pleased to announce to you today that the review of Part L of Schedule 1 to the building regulations is complete, and this week I will sign the amendment regulations to make these plans a reality. Addressing climate change is a key Government priority, and building regulations are a crucial tool for tackling greenhouse gas emissions in the built environment.
 
We previously consulted on ambitious plans to use the building regulations to reduce these emissions by 40% compared with the 2010 building regulation standards. The consultation responses that we received were largely supportive of our proposals. However, they also pointed out the potential for unintended negative consequences. In the case of new homes, there were concerns that increased standards would mean increased costs at a time when the housing market was still recovering from the crash of 2008.
 
House building is an important element of the Welsh economy and I was mindful of the negative impact that changes at the time might have had on the housing and labour markets. With this in mind, I decided to implement a revised energy efficiency target, equivalent to an 8% improvement on 2010 targets for all new homes in Wales. Although this is lower than the previous preferred consultation target, I believe that it represents a practical and logical step that will improve our emissions’ position. This is because the 8% improvement for new homes will align building regulations with the existing planning guidance, namely technical advice note 22. My July statement indicated my intention to review technical advice note 22, looking to simplify and reduce policy burdens now that we have the power to make building regulations. However, there will be no let-up in the sustainable agenda. TAN 22 has been useful in raising the profile of sustainability in the building environment. We will now look to embed the key criteria that the Building Research Establishment environmental assessment method and the code for sustainable homes provide for within existing policy tools, including building regulations.
 
It is not just new homes that will benefit from the changes to the building regulations. We have also made significant improvements to how we regulate building work in existing buildings. From July this year, buildings subject to extension or integrated conversion will be required to undertake consequential improvements. That will mean that, as part of our changes to the building regulations, any extensions or integrated conversions will be required to meet improved standards of fabric efficiency. That means that if you are building an extension, it will not be acceptable to simply build it to the same standards as your existing property. You must build it from materials that are as thermally efficient as any new home in Wales. However, even with these improved fabric standards, the increase in a building’s size will almost inevitably mean an increase in its energy consumption.
 
The introduction of consequential improvements will mean that when a building is extended or subject to an integrated conversion, the original building will also be subject to energy efficiency improvements. For homeowners, this could mean installing loft, cavity or hot-water insulation. However, we would only expect them to do that where it was cost-effective and suitable to do so. For non-domestic buildings, all extensions, regardless of size, will require the owner to spend 10% of the total extension cost on making suitable improvements to the original building. Currently, the requirement applies only to buildings over 1,000 sq m.
 
Moving on to non-domestic buildings, I have decided that we will press ahead with our plans to reduce the emissions of all new non-domestic buildings by 20%. This improvement will be achieved through a mixture of improved fabric and building standards. It is also likely to require renewable technologies such as solar panels. Non-domestic buildings include hospitals, schools and factories. These buildings are responsible for around a fifth of all greenhouse gas emissions in Wales. Improving the efficiency of new non-domestic buildings represents a significant step forward towards our ultimate goal that all new buildings in Wales will be nearly zero energy by 2019 for the public sector, and 2021 for all new buildings.
 
This goal has been set by the European energy performance of buildings directive. It has created a legal obligation for us to reduce our buildings’ carbon emissions. These changes to the building regulations represent an interim step forward to meeting these obligations. I plan to review Part L of Schedule 1 to the building regulations again in 2016. I will continue with that. As with the changes that I have described to you today, the review will be subject to a full public consultation. We will also seek guidance from the Building Regulations Advisory Committee for Wales.
 
The final objective is clear: from 2021, a new building in Wales will be zero carbon or nearly zero energy. These changes to the building regulations represent a significant step forward today towards realising those objectives.
 
15:53
Russell GeorgeBiography
I thank the Minister for the opportunity to scrutinise this policy decision. The first thing that struck me when the initial announcement was made in the summer was the stark difference between the ambitious proposals set out in the consultation document, which I thought were very detailed and comprehensive, compared with this final analysis and announcement. The Government inflated expectations prior to the devolution of building regulations in 2011 about what it intended to do with them. In 2012, the Government claimed that new regulations were going to achieve a 55% improvement in energy efficiency over the 2006 levels, and 40% over the 2010 levels, which was consistent with the goal set out in the current programme for government.
 
You have said repeatedly that you took the final decision based more on socioeconomic consequences, rather than on solely environmental ones. I understand that the industry, directly and indirectly, has raised concerns, but I would like to understand why the gap between what was initially proposed to what we have today is so great.
 
We are now in the position where we have two very different regulatory environments between Wales and England. The UK Department for Communities and Local Government made its announcement on 30 July while introducing 2014 standards, which are similar to the new Welsh ones. However, it stresses that zero-carbon homes will be built in England from 2016. I know that the industry is also concerned with the 2016 target in England, but do you believe that having a lower target in Wales—considering that you are setting out baseline requirements to move to those new build EU targets of nearly zero by 2019 and 2021—will stimulate more building development in Wales, particularly new domestic developments? If you believe that it will, do you feel that there is an opportunity there to work with the industry and, perhaps, the social rented sector to pilot some zero-carbon developments in targeted communities across Wales, which may go some way to return to the Government’s original aspiration for building regulations?
 
Finally, while I understand the desire to factor in renewable technologies to new developments, which will go some way to making buildings more sustainable, I am a big believer that energy conservation goes before energy creation. All you are potentially doing, if standards are not suitably robust, is losing that energy that you will generate. That is why I would like to see the gap in terms of energy efficiency between building design and development performance narrowing, ensuring that targets that are set for developers are not just achieved, but exceeded. How will the Government be persuading developers to undertake more performance measurements during the construction phase, ensuring that standards are being complied with, and that stated design performance is being achieved?
 
