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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 Minister for Health and Social Services
Asperger’s Syndrome
 
13:30
Alun Ffred JonesBiography
1. Will the Minister make a statement on the future of the strategy for those suffering from Asperger’s syndrome? OAQ(4)0531(HSS)
 
13:30
Mark DrakefordBiographyThe Minister for Health and Social Services
Thank you very much for the question. The Welsh Government is working with a stakeholder group that is advising on this area of policy and practice. In the new year, the group will present proposals to update our strategic action plan for autism spectrum disorders, published in 2008. These proposals will refer to the future of services for people with Asperger’s syndrome.
 
13:31
Alun Ffred JonesBiography
Thank you very much. Gwynedd and Anglesey, and a number of other counties, are seeing a significant decrease in the funding available to implement the strategy. You have removed the protection for this funding. Can I ask you to reconsider this, and to explain how you will secure the future of the strategy after this funding disappears into general support for local authorities?
 
13:31
Mark DrakefordBiography
Llywydd, the Member is right to point to the fact that, after a number of years in which we have provided a specific ring-fenced grant for the implementation of the autism policy, we have transferred it, as from next year, into the revenue support grant. It is £880,000. It is the right thing to do. It is in line with our general policy. The policy, as you know, is this: when a service is new, or where a service is being remodelled, we provide money from the centre. Once you get to a point where that is a mainstream service, it is right to transfer the money to those who are responsible for it.
 
However, I understand the anxieties that there are in the field, that the money that they have been able to identify in the past might disappear into the RSG. I have written, therefore, to all local authorities in Wales, to set out my expectations that they will continue to provide that money in a way that is clearly identifiable. I have agreed that my officials will track that money with local authorities, to make sure that it does not get siphoned off into any other service.
 
13:32
Joyce WatsonBiography
Minister, three years after the Winterbourne View scandal, it emerged that more people with learning disabilities in England are continuing to be admitted to hospital than are being discharged. That is despite Government promises to the contrary. The Bubb report into the scandal has called for action. While no Welsh patients were involved in this awful episode, what can we learn from this case?
 
13:33
Mark DrakefordBiography
I thank Joyce Watson for that. I have read the Bubb report. I think that there are three things that we are able to learn from the report, as far as people with autism, including those with Asperger’s syndrome, can be drawn from it. First of all, in our Social Services and Well-being (Wales) Act 2014 last year, we particularly provide new provision for the safeguarding of adults using our services. That will be something important. We will use the regulation and inspection Bill, which I hope to bring to the floor of the Assembly early next year, to respond as well to some of the conclusions being drawn from the Winterbourne View episode. Finally, we are fortunate, I believe, that Dr Margaret Flynn, who was the author of the inquiry into Winterbourne View, is now working in Wales in a number of different capacities, and we are able to draw on her expertise as well.
 
13:34
Nick RamsayBiography
Minister, returning to your answer to Alun Ffred Jones on your autism policy, as you called it, is it not the fact of the matter and is it not the truth that that autism policy really does need beefing up? During the last cross-party autism group meeting in the Assembly, on 19 November, Members virtually unanimously expressed their view that autism is no longer a key priority for the Welsh Government. That is how they see it. Across the border in England, they have an autism Act that they are pressing ahead with. We do not have the same equity here. David Malins, a representative of the National Autistic Society Cymru, spoke about the need for Wales to have a legal statutory instrument to ensure consistency of support. Will you now accept that an Act is the way to go? It is working in England; it can work here. Let us give those people in Wales who are suffering from autism issues the support they need.
 
13:35
Mark DrakefordBiography
Well, Llywydd, I would not start from where the Member started. I think that the 2008 autistic spectrum disorder action plan has produced real pluses for autism services in Wales, with £12 million extra invested in those services since that time. However, as a result of discussions, partly on the floor of this Chamber, with the previous Deputy Minister for Social Services, we have embarked on a refresh of that policy. We have a stakeholder group working on it, and it has met eight times already. It met in November, and it has provided advice to me as to the next steps that we should take. The idea of an autism Act is part of what is discussed. I am open-minded about it. I will see the advice that I get. If it is true that there are things that we could do to strengthen the legislative basis of these services, then I am very willing to look at that.
 
The Autism Spectrum
 
13:36
Peter BlackBiography
2. Will the Minister make a statement on assistance provided to people on the autistic spectrum in Wales? OAQ(4)0520(HSS)
 
13:36
Mark DrakefordBiography
I thank Peter Black for that question. Since 2008, assistance to people on the autistic spectrum has been delivered through the spectrum disorder strategic action plan. This includes a local authority infrastructure with local ASD leads and a national co-ordinating group. Developments have drawn on more than £12 million of additional investment over that period.
 
13:36
Peter BlackBiography
Thank you for that answer, Minister, and thank you also for the letter that you sent to me in response to a question that I raised with the First Minister specifically on this issue. However, I think that it is quite clear that the Claire Dyer case in Swansea highlighted a significant number of gaps in provision, which do need to be addressed. In my casework as well, I have also had a particular issue in relation to the provision of autism specialist consultants. In your letter, you state that the autism spectrum disorder adult diagnostic pre/post counselling network across Wales includes consultant psychiatrists and other practitioners supporting people with autism in Wales. However, none of those is a specialist autism consultant. Would you be willing to have a look at that to see whether that need can be met in Wales?
 
13:37
Mark DrakefordBiography
I am willing to look at the issue, of course. Peter Black is right to say that the network has increased the number of clinicians qualified to provide adult diagnostic services in autism. I think that the clinical world is moving away from ever-further dissection into specific specialisms and more towards people who are able to provide a holistic service, with the additional ability that they need to respond to particular needs. The pre and post counselling network is developing a community of practice in this area. It is meeting for the first time today, in fact, and I look to the network to be able to provide the necessary clinical skills to provide a service in this area.
 
13:38
Mike HedgesBiography
One of the problems that some of my constituents encounter is the transition from child to adult services. What importance is given by the Welsh Government to managing the transition of those with autism from child to adult?
 
13:38
Mark DrakefordBiography
The Member is absolutely right, and it is an issue not confined simply to this area. The point at which someone moves from being a child, and in receipt of paediatric services, to an adult is often where there are difficult transition points, and I am aware that it is an issue in relation to autism services, too. Just this morning, in fact, I helped to launch, with South Wales Police, a Keep Safe Cymru card, which is designed to make sure that young people, including those with Asperger’s, who may get into trouble because they have communication difficulties, are able to have those difficulties identified. People whom I spoke to at that event specifically mentioned the usefulness of the card for people who are at the cusp of services for young adults and adults themselves. So, the Member is absolutely right and it is an issue that we are attending to.
 
13:39
Mohammad AsgharBiography
Minister, the UK Government has made £1.2 million available for innovation in autism services and to increase autism awareness in England. What is the Welsh Government doing to recognise the diverse needs of people with autism, by funding new and innovative models of support for autism services, as in England?
 
13:40
Mark DrakefordBiography
I have already identified some of the things that we are doing here in Wales. I will mention one or two more in a moment. I have to say to the Member that the constant belief that there is more money available for everything in England turns out absolutely not to be true once you examine it. Every time an announcement is made, of millions more for this and millions more for that, I ask my officials where the Barnett consequential for that money is and, every time, I am told, of course, that it is not new money at all. There is no new money; it is simply old money. You re-badge money and re-announce money. It is money moved from one thing to the next, and so it goes on.
 
So, here in Wales, I have already said that we have spent more than £12 million of new money—genuinely new money—on these services since 2008. We have the pre and post counselling network, and we have the community monitoring and support service, which is a genuinely innovative service designed to meet the needs of young people, particularly with autism, whose needs are below what you would need for a specialist service, but who still need support at the community level. That is provided on a regional basis, it has £0.25 million investment from the Welsh Government, and it happens in all parts of Wales.
 
13:41
Llyr GruffyddBiography
How does the Government assess the level of provision available to those on the autism spectrum from the point of view of services through the medium of Welsh? Can you tell us how much progress there has been in the provision of those services over the past few years?
 
13:41
Mark DrakefordBiography
Of course, to get services running through the medium of Welsh, it is essential that we resolve the problems of communication. I acknowledge the point that the Member is making. I do not have the figures with me this afternoon, but I am quite happy to ask for those figures, if they are available, and I will report back to the Member, on the efforts that we are making in this field and in the mental health field generally, to grow the services that we are able to provide through the medium of Welsh.
 
13:42
Jeff CuthbertBiography
Minister, on 2 April this year, World Autism Awareness Day, I helped to launch the autism heroes awards, which were set up by my constituent Jo Salmon and her daughter, Holly, who has Asperger’s syndrome. These awards recognise excellence achieved in the world of autism in Wales, and the winners are announced at Holly’s ball every year, which is a major fundraising event to support people with autism and their families.
 
The nominations for next year’s autism heroes are open until 31 December, and I would urge everyone who knows someone who should qualify for an award to nominate them. Minister, will you agree with me that the efforts of volunteers and fundraisers in helping to raise awareness of autism need to be recognised and valued?
 
13:43
Mark DrakefordBiography
Could I congratulate Jeff Cuthbert and in particular, his constituents, on the fantastic work that they do in this field? So much of what goes on in the autism and Asperger’s field relies on the efforts of parents, volunteers, carers and the fantastic contribution that they make. We have ensured that there is parent and carer representation on the stakeholder group that I mentioned earlier, which is refreshing the ASD action plan. It is drawing on exactly the sort of experience that you have mentioned that we want to capture, in the way that we refresh that plan for the future.
 
Questions Without Notice from Party Spokespeople
 
13:43
Y Llywydd / The Presiding OfficerBiography
First this afternoon, I call the Welsh Conservatives’ spokesperson, Darren Millar.
 
13:44
Darren MillarBiography
Thank you, Presiding Officer. Minister, a study by the Institute of Education at University College London found that Wales had the UK’s highest proportion of obese and overweight 11-year-olds. What action is the Welsh Government taking to tackle that problem?
 
13:44
Mark DrakefordBiography
Darren Millar puts his finger on a very important issue. He will have seen, I think, the recent McKinsey report published just two weeks ago, which analysed, across not just the United Kingdom but Europe and beyond, a very large number of actions, which Governments and health services are taking to try to address the issue of obesity. That concluded that there is no single set of actions that have been found to be successful anywhere. It actually concluded that the most effective actions of which it is aware are not ones that the health service provides after the problem has occurred, but those things that Governments can do, for example, to cut down on the level of sugar in processed foods, to create an environment in which people are encouraged to walk and to exercise rather than to use their cars, and therefore to prevent the problem becoming one that the health service has to try to rescue.
 
13:45
Darren MillarBiography
Thank you for your response, Minister. I was a little bit disappointed that you did not make reference to your public health White Paper, of course, which made reference to trying to tackle the obesity epidemic in Wales. One thing that has been excluded from the public health White Paper, quite surprisingly, is the ability of the Welsh Government to introduce health impact assessments through the planning system and, indeed, through the licensing system. Why is that something that has been omitted?
 
13:45
Mark DrakefordBiography
Of course, I am very pleased to talk about the public health White Paper and the measures that we have identified there in relation to obesity. Darren Millar will be aware that, as a result of earlier discussions on the floor of the Assembly, we are carrying out a further round of discussions with organisations to see whether there are any further legislative ideas that could be contributed to the White Paper and the Bill that will follow. As far as health impact assessments are concerned, I have read the responses that have come in on the public health White Paper, and I think that they make a cogent case for health impact assessments. Discussions are going on across Government as to how we might best take that agenda forward.
 
13:46
Darren MillarBiography
Would you agree that the public health Bill, as it will be published, is the appropriate vehicle to introduce health impact assessments, particularly given that it can look at the planning and licensing system at the same time and given the omission of such impact assessments in the Well-being of Future Generations (Wales) Bill or in any discussions on the Planning (Wales) Bill to date?
 
13:46
Mark DrakefordBiography
Darren is absolutely right to identify the public health Bill as a potential legislative means for putting health impact assessments on a statutory basis. I have certainly not ruled that out. There are some other possible routes to achieving this, and I continue to explore them as well.
 
13:47
Y Llywydd / The Presiding OfficerBiography
We now move to Plaid Cymru’s spokesperson, Elin Jones.
 
13:47
Elin JonesBiography
Minister, home carers perform one of the most important aspects of health and social care. A report this week in England found that 60% of care workers were on zero-hour contracts and around a third earned less than the minimum wage because they were not paid for travelling time. Is there any evidence that the situation in Wales is any different?
 
13:47
Mark DrakefordBiography
There is evidence of the nature of the domiciliary care market in Wales, because some significant research has been carried out and published in Wales about it in recent months. It shows that the pattern in Wales is different to the pattern in England, but it does not show that what goes on in England is eliminated here in Wales. It shows, to my mind, that there is a real job of work to do in persuading those firms that provide domiciliary care that cutting costs upfront simply lead to them incurring those costs through staff turnover, for example, and that they would be better off thinking about ways in which they can invest in the terms, conditions, pay and training of their staff that leads to those staff wanting to stay with those companies, to provide a service that is therefore improving and, in the end, leads to better business outcomes for the firms concerned.
 
13:48
Elin JonesBiography
I have an aspiration that all homecare workers would earn at least the living wage, and I hope that you share that aspiration. One of the first homecare companies in the UK to pay a living wage to its workers is a Pembrokeshire company called Care in Hand. In your discussions with local authorities, have you had discussions with them that the contracts that they have with domiciliary care providers rule out zero-hour contracts and insist on payment for travelling time and at least the minimum wage, if not a living wage?
 
13:49
Mark DrakefordBiography
I congratulate the Pembrokeshire company that the Member has mentioned. There is no excuse, in my view, for anybody to be paid below the minimum wage. That is a statutory right that people have. Firms that seem to erode that, by trying to get round it in some ways, are firms that we need to identify and to have that out with them. Beyond that, it is a matter for local authorities to carry out the negotiations with local suppliers that lead to domiciliary care services. In these times, when there is so little money to do all the things that we know need to be done, we cannot enter into those conversations in the naive belief that simply scolding local authorities will get us to the place that we want to be. They will be trying, I am sure, their very best to provide domiciliary care services that meet the needs of their local population, while attending to the legitimate rights of the people who provide those services.
 
13:50
Elin JonesBiography
You will recall, during the passage of the Social Services and Well-being (Wales) Act 2014, that Jocelyn Davies AM proposed to amend that legislation to ban zero-hour contracts in the social care sector. At that time, the response of the Welsh Government was to be cautious in that it feared that it did not have the competence to legislate on this. Since then, we have had the judgment of the Supreme Court on the Agricultural Sector (Wales) Act 2014. Do you think that it is now appropriate for the Welsh Government to use that judgment and your experience to use the forthcoming legislation on regulation to introduce a ban on zero-hour contracts for social care workers?
 
13:51
Mark DrakefordBiography
I think that the previous Deputy Minister, in taking the social services Bill through the Assembly, was absolutely right in the advice that she gave us that we should not put that Bill in peril, with all the work that it is required to do, by risking it ending up in the Supreme Court for many long months. In the meantime, though, as Elin Jones says, we have had the Supreme Court judgment on the agricultural wages Bill. It will be a material factor in the consideration of the regulation and inspection Bill, and I take notice of the points that she has made this afternoon.
 
13:51
Y Llywydd / The Presiding OfficerBiography
We now move to the Welsh Liberal Democrat spokesperson, Kirsty Williams.
 
13:51
Kirsty WilliamsBiographyThe Leader of the Welsh Liberal Democrats
Thank you, Presiding Officer. Minister, this week, we mark World AIDS Day. In England, they provide postal HIV testing as a way of giving people convenient, discreet and timely HIV tests. Will you commit to introducing a similar scheme here to ensure that we help the 24% of those living with HIV who are undiagnosed to access the timely treatment that they need?
 
13:52
Mark DrakefordBiography
I have had an inquiry made following Eluned Parrott’s question to the First Minister, I believe, yesterday. The advice that I have had so far—but I will say that it is advice provided within 24 hours—Is that the Terrence Higgins Trust provides that service in Wales now and, therefore, that Welsh patients are able to have HIV tests done through the post by taking blood themselves and using the Terrence Higgins Trust service to get a result via the post. However, I am meeting representatives of the Terrence Higgins Trust myself later today. I believe that you and Darren Millar may have met them already, and I will explore that with them then. If it is not available in Wales, it is a service that we would like to see available here.
 
13:53
Kirsty WilliamsBiography
I am grateful for that positive answer. My understanding is that it is run by Public Health England across the border, but I am grateful that the Minister demonstrates a desire to move to such a system in Wales. Minister, there is no medical evidence that those with HIV need to have their medication assessed on more than a three or even six-monthly basis, and there is no evidence that there is an issue with patients stockpiling their medicines and not taking them. Why is it that Cardiff and the Vale health board is the only LHB in Wales that will prescribe only 30 days’ worth of medication at its HIV clinics, making it inconvenient for patients and putting additional pressure on clinics?
 
13:53
Mark DrakefordBiography
The general advice that the National Institute for Health and Care Excellence and others provide is that 28-day prescriptions are the best way to make sure that people get medicines that they then use accurately and to eliminate waste in the system. However, I have pursued this matter previously, again as the result of an individual matter that Eluned Parrott has brought to my attention, and made it clear, as I believed, to the NHS in Wales that while that is the starting point, it is not an absolute rule, that it should apply it sensibly in the circumstances of individual patients, that where there are individuals who are stable and whose regime could be equally well served by a longer prescription and where clinicians are confident that the individual is capable of managing their medication over that long period, that there is no barrier in the rules that we have set down in Wales to that happening.
 
13:54
Kirsty WilliamsBiography
Thank you, Minister. Perhaps you could try again to have that discussion with officials at Cardiff and the Vale.
 
Minister, there has been a trial scheme in England that has examined the use of pre-exposure prophylaxis for those who are most at risk of contracting HIV. It has been so successful that the pilot has been accelerated. Will you commit to examining the use of PrEP as a way of reducing onward transmission of new infections in Wales?
 
13:55
Mark DrakefordBiography
Absolutely. I am not aware of the experiment, but if there is success being reported in it and there is evidence that we can draw on in Wales, I am very happy to commit to doing that.
 
13:55
Y Llywydd / The Presiding OfficerBiography
We will now move back to the questions on the paper. Question 3, OAQ(4)0530(HSS), has been withdrawn.
 
The Nutritional Needs of Older People
 
13:55
Lynne NeagleBiography
4. What steps is the Minister taking to ensure that the nutritional needs of older people living in residential care in Wales are met? OAQ(4)0523(HSS)
 
13:55
Mark DrakefordBiography
I thank Lynne Neagle for that question. Our public health White Paper set out an intention to introduce mandatory nutritional standards in care home settings. The proposals were explored in the consultation process. They will now be developed further in the light of responses received.
 
13:56
Lynne NeagleBiography
Thank you, Minister. You will remember that I wrote to you recently, highlighting the unified menu planning system developed in Torfaen, which aims to improve the nutritional standards of meals provided in residential care and which was cited as an example of best practice in the recent ‘A Place to Call Home?’ report. It is a really fantastic initiative developed through a partnership between Torfaen trading standards and Aneurin Bevan Local Health Board, which are very keen to see this rolled out across Wales. I have also written to the Minister for finance about the project, as I think that it is a very worthy candidate for invest-to-save funding. Will you commit to working with us so that this exciting project, pioneered in Torfaen, can contribute to the wider drive to improve health and nutritional standards within care home settings in Wales?
 
13:56
Mark DrakefordBiography
I thank Lynne Neagle for her letter. I am aware of the excellent work that has been carried out in Torfaen on the development of its menu planning system. I know that the Minister for finance has indeed received a letter about invest-to-save possibilities. The invest-to-save latest call for proposals opened on 7 October. Expressions of interest have to be in by 7 January. There is £20 million set aside by the Minister for finance for that round, so I would certainly encourage those organisations that have been involved in the Torfaen project to consider making an expression of interest within that call.
 
13:57
Janet Finch-SaundersBiography
It is really good to hear about the mandatory process to be, but it is a matter of how that message is going to get through, because the older people’s commissioner’s review into care homes exposed blatant inconsistencies in residential and care homes in terms of nutritional support. She highlighted poor meal choice, the limited availability of food outside of formal regime, and the lack of support to help residents with their meals, which, of course, can then result in them losing the physical ability to feed themselves. In fact, one in three residents are already suffering from malnutrition upon entry to a care or residential home setting. As regards this evidential report on this particular aspect on nutrition, how will this now actually influence your future direction and actions?
 
13:58
Mark DrakefordBiography
Thank you for that question. In some ways, Llywydd, it is the other side of the coin to the question that Darren Millar raised earlier, because our proposals for mandatory nutritional standards are both about addressing obesity, where that is to be found, but also about addressing malnutrition where we see that in care home settings. Janet Finch-Saunders is absolutely right to draw attention to what the older person’s commissioner said. The commissioner will be launching tomorrow a piece of work to celebrate the Torfaen scheme that Lynne Neagle has mentioned. Our mandatory nutritional standards would mean that care homes would have to abide by those standards. They will be statutory in nature, and therefore they would meet some of the concerns that the older person’s commissioner identifies in her report.
 
13:59
Lindsay WhittleBiography
While the quality of food in care homes is important, so are the times that residents can have food. Again, I refer to the older people’s commissioner. In her report, there is a general lack of choice about what to eat, and when and where to eat. I have visited some homes where mealtimes are actually buzzing, and I have visited other care homes where, quite frankly, it is like a monastery—no-one speaks at all. There should be interaction between staff and residents, and between residents and residents. What improvements will you be expecting care homes to make in being much more responsive to residents’ needs, especially those who are suffering from dementia? I know of one lady who asked for a piece of toast at 9 o’clock and was denied it. That cannot be right.
 
14:00
Mark DrakefordBiography
Of course not. Lindsay Whittle points to a debate that I think the older people’s commissioner has very usefully drawn to the surface. She says two things on this. If you have heard her speak, you will know that she talks about the importance of nutritional standards and making sure that meals are there that prevent malnutrition. She also talks about the fact that these are people’s homes, and that if you were living in your own home, you would be able to choose what you ate yourself and if you chose some unhealthy choices, no-one would be there to tell you that you could not make them. So, how do you marry together both our wish to make sure that residential care services provide food that is right for people, from a health point of view, and at the same time not ending up with a regimented regime, of the sort that Lindsay has just mentioned, where people appear to have no choice over the way they live their own lives? There are some tensions between those two things.
 
In extra-care homes, where restaurant facilities are the way that meals are provided, people are able to make those choices for themselves, using them when they want to and not using them when it does not suit them. So, we have models that we can draw on to do things better and the older people's commissioner’s report will help us in doing that.
 
14:01
Aled RobertsBiography
Minister, the cross-party group on coeliac disease and dermatitis herpetiformis also received evidence that specialist diets are not available in certain residential homes, and Vaughan Gething, in response to a short debate recently, explained that you were to include those too within the mandatory standards. In the meantime, the Deputy Minister accepted that the evidence base was not robust in terms of provision on the ground. May I ask you, therefore, to ask the inspectorate to ensure that inspectors question provision within these homes as they carry out their inspections?
 
14:01
Mark DrakefordBiography
I heard the Deputy Minister responding to the short debate on that particular issue, and the debate was very interesting, in my view. As the Member says, the inspectorate visits all residential homes the length and breadth of Wales, so I am happy to speak to the head of the inspectorate to ask what can be done in the meantime in this area.
 
14:02
Sandy MewiesBiography
Minister, I have heard and welcomed the very positive responses that you have made up to now about nutritional standards for people living in residential care homes. Could you give us an idea of the timeline of when these are going to be introduced and whether good schemes, sych as the one mentioned by Lynne Neagle in Torfaen, will in future be pointed to as good practice? Lastly, on Lindsay’s Whittle’s point about extra-care homes, which actually do move very close to being people's own homes, even though they are shared as a community, what measures can the Welsh Government take to encourage the development of such facilities?
 
14:03
Mark DrakefordBiography
Llywydd, I was very pleased to visit with Sandy Mewies an extra-care facility in her constituency, which managed to do exactly what we have been talking about this afternoon—marrying the support that people need with the freedom for them to make their own choices about their own lives to the maximum extent.
 
In relation to the timetable, we are working through the consultation responses. There were 115 responses on this aspect of the White Paper alone. They were most often supporting the proposals in the White Paper, but asking us to take them further by applying mandatory standards to other settings, too. So, there is a job of work for us to do, alongside the timetable that we have already set out for the White Paper.
 
Mental Health Problems
 
14:03
Simon ThomasBiography
5. Will the Minister make a statement on services for young people in Wales who have mental health problems? OAQ(4)0532(HSS)
 
14:04
Mark DrakefordBiography
Thank you, Simon Thomas. Adolescent mental health problems can be treated effectively in a variety of settings. These include school counselling services and the new primary mental health services that we have established in Wales. Specialist mental health services for children and adolescents are available to provide effective treatment for those young people who have more severe mental health problems.
 
14:04
Simon ThomasBiography
Thank you, Minister, for that response. I am not sure whether you had an opportunity to see ‘Y Byd ar Bedwar’ on S4C last night, which dealt with this issue. One of the young people who spoke very eloquently about her problems in seeking appropriate treatment within the NHS in Wales for mental health problems was one of the young people who also contributed to the work of the Children, Young People and Education Committee on the report that we published about a fortnight ago. One of the things that became apparent in that report is that there is deficiency at the basic level leading to young people either being inappropriately referred to specialist services or being inappropriately provided with drugs rather than with talking therapies, for example. Is there anything that the Government could do to ensure that the primary service is appropriate for children and young people?
 
14:05
Mark DrakefordBiography
I did not see that programme last night, but the point that he has made has already been discussed here. I agree. We must try to strengthen primary services and persuade those who deliver those services to be able to do more to cope with young people with mental health problems in a better way. The Minister for Education and Skills and I have agreed to prepare new guidance about what should go on in schools and in CAMHS, but there is still more that we could do in the new service that we have established in Wales. I spoke at the Health and Social Care Committee about a week ago, with Members there, about what we are endeavouring to do next year to strengthen what they are doing for the young people.
 
14:06
Julie MorganBiography
Could the Minister tell us what progress has been made in ensuring that children cared for by the children and adolescent mental health service have care and treatment plans under Part 2 of the Mental Health (Wales) Measure 2010?
 