The Deputy Presiding Officer (David Melding) took the Chair at 15:54.
 
15:56
Carl SargeantBiography
I thank the Member for his questions, although I am slightly surprised by the content of his contribution this afternoon. When I came into post as Minister for Housing and Regeneration, it was obvious to me from all quarters of the political representation here, as well as from external bodies in the private sector, that there were pressures within the housing and construction industry. I took a very strong position in terms of reviewing policy, not only on building regulations and energy conservation, but on the building supply opportunities that we are currently looking at. In terms of that process, the consultation document that the Member refers to was purely a consultation document. Of course, there were Government aspirations to deliver on the target, which was a European directive target, and we are still ambitious enough to be able to look to deliver on the same scale as the English model to which the Member refers.
 
On the basis of economic challenges, the Member tried to make some comparisons between England and Wales. I recognise that the Member is within his right to do so, but he should also recognise the additional challenges that we face in Wales in terms of the construction industry itself; the viability of land opportunities in Wales is a lot lower than in the markets of the south-east of the UK. The construction industry has to consider that in that process.
 
My decision to reduce the journey time of change for energy conservation and energy performance has been welcomed by the industry. I would hope that the Member would reflect on his challenges and that he would also welcome the private sector wanting to support these proposals. It is still my intention to move forward with the target date of 2020, as I mentioned in the opening part of this debate. The Member will, I am sure, welcome the opportunity to review the performance targets in 2016, when I look again at Part L in terms of what that could mean for the reintroduction of a new target in 2016, subject to market conditions. I think that that is a wise move in terms of looking at how the sector is doing economically before we pile more challenges onto it and before we try to achieve targets that prevent and prohibit new opportunities for development in Wales, while seeking to have a balance between the environmental and energy performance that we strive to achieve.
 
15:59
Keith DaviesBiography
I have something important to raise with you today, Minister. Swansea University has been working with the metals sector for around a century now on worldwide research that leads to developing new products. Lately, the university has worked with Imperial College London and Bath university and Tata and Pilkington companies. The research is developing glass and steel products to be incorporated into current buildings and new buildings and which will enable walls and roofs to produce, store and release energy. Have you discussed this research with the university in order to decrease the energy that is now being used in our buildings?
 
16:00
Carl SargeantBiography
The Member makes a very important point about technology and the opportunities we seek from business and our education sector in Wales. I have not had a conversation with the university directly, but I have visited Tata Steel’s energy centre in my constituency, where I saw examples of really up-to-date technology relating to energy development, which can be applied to domestic supply and non-domestic properties. The timeline that it faces for development and new products is an interesting one because you have to have the market to build into. What we are trying to create in Wales is a market that can grow and be sustained, and therefore the products will be more accessible and be able to be used on new developments. So, I welcome the Member’s contribution today. He raises a very important point about using new technologies to increase energy efficiency in buildings in future in Wales and beyond.
 
16:02
Llyr GruffyddBiography
I have expressed my disappointment previously in this Chamber that this target of an 8% emissions cut is too small a cut. I admit that 40% is ambitious and would bring challenges with it. However, I would want to ask the Minister whether he would agree that a higher target would also have brought opportunities, such as an opportunity for Wales to be in the vanguard of adopting zero-energy standards at an earlier stage than vast parts of Europe. It would give us an opportunity to develop a sector of constructors and entrepreneurs that would develop expertise and excellence in this area before everyone else, which, in turn, would have brought opportunities. People talk about Germany having been innovative in the area of photovoltaics. Well, there would be an opportunity for Wales for once to export expertise and skills to other nations within the UK and even further afield across Europe. So, I would like to hear what consideration you gave to any economic opportunities that could have emerged in light of setting targets that were a little more ambitious.
 
Homes produce 20% of greenhouse gases in Wales, and I feel that we are losing an opportunity to do more to reduce carbon emissions and to reduce customer bills. The target of 8%, of course, is not adequate in terms of meeting the Welsh Government’s target of reducing emissions by 40% in Wales by 2020. Research has demonstrated that a third of Wales’s housing stock would have to be renewed over the next decade if we were to get close to achieving that target. You say in your statement,
 
‘climate change is a key Government priority’.
 
You also say that,
 
‘there will be no let-up in the sustainable agenda’,
 
but the evidence here, to me, indicates differently.
 
I acknowledge that you say that there will be a further review in 2016, but may I ask whether you gave any consideration to mapping out the targets for energy efficiency in the run-up to 2021, in order to set milestones that would perhaps assist the construction sector to forward plan, particularly if you are seeking a more gradual increase or progress? I would be pleased to hear what consideration you gave to giving that guidance over the longer term to the sector. On the other hand, if you want to wait to see what sort of impact the 8% level actually has in order to feed into that further review in 2016, that may suggest, to a certain extent, that you would consider not achieving your ultimate target and that, perhaps, Wales will not comply with the European directive on energy building requirements by 2021 because of the other negative impacts that may come into play. So, I would be pleased to hear what you have to say in that regard. If we are to develop a strong narrative of tackling carbon emissions and climate change here in Wales, the Welsh Government must show more leadership and more backbone on issues such as this.
 
If, as you say in your statement, 8% is a ’significant step’, then I have to question the true commitment of the Welsh Government to achieving its target.
 
16:05