14:06
Mark DrakefordBiography
As well as improving primary care mental health services for young people, the Measure that this Assembly passed in the last Assembly term also created care and treatment plans, under part 2 of the mental health Measure. They have been very successful, I believe, in making sure that children and young people have those care and treatment plans in place. Cardiff and Vale University Local Health Board, for example, reported in the year before the Measure was introduced that only 55% of children needing secondary mental health services had such a care and treatment plan. In August of this year, it reported that over 95% of young people now had a care and treatment plan in place.
 
14:07
Russell GeorgeBiography
Minister, the evidence from my own constituency is that CAMHS is overstretched and that young people are forced to access treatment outside the area. Would you agree that young people with mental health issues should be able to access treatment and services locally, close to their homes and families? What can you do to ensure that mental health services are improved in mid Wales specifically?
 
14:07
Mark DrakefordBiography
CAHMS is overstretched; I agree with that. The question is: why is it overstretched? It is overstretched because it has had a 103% increase in referrals over a four-year period. Although today, CAMHS is seeing 70% more young people within four weeks than it was four years ago, it spends its time assessing young people who simply did not need the service to which they were referred. As a result, there are other young people who do need such a service who have to wait too long to get it. The answer, I believe, is the one that Simon Thomas referred to earlier. There are people in the system—not just in the health system, but in the youth service, in the school counselling service and in other places too—who need to do more to respond to the needs of young people who are struggling with the difficult business of growing up and who cannot regard making a referral to somebody else as having discharged their responsibility to that young person.
 
14:09
Eluned ParrottBiography
Minister, I wish to raise the question of long diagnosis times for those children presenting with a complex package of mental health and additional learning needs, and the breakdown in communication between child psychiatry and child psychology. I wonder if you would consider looking at one-stop-shop models for improving diagnosis rates, whereby families can go to one centre and meet with several specialists on a single day. At the end of that day, they have a case conference for each of those families and are able to resolve things much more quickly.
 
14:09
Mark DrakefordBiography
I thank Eluned Parrott for that contribution. She may know that we have asked Professor Dame Sue Bailey, former president of the Royal College of Psychiatrists and an internationally recognised child psychiatrist, to help us with the remodelling of our CAMHS services, and particularly to do it from the professional leadership point of view. That work has already started. We plan a major conference here in Wales in February next year. I will make sure that that possibility is fed in to the work that is going on.
 
14:10
Ann JonesBiography
Minister, how would you respond to reports that English authorities are placing looked-after children who need care in a residential home in residential care homes across north Wales with very little supporting evidence accompanying those children? Those children often have to access the support of CAMHS in north Wales. What is your assessment of that issue?
 
14:10
Mark DrakefordBiography
I think that Ann Jones has identified a matter that is of genuine emerging concern. It is not just in north Wales, either; it is certainly in north Powys and in parts of Hywel Dda. A very rough and ready headcount has been carried out for me over recent weeks, and that suggests that there are 220, as a minimum, looked-after children from English authorities being placed in north Wales, with 150 and more of those in north-east Wales. That is a very high concentration of young people coming over our border. I met representatives of CAMHS in north Wales during the October half term. What they said to me was that these young people are often placed without the full information being provided about the level of needs that they experience. Then they have an episode, for example, of mental ill health, and it is local services that have suddenly to respond to the sometimes very significant mental health needs of a young person who has been placed from outside. I raised this matter with Baroness Jenny Randerson in my last meeting with her as a Wales Office Minister, and I plan further work with colleagues in the Government at Westminster to make sure that we have a full understanding of the nature of this issue. If costs are being incurred by Welsh services, we will need to make sure that those costs are properly covered by the authorities responsible for them.
 
Continence Services
 
14:12
Mark IsherwoodBiography
6. Will the Minister outline the Welsh Government’s provision for continence services in Wales? OAQ(4)0521(HSS)
 
14:12
Vaughan GethingBiographyThe Deputy Minister for Health
I thank the Member for the question. All health boards and Velindre NHS Trust provide continence care to their patients based on their individual needs. The level of support will vary from essential care provided by front-line nursing staff, to more advanced care provided by continence nurse advisers or specialist medical care within the urological medicine and surgical services.
 
14:12
Mark IsherwoodBiography
Continence is one of the biggest issues for members of the 18 charities that, with Shine Cymru, developed the report ‘Improving continence services in Wales: A call to action To the Welsh Government and Local Health Boards’. I understand that they have written twice to the Minister, and he responded positively in terms of services in hospitals and, in a subsequent reply, made reference to services for older people, but I understand that he has not yet acknowledged the wider issues of community care or services for younger people—because it is not just about older people. What action can you, working with the Minister, take to ensure a joined-up, holistic approach to all the findings of that report and the recommendations that it makes, in hospital and in the community for people of all age groups?
 
14:13
Vaughan GethingBiography
I thank Mark Isherwood for the second question. He is right to point out that continence issues are not simply a matter for the older population. The continence bundle—the package of care and the assessment tool—is there for people of all ages, and it is important to recognise that this is about assessing somebody's need in the first place, to make sure that there is a consistent way of dealing with that process of assessment, and then to have the appropriate intervention and support, regardless of the care setting. Broadly, we know that continence care is provided with real dignity across Wales most of the time, but I would be happy to look in more detail at the report to understand the depth of the issue that he describes and to understand what more we could do to support the provision of effective continence services across Wales.
 
14:14
David ReesBiography
Deputy Minister, last week, I met with a group of physiotherapists from Abertawe Bro Morgannwg University Local Health Board who have been funded for a pilot project to deal with continence issues and, in particular, their psychological impact. It is important that we get the physiotherapists to work with them, because they do a tremendous job in dealing with incontinence issues, particularly urinary incontinence in that sense, and they actually reduce the ability to go to a consultant. You just mentioned the appropriate services. Will you be looking at the way in which physiotherapists are used to deliver on incontinence issues, particularly to avoid going to a consultant in the first instance, so that referral is made to a physiotherapist, thereby perhaps reducing the need to go to consultants? Will you look at the project in Swansea to see how work is being done, particularly in women’s health, to tackle this issue, which is something that is very private for many individuals, but needs to be addressed on a wider basis?
 
14:15
Vaughan GethingBiography
I thank David Rees for raising the issue. He is right to point out that urinary incontinence does have a major impact on quality of life, especially in terms of the significant number of women who are affected as he identified in his question. I am pleased that he has pointed out the role of physiotherapists in this because we recognise that physiotherapists have a much wider role to play in the whole system of care and this is another good example. They should be part of a multidisciplinary team. I also recognise that it is clinically and cost-effective too. I recognise importantly the point around providing real dignity and providing a service. I note that he has identified a project in Singleton Hospital and I would be happy to arrange with him and the local Member to visit the team at some point in the future.
 
14:15
Bethan JenkinsBiography
Minister, I understand, and this may follow on from what David Rees said, that 20 hospitals have been included in the spot checks that will look at continence services across Wales, including the Princess of Wales Hospital in my own area. Can you tell us whether we will have data on the specific hospitals or will the data be provided on an all-Wales basis, that is, are we going to be able to understand how hospitals in our own areas are performing in order to restore credibility in the system?
 
14:16
Vaughan GethingBiography
I thank the Member for the question. I do not think there is any lack of credibility about the system and the quality of care that is provided. In terms of dealing with the specifics I will come back to you on whether the data is on an all-Wales basis or is going to be provided on an individual location basis. The broad message from the unannounced spot checks on continence care was that a good standard of care is being provided with excellent examples of good practice. It is about ensuring that that is delivered on a consistent basis. I will happily come back to you with more detail on the specific points that you raise and how the data will be provided. The serious spot checks do provide people with a level of real reassurance. They were unannounced and I am very pleased that they have identified lots of examples and consistent examples of good practice.
 
The Future of Unscheduled Care
 
14:17
Darren MillarBiography
7. Will the Minister make a statement on the future of unscheduled care in Wales? OAQ(4)0516(HSS)
 
14:17
Vaughan GethingBiography
I thank the Member for the question. Our vision for unscheduled care in Wales is that everyone should be supported to remain as independent as possible, with timely access to the right care, in the right place, at the right time. Chief executives are currently reviewing the unscheduled care programme to ensure that its actions support this aim.
 
14:17
Darren MillarBiography
Thank you for the answer, Deputy Minister. I think it is very disappointing that figures for October suggest that the worst performing accident and emergency department in England and Wales in terms of the four-hour target is actually in north Wales supporting my constituents, namely Ysbyty Glan Clwyd. The third worst in England and Wales is Wrexham Maelor Hospital. Given that you have two very poorly performing hospitals in one particular health board area, what action is the Welsh Government taking to address the problems in that health board area in terms of its performance against the four-hour waiting-time target?
 
14:18
Vaughan GethingBiography
I think that it is important to make the point again that it is not a waiting-time target; it is the four hours from entry to discharge having been seen and treated. I think some people really do misunderstand and think that they are going to wait four hours before they are seen and then treated. In terms of points that you raise, it is also important to recognise that the unscheduled care system is part of a wider system of care and the point that I make about trying to prevent people from needing to go into the unscheduled care system in the first place should not be lost. When they then go into the unschduled care system, if there is a need, our expectation is that they are seen and treated promptly. I was in north Wales and I visited Wrexham Maelor last week in fact and I recognised the significant pressures its staff were under, again because of a significant influx of older people who had come in and the A&E department was nearly full as a result.
 
I recognise that there is a need to improve the whole unscheduled care system. I met with Adam Cairns, who is the lead chief executive on unscheduled care, and I made it very clear that there is an expectation that they will not only talk about improvement, but they will identify the key drivers for improvement and deliver it on a consistent basis across Wales. There are hotspots in virtually every local health board where the unscheduled care system could and should perform better. There will be particular focus on all of those areas, including in Betsi Cadwaladr. I have made clear that this area of accountability will not go away, but they can expect to have further conversations with me to ensure that improvement is made real and is not simply a matter of theory.
 
14:19
Joyce WatsonBiography
First of all, I would like to thank Mark Drakeford for meeting with me yesterday at extremely short notice to discuss the situation at Withybush hospital. I, like everyone in Pembrokeshire, was hugely relieved by Hywel Dda Local Health Board’s categorical rebuttal of the claims that Withybush’s A&E department could be anything less than a 24/7 service. You will know better than most, Deputy Minister, that the root cause of many of the pressures and pinch points in the service is recruitment. Every time a leaked document creates a furore like this, Withybush, I suspect, becomes a less attractive prospect for an ambitious, newly qualified consultant, and it becomes a vicious circle. Will you work to ensure that the health pressure groups work more closely with the health board to promote clear lines of communication? What can the Welsh Government do to further support recruitment in the west Wales NHS?
 
14:21
Vaughan GethingBiography
I thank the Member for the question. I want to recognise at the outset and welcome the response of the clinical community across Hywel Dda to ensure that there is a future for 24-hour emergency-admission coverage. They have provided a solution for the next six months to allow them the space and time to deliver a longer term sustainable service. It is important to have that reassurance for the public.
 
The point you make around the conversations that take place around hospital sites and the impact that they have on recruitment and staff morale is important. If we think back to different conversations in different hospital settings, there was something similar in another part of Wales that has now largely been resolved because the clinical community and the patient community have managed to have a conversation around what they want to do to improve and sustain the service there. I would like the same conversation take place within Withybush so that the health board, the clinical community and the patients themselves can be reassured that the service will be provided in a sustainable form for the future. The conversation that takes place with the constant suggestion that there is a secret plan to do away with the service, when there is no such thing intended at all, is not helpful for the staff who work there or and for the staff that we want to recruit to and retain in what is, after all, a fantastic place to live and work.
 
14:22
Simon ThomasBiography
Specifically on Withybush, Deputy Minister, you will have had a chance to see what the Hywel Dda board proposed yesterday as a temporary fix for emergency care at Withybush. My understanding and reading of that proposal is that it does not meet the College of Emergency Medicine’s guidelines on the availability of consultants, and so forth, particularly as there is no 24-hour paediatric service in Withybush. What assessment has the Government made of the safety of that service, and what assessment have you made of the safety of that service going forward?
 
14:23
Vaughan GethingBiography
I thank the Member for the question. The plan that was announced yesterday provides time for a period of stability to allow a longer term plan to be drawn up about the future of the service. It is important to recognise that the whole clinical community in the health board is engaged in that process. It is no-one’s interest for the service to fall over in Withybush, and I appreciate that that will not be happening as a result of the agreement reached.
 
We will support the health board in its efforts to ensure that staff are recruited and retained within that particular area. There is no assessment to be made to say that this is in any form an unsafe service, and I would not want to try to feed any suggestion that it is. We know that there are different models; for example, the Prince Philip Hospital model, which the Royal College of Physicians was very keen to promote as a really positive alternative that is providing care for that local population in a setting that they are familiar with. So, I look forward to seeing more detail from the health board on the workings of the plan it has announced to date, and to seeing the longer term plan that it expects to work up, as I said, with the whole clinical community in the Hywel Dda health board area.
 
14:24
Kirsty WilliamsBiography
Would the Deputy Minister agree that the difference between the situation in Llanelli and Pembrokeshire is that people in Llanelli have access to a full A&E and trauma service at Swansea, and that the concern of the people of Pembrokeshire is that they will be a significant distance away from a full A&E? What we know is that the nature of A&E attendances is changing, and that we are having more major and fewer minor cases. Where do you perceive that the major cases in Pembrokeshire will be receiving treatment after May?
 
14:24
Vaughan GethingBiography
You are asking me to forecast the outcome of a plan after the six-month period of time that the health board has designated to provide stability for the service within Withybush. It would be quite wrong for me to try to set out what that service would look like. It is for the clinical community within Hywel Dda to ensure that it can provide a plan for the service within Withybush that meets the need for 24-hour cover for emergency admissions that is delivered in a safe and sustainable way. It is important to talk about the whole clinical community because people in Glangwili will recognise that having services inappropriately moved to them when they could and should be dealt with at Withybush is not desirable. That is why the whole community being engaged in that plan is what is important. It is not the right thing for Ministers here to set out what must or must not happen at the end of that, apart from the architecture of a safe and sustainable service that serves and meets the needs of the local population.
 
Funding Local Health Boards
 
14:25
Nick RamsayBiography
8. Will the Minister provide an update on funding local health boards? OAQ(4)0526(HSS)
 
14:25
Mark DrakefordBiography
Funding to local health boards in Wales has been increased by £200 million in the current financial year and by £225 million in 2015-16 as a result of decisions announced by the Minister for finance on 30 September.
 
14:26
Nick RamsayBiography
May I ask you specifically about funding for wet macular degeneration? It was raised by the leader of the opposition with the First Minister yesterday. You have said this year that you will allocate funds—or rather the Minister for finance has—for treating wet macular degeneration directly to the local health boards, rather than what has been done in previous years when that money has been provided directly. Every year, an additional 1,000 people are diagnosed with wet macular degeneration. We all know that if that condition is not treated within weeks of diagnosis the prognosis is very poor and it often leads to blindness. Given the increasing number of people who are going to be getting that and given that you are giving money to the health boards this year to cover that, will you give a guarantee that, in future years, adequate funding will be provided to the local health boards so that they can effectively treat wet macular degeneration? Will you guarantee that you are not going to do a Pontius Pilate and simply wash your hands of people suffering from this condition in years to come?
 
14:27
Mark DrakefordBiography
Maybe I could just correct some of the many factual errors in what we have just heard. First of all, it is my decision and not the Minister for finance’s decision how to allocate funds within the health portfolio. Secondly, the money is not going to health boards this year. It is an intention from next year, so in this year the way that we have done things since 2008 will continue. As for next year, the £16 million and more that we invest in wet macular degeneration services will go to local health boards. It will go to them against the background of a reporting regime that I have already set out with local health boards, which will require them to report monthly to me on the total number of new patients they are seeing, the total number of new assessments they are undertaking, the total number of wet macular degeneration treatments they are undertaking, the number and percentage of patients who began wet macular degeneration treatment within two weeks of referral, and the number and percentage of patients treated within their clinician’s allocated follow-up interval. There is absolutely no sense at all in which the Welsh Government, which now provides £16 million, none of which was provided in 2008, to treat 16,000 patients, none of whom were treated just that time ago, is doing anything other than ensuring that that very significant and important service continues.
 
Access to Cancer Treatments
 
14:28
Andrew R.T. DaviesBiography
9. Will the Minister make a statement on access to cancer treatments in South Wales Central? OAQ(4)0528(HSS)
 
14:28
Mark DrakefordBiography
Thank you for that question. Cancer services in South Wales Central aim to provide patients with a comprehensive package of cost-effective, evidence-based NHS treatment to meet their clinical needs.
 
14:28
Andrew R.T. DaviesBiographyThe Leader of the Opposition
Thank you, Minister, for your answer. Yesterday, you will have heard the exchange I had with the First Minister about a new cancer treatment fund and in particular whether, if consequentials were flowing from the budget statement today, the Government would give consideration to allocating moneys to such treatments. I was interested in particular in the third answer that the First Minister gave. I offered him the opportunity to clearly push that firmly out of the way on behalf of the Government and he clearly would not do that. So, I am wondering whether you as Minister for health will now be making the case to seek some of that additional money that the Welsh Government will be having to invest in cancer services here in Wales, but in particular in a new cancer treatments fund, which many patients and clinicians are calling for here in Wales.
 
14:29
Mark DrakefordBiography
Well, Llywydd, there is a whole series of ifs and buts in that question that I am not in a position to answer. When I came across to the Chamber this afternoon, the Chancellor of the Exchequer was still on his feet, so I have no idea whether there is money coming to Wales. If money does come to Wales as a result of the autumn statement, the leader of the opposition will be very well aware of the constitutional arrangements that mean that the money comes to the Welsh Government for purposes that the Welsh Government will then propose and bring to the floor of the National Assembly. It is far, far too early in that for me to anticipate anything in the way that he invites me to.
 
14:30
Y Llywydd / The Presiding OfficerBiography
Thank you very much.
 
14:30
Questions to the Counsel General
Y Llywydd / The Presiding OfficerBiography
There are no questions.
 
14:30
Questions to the Assembly Commission
Y Llywydd / The Presiding OfficerBiography
There are no questions, so we move to the next item, which is a statement by—[Interruption.] Am I missing something? No. Thank you. We now move to the next item, which is a statement by Kirsty Williams.
 
14:30
Statement: Introduction of a Member-proposed Bill—Safe Nurse Staffing Levels (Wales) Bill
Y Llywydd / The Presiding OfficerBiography
I call on Kirsty Williams to speak.
 
14:30
Kirsty WilliamsBiography
Thank you very much, Presiding Officer. On Monday, I laid the Safe Nurse Staffing Levels (Wales) Bill in the Table Office. I would like to place on record my thanks for the strong cross-party support that the Bill has received to date and to allow me to get to this point.
 
The purpose of this Bill is to ensure that nurse staffing levels within the Welsh NHS are sufficient to provide safe, effective and quality nursing care to all patients, at all times. It is about providing nurses with the time to provide compassionate care. This Bill is about transforming the quality of care provided within the Welsh NHS, with the ambition of putting it among world leaders in this field.
 
It is a staggering statistic that a major European study, published in ‘The Lancet’, revealed that, for each extra patient a nurse is responsible for, the likelihood of an in-patient dying within 30 days of admission increases by 7%. A study across 30 English acute trusts found that hospitals with the highest numbers of patients per nurse had a 26% higher mortality rate.
 
The premise of this Bill is simple: nurses with fewer patients to care for can spend more time with each patient, and, as a result, they can provide better care. They have more opportunity to identify and address potential problems with a patient’s care, and can play a preventative, rather than simply a reactive, role. So, this would mean fewer patients needing treatment—for instance, for falls or bed sores—and it would also, consequently, mean less cost to the NHS. There is clear evidence that safe staffing levels lead to a decrease in delayed discharge from hospital, and also a reduction in readmissions to hospital.
 
Now, I believe that this legislation is needed because the current regime alone is simply not getting the job done. The Chief Nursing Officer for Wales issued guidance in 2012, setting out that the number of patients per registered nurse should not exceed seven by day. However, health boards’ responses to freedom of information requests in May to June 2013, sometime later, which are set out in table 1 of my explanatory memorandum, clearly demonstrate that this guidance is not being consistently met across Wales. Let me make it clear: this is not to suggest that health boards, or the Welsh Government, have been complacent. The Welsh Government has progressed plans to introduce workforce planning tools, based on the severity of patients’ conditions, to assist NHS organisations in determining appropriate nurse staffing levels at a local level. The first of these, which focused on adult acute hospital wards, was introduced in April 2014.
 
However, the experience of nurses on the ground feels very different. In January 2014, the Royal College of Nursing employment survey for Wales reported that over half—56%—of nursing staff still felt unable to give the level of care that they would like to. Currently, in Wales no duty exists to deliver safe nurse staffing levels. This Bill will place a duty on health service bodies in Wales to have regard to the importance of ensuring an appropriate level of nurse staffing wherever NHS nursing care is provided. It requires the Welsh Government to issue guidance for adult acute hospital wards, setting out the methods and processes by which NHS organisations will be expected to determine nurse staffing levels that are locally appropriate and safe at all times.
 
This Bill will also place a statutory duty on health service boards to take steps to ensure that nurse staffing levels on adult acute wards do not fall below certain levels. These minimum levels are to be included in the statutory guidance as minimum nurse-to-patient ratios, and nurse-to-healthcare-support ratios. There is provision for this duty to be extended to other healthcare settings at a future date.
 
The Bill will also place a duty on health service bodies in Wales to monitor their compliance with safe nurse staffing requirements and to take action where failings occur. Furthermore, it provides a statutory basis upon which patients and staff can challenge poor levels of nurse staffing.
 
Safe nurse staffing levels are the bedrock, I believe, for effective care. Nurses provide round-the-clock care for patients and work in every kind of healthcare setting. Quite simply, nurse staffing levels are too important to be left to non-statutory guidance, or addressed by temporarily raising their status to a tier 1 priority, leaving them still vulnerable to subsequently being identified for efficiency savings. Legislation changes behaviour in a way that non-statutory guidance does not. It ensures that staffing levels are adhered to, that performance is measured and monitored, and that action is taken where there is non-compliance. Making safe nursing levels a statutory responsibility will also provide a legislative basis for patients and staff to challenge poor levels of nurse staffing.
 
Before closing, Presiding Officer, I would like to thank everyone who has engaged in the two consultations that I have conducted in the development of this Bill, and the hundreds of individuals who have spoken personally with me about its proposals. I am pleased that the majority of responses have been very positive about the Bill, and I believe that the Bill has been improved as a result of that input. I continue to welcome such input, and look forward to open-minded and thorough discussions in the course of this Bill’s legislative journey through the Assembly.
 
This is one of the most concise Bills introduced before the Assembly, but it is also a Bill filled with a big vision. It looks to deliver real outcomes for people in Wales—both now and in the years to come. I commend it to the Chamber.
 
14:37
Y Llywydd / The Presiding OfficerBiography
I call on the Minister for Health and Social Services.
 
14:37
Mark DrakefordBiographyThe Minister for Health and Social Services
Diolch yn fawr, Lywydd. I begin by congratulating Kirsty Williams on the substantial work that she has undertaken over recent months and on having brought her Bill to this stage in the Assembly’s processes.
 
The objective of the Bill, as we said at the time when the Government did not seek to oppose the idea of its being introduced, is one that we share. Once again, this afternoon the leader of the Welsh Liberal Democrats has made an eloquent case for the importance of nursing in the Welsh NHS. What she has now embarked upon, however, is something slightly different to making that case; she is embarking on making the argument as to why legislation is the right means of fulfilling the ambitions that she sets out, and not just why legislation, but why this particular piece of legislation—the Bill as she has presented it to us.
 
Llywydd, I wanted to recognise the important changes that have taken place between the Bill as presented to the Assembly and the Bill as it might have originally been anticipated. I see on the face of it the new clarity that the Member in charge has brought to the meaning of the term ‘nurse’ and I see a very welcome pulling back from placing on the face of the Bill a rigid formula about the provision of nurses in favour of providing guidance. I listened carefully to what Kirsty Williams said about being open-minded in the way that the Bill might develop further as a result of the scrutiny that the Assembly will now provide to it.
 
In all of that, it is right and proper that there will be a series of questions that Members here will want to test. Members will want to know how the proposals deliver the objectives that the Member has set out, and how it does so in ways that are notably superior to other ways of achieving the same ends. Members will want to know how the proposals seek to avoid unintended consequences, attempting to fix one problem only to create a series of others. It will be important to understand how the proposals align with the shared ambition across this Chamber for an integrated approach to health and social care. The Member in charge will need to respond to the hostility that the proposed legislation has engendered in some other parts of the workforce, wondering how the privileging of one professional group over and above all others can advance the necessary agenda of multidisciplinary working. From my perspective as Minister, certainly, I will want to think about how Part 3 of the Bill might be improved to prevent it from dragging the NHS away from the focus on patient outcomes, which we need to achieve, back to a world focused on inputs and outputs—counting everything—with far too little interest in where all of that activity actually makes a difference for patients.
 
How, for example, within the list of factors that the Bill claims to constitute indications of safe nursing, are readmission rates indicative of safe nursing ratios in adult inpatient wards in acute hospitals? What causal link does the Member believe can be drawn between such ratios and, let us say, the readmission of a patient for an entirely different reason in an entirely different part of Wales to an entirely different sort of hospital, many weeks after the first episode of care has ended? However, if I have read Part 3 of the Bill incorrectly, I am happy to have my understanding corrected. We will be under an obligation to report readmission rates on the grounds that that tells us something significant about nurse staffing ratios. I do not, myself, see that as yet.
 
Llywydd, to resort to a cliché I am afraid, the Member in charge will be very well aware, I know, that the hard work in this Bill really does begin now. The Government will engage constructively in that process, but will only be able to support legislation in the end if it meets the high hurdles that are rightly expected of legislation made in this Chamber and of which, in the context of other Bills, the Member in charge of this Bill has been a prominent guardian.
 
14:42
Kirsty WilliamsBiography
Thank you to the Minister for his response this afternoon and for sharing from the outset what I believe is a shared ambition for nursing quality here in the Welsh NHS.
 
The Minister is right: the Bill, as presented and laid this week, has changed. It has changed to reflect the points raised in the original debate in this Chamber and to reflect issues raised with me during the two consultations that have happened subsequently. I think it is a better and more robust piece of legislation because of that input.
 
To answer some of the points, first, about the need for legislation, I agree completely with the Minister. We should legislate only when absolutely necessary. However, having seen some of the stuff that has come out of the Welsh Government, I think it is slightly rich now to hear a Minister lecture a backbencher in that regard. The Well-being of Future Generations (Wales) Bill—I do not know the reason why—springs to the forefront of my mind. [Laughter.]
 
The Minister asks why this particular group of workers as opposed to anyone else. The Minister is right: this is not about putting a particular profession on a pedestal, but nursing is in a unique position within the Welsh NHS, because it is nurses and nurses alone who provide 24-hour round-the-clock care in a way that no other healthcare professionals do. They have more contact with patients and therefore have the ability to transform what happens to that patient and the experience of that patient in a way that other healthcare professionals simply cannot, because they simply do not spend that amount of time with patients.
 
It is also clear from international evidence that, rather than actually depleting resources for other professions within the healthcare system, that has not happened. Actually, decent nursing and the time to do decent nursing is an aid—it is a boon—to other professionals who work alongside nurses, whether that be in the community or on the ward.
 
I agree completely that we should be focused on outcomes. I agree completely. There is no greater outcome for me than the studies that have been done that show that there is a direct correlation between nurse numbers and mortality. You cannot get more of an outcome than a reduction in mortality rates for patients, let alone a reduction in the length of stay, reductions in falls and other reductions in harm.
 
Actually, I do think that readmission is a positive outcome for patients. We know that there are patients who are discharged from hospital who find their way back into the system as a result of their initial episode of care. I take the point that there may be some patients somewhere who will be discharged from Glangwili today, who may be visiting a relative somewhere in the north of the country later on this weekend, and who may find themselves back in the hospital. However, for the majority of patients, readmission is something that we need to look at, and it is an indicator, I believe, of the initial experience within the hospital ward. I appreciate that the Minister is going to participate in good faith in the process as we go forward. I look to having more interesting discussions and debates with him as we progress.
 
14:45
Darren MillarBiography
Can I also offer my congratulations to Kirsty Williams on the publication of this Bill? I extend that to the Royal College of Nursing, which I know has been particularly active in promoting the Bill. Of course, this Bill’s production is, essentially, an outcome from its Time to Care campaign, which has been ongoing for a number of years. Can I put on record the fact that we fully support the principles behind this Bill? Whether the legislation is something that we will be able to support at the end of Stage 1, I do not know at the moment. We will have to wait to see and hear more of the evidence that is out there through the legislative process. However, the information that has been collated and put into the explanatory memorandum certainly seems rather compelling in terms of making a case for the need for a statutory basis to be put down in Wales, to ensure that there is an adequate ratio of nursing staff to patients.
 
We all know as well, of course, that we have seen horrific reports in England and Wales about the impact of staff shortages on wards, and how that has an effect on patient outcomes. Francis certainly exposed that problem and, indeed, Healthcare Inspectorate Wales, in some of its inspections across Wales, has exposed that problem in some of its dignity and essential care inspections. So, it is very important that we have the right staff to patient ratios, whether that is nursing or other allied health professionals.
 
One aspect of the work that the committee, no doubt, will embark upon will be interrogating particularly some of the financial information that is contained within the Bill, which I thought was quite difficult to fathom, at times. It will be interesting if the Member in charge of the Bill can explain that in a little bit more detail, and particularly the wider health economic impact of minimum nurse staffing ratios, particularly given that there are going to be some beneficial outcomes as well in terms of cost reduction, perhaps elsewhere within the NHS, if the Bill were to be implemented.
 
I have to say that I was a little bit baffled by part of the Bill referring simply to adult in-patient wards rather than all in-patient wards. I appreciate that the Bill itself has the opportunity to expand the provisions into other care settings beyond acute wards in our hospitals, but there is a specific reference in section 2 of the Bill to ‘adult inpatient wards’, which seems to be a little strange to me.
 
Can I just ask the Member in charge why there has been a proposal to measure things at two-yearly intervals in terms of the annual report? Why did she feel that two-yearly intervals rather than an annual report on the impact of the Bill were important? Given the measures that she has identified could be useful in determining whether the impact of the Bill has been positive, or otherwise, how did she arrive at those measures? I fully agree with the Minister that not all of them seemed directly linked specifically to nurse staffing ratios. I think that there are perhaps others that may be more appropriate. I would be interested to know, through the consultation exercises that she has already undertaken, just how those were arrived at in the finality, as it were, in terms of their presentation in the explanatory memorandum.
 
14:49
Kirsty WilliamsBiography
I thank the Member for his questions. The Member is absolutely right to remind me, and it was remiss of me not to mention the Royal College of Nursing in my opening introduction. The Royal College of Nursing has been a massive support in crafting the Bill. It comes, as he quite rightly says out of its campaign, Time to Care. That campaign arose from consultation with its members, who are experiencing these challenges in Welsh hospitals day in, day out. They are trained to do a job and often express extreme frustration that they feel unable to provide the care that they are trained to and want to provide, because of pressures on their time. They often feel quite compromised. One thing that we do know is that, sometimes, people leave the profession because of that. What a waste to the public purse. The Welsh Government has supported an individual through their training, to create that resource for Welsh patients, only to have that resource lost to Welsh taxpayers because of that individual’s frustration with their ability to do their job on the ward.
 
With regard to finances, it is quite difficult to come up with detailed financial implications because, of course, the ratios are not on the face of the Bill. The ratios are not on the face of the Bill for very good reasons. Therefore, it is difficult to provide detailed costings, because of the nature of how the Bill is drafted.
 
However, what we do know is that LHBs in Wales are spending a great deal of money on the employment of bank and agency staff. We know that that is an expensive way to staff our wards. We also know that it is not an effective way to staff our wards. Of course, it is better to have a bank or agency staff member than no nurse at all, but evidence shows that they are simply not as efficient as a permanent member of staff. What we know from the example of the Nye Bevan trust, which has used resources from Welsh Government to create the perfect ward scenario, is that reliance on bank and agency staff when it increased the number of permanent nurse jobs on its wards dropped dramatically. It dropped dramatically by over 60%. So, we do know that there is a direct relation between having permanent staff on wards and a reduction in what is a significant bill for the Welsh NHS, and a bill that does not deliver optimum care for people.
 
On the two years, I am trying to strike a balance between what the Minister would regard as bureaucracy, an added complication, and a reason why he will not vote for the Bill with a practical way of monitoring the impact of this legislation. The time of two years is up for discussion, but I think it is a balance between putting too much bureaucracy into the system and being sure that we are making a difference, and that the legislation is making a difference.
 
The list in section 3 reflects academic evidence and advice and good practice, and that is why that list has been included. Those seemed to me to be key factors in establishing whether people have had the care and the level of care that one would anticipate in the setting. With regard to adults in section 2, you will be aware that the new section 10A(1)(a) that it inserts talks about all settings. We specifically draw out adults in section 10A(1)(b) because that is where the evidence is strongest. I am trying to work with an evidence-based approach, and that is where the evidence, to date, is strongest, but the Bill ensures that all health boards have to have regard for safe staffing across all sectors.
 
14:54
Elin JonesBiography
Congratulations to the Member on being selected to bring forward legislation and for choosing such an interesting area for legislation in what is an innovative area for us here in Wales. As others have mentioned, I am supportive of the principle of ensuring safe nurse staffing levels on wards, and I am very open-minded in thinking that legislation can play a crucial role in ensuring that this is achieved. I look forward to the scrutiny process that will now commence, and to hearing the responses given today and that will be given during the scrutiny process by the Member and by others.
 
Perhaps I could ask some of the questions that strike me immediately. Before doing so, I also congratulate the Member because it was a pleasure yesterday evening to read this Bill. It is such a succinct Bill, over just four pages, that one can digest it in a relatively brief period. As a Bill should do, of course, it raises as many questions as it answers.
 
One of the issues that struck me in reading the Bill was how the Bill and any guidance emerging from such a Bill would allow wards and health boards to ensure that rotas could vary on any ward according to patient need on those wards. We are familiar with situations where a medical ward in a hospital could have no patients suffering from dementia as well as another medical condition on one day, but the next day, there could be a far higher proportion of patients who have dementia and other additional nursing needs. So, how do you anticipate the guidance arising from this Bill allowing that swift flexibility that is so important in terms of staffing rotas?
 
The Bill, along with your statement this afternoon, confirms that this Bill and the legislation could be used to ensure a minimum nurse-to-patient ratio in other health settings as well as the acute setting. Perhaps you could expand on this possibility, and tell us whether you would agree that this should be considered specifically for nurses in the community, given that it is public policy now to consider transferring more and more nurse-led care into community settings. Perhaps the initial question for you on this is why you did not include staffing levels for nurses working in the community as part of this legislation, and why you did not put that on the face of the Bill.
 
The final question to you, which is similar to a question asked by Darren Millar, is on the cost of implementing guidance arising from this Bill. You said in your response that there were no costs arising from what was on the face of the Bill and, therefore, it is not essential for the costs to be outlined in detail at this point. However, you yourself have been critical of the Government when it has brought forward legislation, for failing to outline the full extent of the costs arising from legislation. I particularly recall the legislation on social services. Perhaps you could give us more of a steer as to how you are going to provide us as Members with further information on the financial implications of introducing legislation of this kind.
 
14:58
Kirsty WilliamsBiography
Do you know what, Presiding Officer? I always knew that my scrutiny would come back to haunt me. [Laughter.] I am really wishing that I had been a bit nicer in my questions to other people who have appeared before the health committee, and also in some of the criticisms I have made of the Welsh Government in the past.
 
14:58
Leighton AndrewsBiography
Answer the question. [Laughter.]
 
14:58
Kirsty WilliamsBiography
I am just taking a leaf out of your book, Leighton.
 
First of all, I thank the Member for her general support for the principle of the Bill. I am glad that she approves of the length of the Bill, and that I did not keep her away from her Argentinian Malbec for too long last night. I apply a basic rule to legislation, and that is that size does not matter, and it is what you do with it that counts. I hope that what we have been able to do is produce a concise piece of legislation that is very clear in its aims and objectives, rather than simply using up a rainforest-worth of paper.
 
The Member asked some specific questions about flexibility. I think that you are absolutely right to raise those questions. During the consultation, there have been concerns that an issue around minimum numbers may, by default, become the maximum. I know that there are concerns about that, hence why this is now the safe nurse staffing Bill, rather than the minimum nurse staffing Bill, because I have recognised, during this journey, that actually what is important is not just the minimum number, but the skill mix and having the right numbers of staff on a ward at any one time, hence the change in emphasis in the Bill. Also, section 2(1) talks about involving the use of evidence-based and validated workforce planning tools. The Welsh Government has worked very hard to produce those, so there are systems already coming on-stream that allow you to be able to vary your skill depending on the nature of the patients who are on the ward. The Welsh Government has already done a lot of work in that area. It also allows for the exercise of professional judgment within the planning process, therefore empowering staff on the ward to say, ‘Look, today I need additional support and help’, and it also makes for the provision that the skill mix does need to reflect patient care needs and local circumstances. So, we have tried to draft that into the Bill.
 
I share your ambition that, actually, in the future, more and more care for Welsh patients will be delivered in the community, whether that is in people's own homes or in the renaissance of the community hospital model that the recent mid Wales healthcare report called for. Therefore, we do need to not have this as a barrier to that shift.
 
It is important to recognise that the first line, I think, of the Bill addresses that by saying that the purpose of this Act is to ensure that nurses are deployed in sufficient numbers in all settings. That is the overarching catch-all. There is specific provision for acute wards, because, again, that is where we have the most up-to-date and compelling evidence of the impact. That is not to say that the evidence is not being worked on in other areas. Powys local health board and other organisations are working very hard to establish what safe staffing levels in the community, in the district nursing service, look like—that is, how many people, realistically, one nurse can care for in the community. That work is ongoing and there is provision in this legislation to allow the Welsh Government to bring forward regulations in that area, as and when that evidence is developed.
 
15:02
Antoinette SandbachBiography
I just wanted to say how much I support the principles of this Bill. I know how hard it must have been for you and how much hard work behind the scenes that you have done. I want to echo the point that you made about the reliance on agency staff. In the Betsi Cadwaladr region, we have seen enormous sums—millions and millions and millions of pounds—spent on agency staff, and I have had nurses writing to me saying how demoralised they are to see agency staff coming in from outside to work in their health board area and getting paid so much more than they are, and that the health board is not recruiting when there is a clear need for those positions to be filled on a full-time basis.
 
May I also give my support to your ‘size does not matter; it is what you do with it that counts’ comment? Looking at the Planning (Wales) Bill and the Well-being of Future Generations (Wales) Bill that we have been struggling through, it is a lesson that the Welsh Government would do well to learn itself.
 
15:03
Kirsty WilliamsBiography
I thank the Member for her support. She is absolutely right: we are spending millions of pounds on bank and agency nurses. As I said earlier, that is, of course, better than not having a nurse on the ward at all, but it is a source of great frustration to permanent members of staff. They feel very strongly about it. However, what we know from the evidence is that it is not an effective and efficient way of staffing your ward. Nurses coming into an unfamiliar setting simply cannot be as effective as a full-time member of that team. There is strong evidence to suggest that the outputs that a nurse can deliver over a shift are not the same as those of a permanent member of staff. Therefore, we are having a more expensive system that is actually delivering less. We know that money is tight in the NHS, so we need to make sure that every single £1 of that counts.
 
15:04
Y Llywydd / The Presiding OfficerBiography
I have no more questions for you this afternoon.
 
Debate by Individual Members under Standing Order 11.21(iv): Policing
Y Llywydd / The Presiding OfficerBiography
I call Mike Hedges to move the motion.
 
Motion NNDM5625 Mike Hedges, Jocelyn Davies, Peter Black
 
To propose that the National Assembly for Wales:
 
Believes that policing (excluding the UK National Crime Agency and national security) should be devolved.
 
15:05
Mike HedgesBiography
Thank you, Presiding Officer. I move the motion.
 
I am very pleased to open this debate. I also find that this type of debate, such as today’s and the one on reserved powers last year, gives the National Assembly an opportunity to show the direction of travel that it wants devolution to take. In February last year, First Minister Carwyn Jones called for powers over policing to be devolved to Wales. Alun Michael, a former Home Office Minister and currently the police and crime commissioner for south Wales, has said that many of the levers that affect levels of crime have already been devolved to Wales, such as community safety, education, training, mental health services, alcohol and drug abuse, housing, healthy communities, as well as many other services relating to social factors. Tackling crime and reducing offending and reoffending necessitates working with other public services that already operate on a pan- or sub-Wales level. For example, support for those with mental health conditions—before they reach crisis point and then when they need police intervention and once they have entered the criminal justice system—means working with the Welsh NHS and local health boards, which are devolved.
 
I believe that if policing powers were devolved, it would allow for much greater liaison between services locally and with Ministers and civil servants at a strategic level within Wales, rather than between Wales and Westminster. There is real potential for a successful Welsh model that would build on the strengths of devolution without cutting us adrift of being part of the United Kingdom. That is why I agree with the notion that it should not include the UK’s National Crime Agency or national security, and I would add the strategic policing requirements and counter-terrorism. It is important that police services continue to be able to provide mutual support for large events, which we saw an incredibly successful demonstration of during the recent NATO summit in south Wales. Co-operation in policing clearly needs to extend not just to the British isles, but to Europe and beyond. We know that crime, especially terrorism, crosses borders and knows no borders, more so than ever before. We need to co-ordinate measures to make sure that criminals cannot avoid charges by fleeing to Spain or anywhere else, as once seemed the case—the so-called Costa del Crime. The Welsh Government has shown the capacity for leadership and common sense, implementing policies developed by Welsh Labour through its investment in 500 extra community support officers, which have been invaluable during the harsh period of austerity.
 
Turning to the proposals, first, I will deal with the two exceptions to the proposals—the UK’s National Crime Agency and national security. Obviously, national security needs to be excluded, but dealing with spies or terrorists needs to be done at least on a British basis, and in many cases needs to be done on a whole European basis. The National Crime Agency is a crime-fighting agency with national and international reach, and it has a mandate and powers to work in partnership with other law enforcement organisations to bring the full weight of the law to bear in cutting serious and organised crime. Dealing with border policing command is a vital part of keeping our borders safe and stopping terrorists and other undesirables from coming in. The economic crime command is at the forefront of the fight against economic crime, which affects the UK as well as other places in the world. A lot of this starts outside the United Kingdom, with people setting up in small islands in the Caribbean or countries in Africa, and doing that without the national Governments there knowing. The national cyber crime unit provides a joined-up national response to cyber and cyber-enabled crime to ensure that expertise is focused where it can deliver the most impact and add most value. Also, perhaps many people here will feel that the most important thing is the work done to eradicate the sexual exploitation and sexual abuse of children and young people. The organised crime command leads support and co-ordinates the national effort to identify, pursue and disrupt serious and organised crime. So, those are the bits that are excluded.
 
What that leaves is the day-to-day policing carried out by the four Welsh police forces. Police do not work in isolation. First of all, they work very closely with the fire and ambulance services, which are both devolved. Most people, when accidents occur, call the police, call the fire brigade and call for an ambulance. Another argument in favour of devolving the police is the ability to better connect policing with other devolved services, such as support for victims of domestic abuse and the health service, as Alun Michael has made out. The Welsh Government’s expansion of community support officers by an additional 500 will increase their visibility and will have a positive effect on crime and anti-social behaviour. Community support officers are now the public face of policing in many communities. In many cases, they have built up excellent relationships with their local communities. I am aware of how visible and popular PCSOs are in Swansea East, and I would imagine that that would be the same throughout the whole of Wales.
 
Many of the older generation would remember when we had watch committees responsible for policing in Wales. During most of the twentieth century, policing was a local government function controlled by the local watch committee of the relevant county or, in Swansea, Cardiff, Merthyr and Newport, by the county borough council. We then moved to the local watch committees to two police committees covering the whole of Glamorgan and Gwent, and two others covering the rest of Wales, with very little control over the local police force. The replacement of our police authorities by police commissioners is the only major structural change to have taken place in the forces since the 1960s.
 
15:10
Simon ThomasBiography
Will the Member give way?
 
15:10
Mike HedgesBiography
Certainly.
 
15:10
Simon ThomasBiography
The Member has just gone over the history of the different ways we have governed the police over the years. If we were to see the police force devolved here in Wales, I would support, but would the Member support, having what has happened in Scotland, which is a single police force with a divisional control structure, here in Wales?
 
15:10
Mike HedgesBiography
I think that that is a matter for another debate. I would go for a slightly different system. I would probably go for two: a south Wales police and a mid, west and north Wales police. However, I think that that is a debate for another day, and if we get devolved policing, and we are both here, I think it is a matter that we can engage in during that debate, and I look forward to it.
 
Policing is devolved to Scotland and Northern Ireland, so it is anomalous that it has not been devolved to Wales. The Northern Ireland Assembly, in March 2010, voted in favour of the devolution of policing, with just the Ulster Unionist Party voting against. What happened then? Well, three or four months later they had a department of justice in Northern Ireland and powers were devolved later that year. If we vote today in favour of devolving policing, who thinks that, come the summer of next year, we will have devolved policing?
 
Looking at continental Europe and North America, it is Wales that appears out of step. Across most of the democratic world, other than the control of national security and serious crime, policing is carried out by the regional or local police forces. Law enforcement in Germany lies with the 16 federal states or Länder. Each lays down the organisation and duties of its police. Germany also has a central police force that is responsible for border security and the protection of federal buildings, and a mobile response force that is able to help out to reinforce state policing if requested. Law enforcement in Spain is complicated, but it basically breaks down into local policing and national policing. The United States of America, as people who watch television will be well aware, has federal agencies like the FBI, state agencies such as highway patrols and local policing by county and sheriff departments. What all of these have in common is that local policing is local and major crime and national security are dealt with at a national level.
 
What do the Welsh people think? A poll commissioned by the Silk commission arguing the case for the devolution of more powers to the Welsh Government from Westminster has reported significant public support for moving police powers for Wales to Cardiff. A survey carried out by Beaufort Research for the Silk commission found that 63% of the 2,009 respondents polled between May and June last year were in favour of policing powers in Wales being devolved from central Government in England. Only 35% of those who responded said that they wanted policing powers to remain as they are now, with eight in 10 also saying that they felt that the National Assembly for Wales worked in the best interests of the country and had given Wales a stronger voice in the UK.
 
I believe that the way forward is to devolve most policing to the National Assembly, but to keep the UK National Crime Agency and national security service. Just remember that, in 1960, the large cities of Britain policed themselves, without anyone outside the Home Office having any concerns. The Home Office then set about nationalising them. We should get back the right to police ourselves and hand local policing to the Welsh Government.
 
15:13
Mark IsherwoodBiography
Just as devolution of the UK National Crime Agency and national security would be irresponsible, so would devolution of policing. We cannot agree with the Silk commission that there would not be substantial additional costs. As I said in the February 2006 debate on the then proposed Wales police merger, the police authorities told us that the additional all-Wales annual cost of reorganisation would be up to £57 million, with the chief constables saying that it would be even more. The introduction of the police and crime commissioners did mark an act of real devolution, empowering local communities to have their say on policing priorities and to hold an elected representative to account. We are concerned by evidence that—[Interruption.] Laughter, I am afraid, is pathetic. [Laughter.] We are concerned by evidence that the devolution of policing would compromise—[Interruption.] You weaken yourselves further. It could compromise cross-border working between police forces.
 
When the Assembly’s Social Justice and Regeneration Committee reviewed the structure of policing in 2005, our report noted that criminal activity does not recognise national or regional boundaries and that cross-border partnerships must reflect operational reality. As I said then, almost all the population of Wales lies along the M4 and A55 corridors, separated by a vast expansive rural hinterland, geography, history, transport links and very different policing requirements. Some, I said, had even suggested that the North Wales Police force should combine forces with the north-west of England. As I stated in the 2009 debate on cross-border issues, the Welsh Affairs Committee had identified a lack of co-ordination of cross-border services between England and Wales and stated that citizen engagement should not stop at the border. Mold Town Council had stated that there was no recognition of the relationship that the area’s population had with north-west England. The border between England and Wales is long and porous and, as a result, cross-border movements in services are a long established fact of life, reflecting geographic and demographic realities. It should be a cause for celebration and co-operation rather than an obstacle to efficiency and effectiveness. The objective must be to do things better rather than being different just for the sake of it. We must avoid at all costs a slate curtain in services between these two British nations. As the Police and Crime Commissioner for Dyfed-Powys, Christopher Salmon, said, devolving policing was a ‘power grab’. The Welsh Government’s creeping politicisation of devolved public services is damaging, but the risk of this infecting policing is chilling.
 
As Labour MP David Hanson said when he was shadow Minister for police, devolving the control of the police to Cardiff would be a major step with many challenges and reducing crime was more important than deciding which Government manages the police.
 
He added,
 
‘there are some really complex issues around this in relation to serious organised crime, counter terrorism, the legal system, justice, probation’.
 
It is not just a simple matter of devolving policing to Wales, he said,
 
‘because counter terrorism, serious organised crime, cross-border issues, much of the crime in my part of Wales derives from people who live in England’.
 
As my contacts in North Wales Police told me last week, they have a closer affiliation with north-west England than the rest of Wales, including a joint firearms unit, protective services and emergency backup. They added that there is a lack of competence in Welsh Government to handle the devolution of policing, unlike in England and Scotland. They asked where the money would come from to set up the equivalent of a Welsh Home Office and stated that the focus should instead be on unscheduled healthcare and care in the community, where they said hospitals are at capacity, no ambulances are available and people are therefore ringing the police, putting real and growing pressure on them.
 
The police federation has taken a neutral position. In its ‘A Consensus on Policing in Wales’ book, launched here last night, former Gwent chief constable Mick Giannasi states:
 
‘whilst I could see there might be some strategic benefits from the devolution of police, there are also serious operational risks…putting aside the ideological arguments…the list of potential benefits for me is a relatively short one’.
 
‘With under 7,000 police officers, Wales is too small to stand alone in Policing terms. In a devolved environment, it would continue to rely heavily on English Forces for its resilience both in terms of mutual aid for major incidents and large scale events and in terms of specialist support in areas like Counter Terrorism and serious and organised crime’.
 
As he said,
 
‘the cost of creating ‘stand alone’ resilience would be prohibitive and difficult to justify’.
 
15:18
Y Llywydd / The Presiding OfficerBiography
I just want to remind Members that this is a debate for backbenchers, so if we can just remember that.
 
15:18
Jocelyn DaviesBiography
The devolution of policing is not simply a point of principle. I think that it is a fundamental step forward on our devolution journey that we must take to secure integrated, cohesive public services. The second Silk commission report made new powers over policing a key recommendation for the future of devolution as part of a package of reform to create a clear and stable devolution settlement. It was encouraging to see a positive response from the Welsh Government on those recommendations, even if its Labour colleagues in Westminster are not quite so enthusiastic. However, I am optimistic that the question relating to the devolution of policing is now not ‘if’ but ‘when’.
 
As set out by Mike Hedges earlier, the devolution of policing is in the interest of all those living in Wales. Far from weakening policing, which is the fear sometimes expressed by opponents, it would strengthen it by enabling greater integration between the police and other public services—an area that I think needs considerable improvement.
 
Last week, Her Majesty’s Inspectorate of Constabulary published a report following an investigation into all the police forces in England and Wales, which found that Gwent police, in my own area, is failing on all levels of policing. I want to draw your attention in particular to the significant concerns raised by HMIC over how the force responds to victims of domestic abuse. This is despite tackling domestic violence being a stated priority of the Gwent force following a number of high-profile cases where serious institutional failings were found to have taken place. Joanna Michael was murdered by her partner after calling 999 twice for help. Three years later, Caroline Parry was shot dead by her estranged husband in the street in Newport, again following contact with the police, when she had asked for help. Despite promises to improve, the Independent Police Complaints Commission is once again investigating Gwent Police after a woman was stabbed by her ex-partner within hours of letting the force know that he was contacting her, in breach of a harassment order. The IPCC reports on Welsh police force cases make for very sorry reading.
 
These cases, of course, are tragic and the issues are not confined to Gwent. I will be watching the outcomes of the investigations to see what action needs to be taken. Meanwhile in the Assembly, the Gender-based Violence, Domestic Abuse and Sexual Violence (Wales) Bill is making its way through our processes. While I have been an outspoken critic of some of the limitations of this Bill, I appreciate that the Welsh Government’s intention is improving and ending the postcode lottery for services for victims. However, this will have no impact on the police until powers over policing are devolved.
 
So, how can the Welsh Government successfully improve all services for victims of domestic abuse under a devolution settlement that limits the scope of its work, and how can any Welsh Government deliver successful and integrated public services without the powers to do so? It is already the case that devolution has benefited the police in Wales; an HMIC report from 2011 on the impact of austerity cuts showed that Dyfed-Powys, North Wales and South Wales Police forces faced less than average cuts in their budgets because of decisions made by the One Wales Government. I believe that the Welsh Government has the competence to deliver improvements on policing.
 
Devolving policing would also prevent the confusion over issues such as police and crime commissioners. The UK Government needed the Assembly’s agreement for the reform of police authorities into police and crime panels as part of the introduction of police and crime commissioners. When we voted ‘No’ to give it that authority to change the rules in Wales, the UK Government brought the change through the backdoor anyway, undermining the democratically elected voice of the police. I hope that one of the first actions of the Welsh Government with powers over policing would be to abolish the police and crime commissioners completely, because far from empowering the electorate, they set the record for the lowest ever election turnout. We would never have had police and crime commissioners in Wales if we had the powers over policing that we need. I would prefer to scrutinise the Minister here in this Chamber than try to hold the regional crime commissioners to account through the inadequate structures available to me and to the public currently.
 
We need to improve the Welsh policing system so that it is firmly rooted in the needs and requirements of our communities. It will only be possible when powers over the police are devolved here.
 
15:23
Ann JonesBiography
Before I start my speech on this, I declare an interest, in that my son is a serving police officer with North Wales Police.
 
I rise to just ask a few questions. I remain to be convinced that it is possible to devolve policing without devolving powers over the criminal justice system. I know that the Silk commission and the Welsh Government have recommended that we should have devolution of policing, but without the criminal justice system question being addressed, it leaves me with a very stark choice to make as to whether that is the right choice for the people of Wales.
 
Criminal justice and policing are, in my mind, intrinsically linked. If you have the policing levers, I believe that you need the levers to change the criminal justice system. All of the agencies within the justice sphere have to work in collaboration in order to reduce offending and to protect the public. That is hard enough sometimes, and by devolving the police we would risk having yet another body—this time, the Welsh Government—with no real benefit being felt by our constituents.
 
There are issues around where offenders would serve their time. Who would pay for the time those prisoners served in England if we devolved the policing system?
 
Cross-border collaboration is an important part of protecting the public in my constituency. Mark Isherwood has referred to the North Wales Police firearms unit, which is now being shared in collaboration with Cheshire Police. I do not know who Mark’s people are, but senior officers have told me that this is a good collaboration for financial and operational reasons. However, I do think that that could be at risk if policing was to be devolved. One thing I am sure of, if policing were devolved, is that there is a consensus, if you take the Tories out of the equation, that we would scrap police and crime commissioners. Of course, I would welcome that proposal with open arms, as policing should remain being run operationally by officers who have served through every rank within the police force and got to the top. Police and crime commissioners have been an expensive failed experiment, and while police and crime commissioners do not have responsibility for day-to-day operations, the lack of clear boundaries for them from the Home Office has led to some of them overstepping those marks.
 
I cannot agree with Simon Thomas on this occasion on the fact that we should have one Wales police force as they have done in Scotland. I cannot buy into this idea of ‘for Wales, see Scotland’. We are on a different devolution journey here, I think, and we need to guard against any knee-jerk reactions that just push us down the same road of having one national police force. The Assembly and the Welsh Government just need to look at these issues a little bit more clearly than we are doing. I have always thought that we should devolve powers where we can make a real difference and where there are clear policy considerations to make for that case. Simply saying that we want powers because Scotland has them is a very weak argument.
 
However, we also need to guard against calls for devolving powers as a knee-jerk reaction to austerity. We know that a Tory Government, whose main goal is to cut out most of the much-needed public services, is not inevitable. Crime sharply reduced under Blair and Brown, and the role of community safety was expanded by introducing community support officers here and other measures. Given the steep reduction we have seen in police numbers and with further revelations in the media that officer numbers under a future Tory Government could be driven down even further, we will see the police being able to function only as a reactionary service and jeopardise all of the proactive work that really helps those communities. Here, I just want to pay tribute to chief inspector Jason Davenport from my own central patch who initiated a clean-up arrangement along with beat bobby Les Jones from west Rhyl. They have done that through a multi-agency approach and actually gone out proactively, talking to the community. In the process, I think that they arrested a person as well so that was an extra bonus.
 
However, the simple solution to this is to elect a UK Labour Government next May—a Labour Government that will scrap PCCs and invest in making our society safer. Presiding Officer, devolution is a journey. I want to see us take more decisions here in Wales, by politicians elected by the people of Wales. As a founding Member of this Assembly, I have been proud as we have seen the capacity and competence of the Assembly grow. However, there is still much more work needed on this. I thank the individual Members for bringing this forward. I think that it is an opportunity for backbenchers to express their views.
 
15:29
Byron DaviesBiography
I am delighted to have the opportunity to talk in this debate. I think that it is very healthy that we have this debate. It really does need to be had. I come at it from an operational angle, I suppose. My previous job was as a police officer for 32 years in the Metropolitan Police. The last eight years of those I spent on the National Crime Squad, which was the forerunner of today’s National Crime Agency.
 
During my time as a police officer, there were always many experts lining up with ideas and plans to reform policing. It was to some of us a source of annoyance that there were always people who knew better. It was often, if not always, the case that these people lacked some understanding of what policing and operational policing are really about and lacked practical knowledge of policing. I do not believe that policing should be devolved to Wales as I do not believe there is a demand for it. I firmly believe that police and crime commissioners have already delivered real community policing, in England and Wales. I will say it quite openly: I had reservations about the police and crime commissioners at the outset, and I was not that enthusiastic about them. However, I have to say that it is a very democratic process, and, no matter how many people vote for it, the fact is that it does work. When I look—as has already been mentioned—to people like Chris Salmon down in Dyfed Powys, who is making an excellent job of it, I think that it really does have a future.
 
I will now turn to cross-border crime—and I will return to it again in a moment. Cross-border crime, international crime and online crime make the case for the Welsh Government taking over from the Home Office very weak indeed. I simply do not understand where the demand for the devolution for policing lies. Despite claims to the contrary, other than perhaps a passion for control, I have seen no public demand here in Wales for the Welsh Government to run policing; in fact, it is quite the opposite when I speak to operational officers, as I did even last night at the police federation function.
 
Why would the Welsh Government run policing better than the UK Government, or police and crime commissioners? The truth is that there is little discussion around Wales about policing with the general public, and about policing being given to the Welsh Government, and, indeed, why should there be? I think that it is divisive, and it would possibly open such issues as regional pay—something that I very much object to.
 
Crime is falling year on year under the UK Government currently, and the figures point to that. Police and crime commissioners now offer the most radical, localised policing solutions that we have seen. Indeed, talk to lawyers—and my own son is a barrister—and they will say the same, namely that they currently have the ability to practice across a jurisdiction that is seen as one of the fairest and most successful in the world.
 
The Welsh Government made the devolution of policing the main plank of its submission to the second part of the Silk commission process into the powers of the National Assembly, saying that it made sense when other emergency services were devolved already. Let me say this loudly and clearly: the only similarity between the emergency services is three little numbers—999. So, that logic is flawed, and, I think, demonstrates a real lack of understanding of operational policing.
 
Policing is about intelligence gathering and intelligence sharing. This is a national issue.
 
15:32
Y Llywydd / The Presiding OfficerBiography
Will you take an intervention?
 
15:32
Byron DaviesBiography
Oh, yes, certainly.
 
15:32
Ann JonesBiography
Just on the point that all three emergency services are the same, you will know that my background was in the fire service, and I would argue that, if I was to have an intruder, I would phone the fire service, because I know that I would get five firefighters as opposed to one officer.
 
15:32
Byron DaviesBiography
A matter of personal preference, I would suggest. I know who I would be phoning.
 
As I said, policing is about intelligence gathering and intelligence sharing. This is a national issue and organised criminals do not respect constabulary boundaries, and neither will they stop and consider our national boundary. Technology, transport and the internet have changed the face of policing, which demands a UK approach.
 
I know that Mark Isherwood has already quoted from David Hanson’s words, and I am not going to repeat them, other than to say that I would repeat just the bit that says:
 
‘It isn’t just a simple matter of devolving policing to Wales because counter terrorism, serious organised crime, cross-border issues, much of the crime in my part of Wales derives from people who live in England’.
 
I have to say that, during my time on the national crime squad, with cross-border issues, chief constables are very parochial sorts of people, and they look after their budgets, and it is very difficult, actually, to get them to spend money on cross-border initiatives. I think that devolving policing would make that even more challenging on a Wales-England basis. So, I think that David Hanson was spot on. Policing between England and Wales—unlike Scotland—is intrinsically linked, due to the porous nature of our border and the density of the population on either side.
 
Looking also to major events is a terrific testament to the England and Wales police forces—for example, how they safeguarded the NATO conference—and they are to be congratulated. The organisation at the moment can move resources with ease and very little bureaucratic or political interference. So, for me, it is certainly a case of keeping it as it is. Why on earth mess with the fundamentals of a system that is admired around the world, and that, frankly, proves itself on a daily basis?
 
15:34
Julie MorganBiography
I would like to congratulate Mike Hedges, and other colleagues here, for putting forward this motion; I am very pleased to support it. I do believe very strongly that policing should be devolved to Wales, and I believe that it has the support of most of the public in Wales.
 
It is a major public service and I believe that it should be working along with the other public services. I think that they are very much interchanged. Levels of crime are affected by the youth provision, education provision, community safety and public protection. All of those areas affect what level the crime is at, and all of those services are devolved. I believe that devolution would lead to more joined-up Government, a consistency of approach and an integrated approach, and I believe that that would lead to the reduction of crime. It is very important, when we look at what we would like to see devolved, that we see the actual impact of it. I agree with what Ann Jones said that we do not want to rush to devolve things just because Scotland has had them. I think that we need to look at them closely and see what the impact is on the people of Wales. I do believe that this would provide a better service for the people of Wales and would lead to crime reduction.
 
Several people here have already mentioned the issue of police and crime commissioners. I think that it would be very good if we did have police and crime commissioners devolved to Wales because we would then be able to legislate to remove them. In south Wales, of course, we do have the good fortune of having an experienced politician with a background in youth justice and the Home Office, and a deputy who has extensive knowledge of equal opportunities and policies to address domestic abuse. I want to pay tribute to them because this has meant that South Wales Police has had great foresight and has put domestic abuse at the top of the policy agenda. Alun Michael has given his views on this debate today and has sent in his strong support for the devolution of policing. So, I certainly want to acknowledge their contribution—
 
15:36
Y Llywydd / The Presiding OfficerBiography
Are you taking the intervention? I call Mark Isherwood.
 
15:36
Mark IsherwoodBiography
Will you also acknowledge that the Police and Crime Commissioner for North Wales has supported funding for independent sexual violence advisers and the development of a north Wales domestic abuse strategy, and that there is good work going on across Wales on this basis?
 
15:37
Julie MorganBiography
I am not saying that there is no good work going on, but I am saying that the work on the domestic abuse agenda is outstanding in south Wales. I want to acknowledge that work, while saying at the same time that I think that we should get rid of police and crime commissioners. I know that the Labour Party in Westminster has said that if it gains power it will do so, and I think that that is absolutely the right thing to do. It is really ridiculous to think that they have the support of the public. Somebody has already mentioned the vote when they were actually elected. The votes for police and crime commissioners were absolutely derisory. The Electoral Commission says that the 15.1% turnout in the PCC elections was the lowest recorded level of participation at a peace time, non-local government election in the UK. Throughout the UK, the PCCs are totally male dominated, there is no-one from an ethnic minority, and also, bringing in the police and crime commissioners has brought a whole structure of expense that I think could be much better spent on front-line policing. I know that the Tories have an obsession with electing commissioners and mayors, but on the whole, the public does not want them.
 
15:38
Y Llywydd / The Presiding OfficerBiography
Are you taking another intervention?
 
15:38
Julie MorganBiography
Oh sorry; yes. I did not see.
 
15:38
Y Llywydd / The Presiding OfficerBiography
I call Nick Ramsay.
 
15:38
Nick RamsayBiography
That is alright; I was not rising to vent an obsession on democracy, but we are all democrats here, and you must accept, Julie, that if you look at the voting figures for the National Assembly back in 1999, they were not wonderful. It takes a while for democratic institutions to bed in, does it not?
 
15:39
Julie MorganBiography
I do not think that this institution is bedding in and, certainly, the vote was not 15%. I strongly support the devolution of policing and I also support getting rid of the police and crime commissioners. I know that Silk, and I believe that the Welsh Government has also said, that it will take longer to devolve justice, the courts, the prison service and probation, and I know that it has been said today that maybe policing should not be devolved before those other parts. However, I personally think that it is possible to devolve policing by itself, and I hope that we will be able to move towards devolved policing and then, later, move towards the devolution of probation, courts, criminal justice and all the justice system.
 
15:39
Y Llywydd / The Presiding OfficerBiography
I call on the First Minister to speak on behalf of the Government—Carwyn Jones.
 
15:39
Carwyn JonesBiographyThe First Minister
I thank Members for their contributions. A number of issues have arisen that have been missed, I think, on the Tory benches, and some issues that need to be addressed. First, as the Member for Swansea East has made very clear, he is not suggesting that the national crime agency should be devolved nor counter terrorism; that was as clear as daylight in what he said. Yet, from the Conservative benches, you would swear that that is exactly what he had said.
 
No-one is suggesting that those issues should be devolved. What is being suggested—he did not put it quite this way, but if I could take the liberty—is roughly what Scotland has. There is a template there already in terms of devolution. In Scotland, policing is devolved subject to certain reservations with regard to serious crime. That is a template that would serve Wales, in my view, very well.
 
In listening to what Mark Isherwood said, he sounded like a voice of a man from 17 years ago, telling us how bad devolution was. Yes, of course Wales has a porous border, but the reality of the situation is that that does not stop us from delivering services in our own way. Of course there has to be cross-border co-operation, everybody understands that, but that does not mean that the responsibility for policy and funding should not rest in Wales. He made the point about the PCCs. For the PCC elections, the turnout, on average, was three times lower than the average turnout of an Assembly election. I accept, of course, that we would all like to see an Assembly election turnout being much higher, but at least it is not at the level of the PCCs. To suggest that they are widely accepted and widely supported in the community is certainly stretching it.
 
The reality is this: Wales had PCCs imposed. We had no choice. Scotland and Northern Ireland did not have them imposed. Wales alone of the ‘four equal nations’, as the Prime Minister has put it, had no choice as to whether this policy was taken forward. That must never happen again. Regardless of what a future Welsh Government might do if policing is devolved, at least the decision will be taken in Wales, by the people of Wales, and not by bureaucrats in Whitehall.
 
A lot has been made of cross-border co-operation. This is normal in the UK, unless you are arguing that Scotland should lose control over policing. Scotland has full cross-border co-operation with England and it has a porous border. There is not, as far as I am aware, an electric fence strung across the banks of the Tweed that means that the Scottish border is not porous. In the same way, you only have to look at the border between Northern Ireland and the Republic of Ireland to see an equally porous border compared to Wales, where there are large communities on both sides of the border. Yet, there is co-operation between two different sovereign states in those circumstances, particularly with regard to counter terrorism, but also with regard to ordinary crime. Are we really saying that it is beyond the realms of possibility for Wales and England to co-operate with policing when everybody else does it, even within the UK? Of course not. It is perfectly possible.
 
If we look at the NATO conference as one example: on the one hand, it is said that if you devolve policing, you will not get that co-operation; yet, on the other hand, it is also said that that co-operation was there even though two of the police forces that were involved are devolved anyway. So, of course you get co-operation, even at the moment, when there are two devolved police forces in Scotland and Northern Ireland.
 
In terms of the point that Ann Jones was making, she makes a fair point and it is one that needs addressing. Can you separate policing form the criminal justice system? Sorry, Ann. My answer is different to hers. I would say that you can. The reason I say that is that the police bring people to the door of the criminal justice system. The CPS escorts them through it. Once they are through that door, then the courts are involved, judges are involved, probation is involved and the prison service is involved. It is very difficult to devolve any of those services individually. For example, with probation, if you want to control the number of people coming through probation, you have to control sentencing policy and you have to control the way that criminal law is interpreted. None of this applies with the police. If you have control over the policy and funding of the police, it does not affect the criminal justice system.
 
Byron Davies made the point that he thought that this would affect the practice of law. It has no effect at all on the practice of law, because if policing policy and funding is devolved, the legal system is the same and nobody, regardless of what happens in the future, would want to make it difficult for barristers and solicitors in England and Wales to practice cross-border. That happens now in Northern Ireland, so that should not happen in Wales.
 
15:44
Ann JonesBiography
Will you give way?
 
15:44
Carwyn JonesBiographyThe First Minister
Yes, Ann.
 
15:44
Ann JonesBiography
Thank you very much for taking the intervention. I appreciate what you are saying, but for me, I still think that—. I hear what you say about the police taking them to the door and then the Crown Prosecution Service takes them after that, but what happens if there is delay in the court lists, because barristers will not look at it if we have devolved the policing system? What happens then? What happens to the ordinary member of the public who then has to wait for justice, if it is longer? I just cannot square the circle; that is my problem.
 
15:44
Carwyn JonesBiographyThe First Minister
It would not affect the courts at all if policing was devolved because, of course, the criminal justice system would still be in a position of being an England and Wales system, so there would be no effect whatsoever. The police would arrest somebody, they would take them to the position of the Crown Prosecution Service then deciding whether to prosecute or not, and all the rest of the system is unaffected, whether you devolve policing or not.
 
Some other points that Members have made I think need to be addressed. First of all, we have to remember that the police could not function in Wales anyway without Welsh Government funding, because a chunk—nearly a quarter—of police funding comes from Welsh Government. Without that, the police could not function in any event and yet we do that without any formal control over policing policy. It is true that there are good informal links, but that formality is not there.
 
I have to say, as far as Byron Davies’s comments are concerned, he said that he did not think that there was a demand for devolving policing in Wales. All the polls suggest otherwise. I have to say that more and more people come to me in my surgery convinced that policing is devolved, which is why they come in the first place. When you explain that the police are not devolved, they cannot understand it. That is part of the problem that we have. The other thing that we have to understand as well is that the Home Office has a very poor record of understanding devolution. We deal with it, and it is not deliberate on its part, but it does not understand devolution. It does not understand the difference in structures between Wales and England, and that can cause problems for us. They are usually ironed out, but we could do without those problems.
 
The final point that is worth making is this: we cannot cherry-pick Silk part 2 and, indeed, the Smith commission. If it is good enough for Scotland and to be on offer to Scotland, it is good enough to be on offer to Wales. The UK Government would not dream of cherry-picking the Smith commission’s report, yet it is trying to cherry-pick Silk part 2. No more dithering, no more faffing about, and no more cherry-picking: we need to see Silk part 2 implemented, including policing. We need to make sure that the Smith commission’s proposals are on offer to Wales. We need to make sure that air passenger duty is devolved, otherwise how else could we possibly think of it other than discrimination, bluntly? We need to see control over the electoral system of the Assembly devolved to Wales. We need to make sure that funding is resolved. None of these things is happening at the moment. The issue of policing is bound up in that. The whole point about Wales being treated differently and in a more discriminatory way than Scotland: no more of it. Policing needs to be devolved. We need to make sure that we see progress on Silk part 2. We need to make sure that the Smith commission’s proposals are on offer to Wales. No more dithering. I say to the UK Government: treat Wales with the respect you give Scotland.
 
15:47
Y Llywydd / The Presiding OfficerBiography
I call on Peter Black to reply to the debate.
 
15:47
Peter BlackBiography
Thank you, Presiding Officer, and may I thank all those who have contributed to this debate? I thank the First Minister for doing most of my summing up for me in terms of responding to some of the points that have been made. If I can just briefly go through a number of those points, Mike Hedges started off by quoting Alun Michael and the very strong case that Alun Michael circulated to all Assembly Members in the last couple of days in terms of devolving policing, but also, I think, underlined the exceptions in this motion, which are the UK National Crime Agency and national security. I agree that those functions need to be undertaken on a UK-wide basis as they often involve international liaison, tackling sophisticated and determined criminals who operate without borders. For that reason, I think that it is right that we should exclude those from the devolution that is being proposed here. I think that Silk 2 also highlighted that particular issue.
 
Mike Hedges also highlighted the interaction with other emergency services, as did other Assembly Members, and I think also pointed out that the Welsh Government already deals outside the strict boundaries of devolution. It has already funded the police on areas outside of devolved powers. I have referred in the past to Operation Tarian, which we provided funding for a couple of Assemblies ago, as well as the police community support officers. Also, of course, as the First Minister just pointed out, we currently fund about 50% of the police grant from our own budget, but on the basis of a formula that we do not control and subject to top-slicing for other forces outside of Wales, not to mention the anomalous way that Cardiff is treated as a capital city compared with Edinburgh and London. So, clearly, there are issues there in terms of the funding, which we would be able to address as part of the devolution of functions to Wales, which I think would, again, benefit the police across Wales.
 
I thought that Mark Isherwood very much confused reorganisation with devolution. Giving responsibility to the Welsh Assembly does not necessarily mean that we going to merge all the forces or reorganise them. Clearly, that would be expensive, and, of course, we rejected that when it was proposed by the last Government. What it would mean, though, is that an important service would work more effectively in a Welsh context and to a Welsh agenda. This is not a power grab. It is a sensible recognition of the reality of policing in Wales. Nor would devolution throw up a wall around Wales—
 
Mark Isherwood rose—
 
15:49
Y Llywydd / The Presiding OfficerBiography
Are you giving way?
 
15:49
Peter BlackBiography
I will just finish this point, Mark, and I will let you in.
 
Nor would devolution throw up a wall around Wales as far as policing is concerned. The motion specifically excludes the UK National Crime Agency and national security, while forces would continue to work with partners across the border, as is sensible, and as do other devolved services such as health.
 
15:50
Mark IsherwoodBiography
Is not the reality that, unlike in Scotland, two thirds of the population of Wales live within 50 miles of England, and that we have a west-east criminal economy, if you want to use that term, in the north and south? The quotations that I gave from North Wales Police, from only last Friday, were made by serving police officers at all levels, not by me.
 
15:50
Peter BlackBiography
Well, that reality applies to a whole range of devolved services, especially health, but other services as well, and we have to work around those issues. We are talking here about services delivered in Wales, and policing is a service that is delivered in Wales, and that has to be recognised as part of this. However, that is not an argument not to devolve policing. In fact, it is an argument for saying that we need to accommodate that, and I have said that that will continue to happen, as is sensible.
 
The Deputy Presiding Officer took the Chair at 15:51.
 
Peter BlackBiography
I do, however, agree with you, Mark, that commissioners are a form of devolution, but would argue that the arrangement that we are proposing here would make that devolution more desirable, because we have already started the process and we can take it further forward.
 
Jocelyn Davies talked about the devolution of policing as ‘not if, but when’, and I agree, but she also reiterated the point that it will strengthen relationships with other public services. She highlighted the domestic abuse Bill currently being considered by the Assembly and the important link between measures in that Bill and the work of police forces, and I think that that is absolutely right and, again, makes the case even stronger in terms of supporting this motion.
 
I understand that Ann Jones remains to be convinced that it is possible to devolve policing without the criminal justice system. I agree, in fact, that the two are intrinsically linked, and I think that Silk also recognises that. I noted the First Minister’s point that you cannot cherry-pick Silk 2, and Silk 2 did say that there should be a review within 10 years of the case for devolving legislative responsibility for the courts service, sentencing, legal aid, the Crown Prosecution Service and the judiciary to the National Assembly.
 
My view is that administrative devolution is possible in the short term, but that the justice system would need to follow and that would involve us having to address gaps in the Welsh prison network, for example, either by building more prisons or, more realistically, working in partnership with England. We certainly need provision for female prisoners in Wales, although there is also a case to reduce or abolish custodial sentences for women in many circumstances, as there is evidence that they are treated more harshly by the courts system. However, clearly, we would have to consider justice, but I think that, in terms of Silk 2, that would come later and as part of a review, and I think that that is the right way to go about it. However, administrative devolution of the police is very much possible and very much a realistic way of doing things.
 
Byron Davies asked why the Welsh Government would run policing better than the UK Government. The answer actually lies in the many policy and operational synergies that devolved police forces would be able to access, which has already been pointed out by me and by previous speakers. Julie Morgan, in fact, pointed out that the levels of crime are very much affected by devolved services and that the devolution of policing would lead to better linkages within Wales and a better service. I think that that point answers very well the question that Byron Davies posed for us.
 
The First Minister, of course, drew parallels with Scotland, which already has the responsibilities that we are seeking in this motion and, again, I think that it is right that we should also seek those powers.
 
I do not think that it is helpful to make this a debate about police commissioners, by the way. The case for devolving policing is much stronger than some people’s dislike of a particular innovation. The argument here is that the case for devolving policing is self-explanatory within the context of devolution and strong enough without focusing on other issues. By all means, restructure the accountability framework once devolution has taken place, but that is not and should not be the rationale for change. Change is necessary because it is logical and will deliver a more effective and joined-up service, and, for that reason, I hope that Members are able to support this motion.
 
15:54
Y Dirprwy Lywydd / The Deputy Presiding OfficerBiography
The proposal is to agree the motion. Does any Member object? There is objection. I defer voting on this item until voting time.
 
Voting deferred until voting time.
 
15:54
The Enterprise and Business Committee’s Report on the Welsh Government’s Approach to the Promotion of Trade and Inward Investment
Y Dirprwy Lywydd / The Deputy Presiding OfficerBiography
I call on the Chair of the Enterprise and Business Committee, William Graham, to move the motion.
 
Motion NDM5644 William Graham
 
The National Assembly for Wales:
 
Notes the report of the Enterprise and Business Committee on its Inquiry into The Welsh Government's Approach to the Promotion of Trade and Inward Investment, which was laid in the Table Office on 10 October 2014.
 
15:54
William GrahamBiography
I move the motion.
 
I am glad to open this debate today and to move the motion on the Enterprise and Business Committee’s report on trade and inward investment. We launched our consultation in November 2013 and had 12 written responses. We then took oral evidence from 16 witnesses over eight evidence sessions, and heard from the First Minister as well as the Minister for Economy, Science and Transport. In addition, we met with Welsh Government officials in Brussels, and spoke with businesses at the Institute of Life Sciences in Swansea. The Assembly’s outreach team also produced a video that captured interviews with a range of small and medium-sized enterprises across Wales. I would like to thank everyone who contributed evidence to our inquiry, as well as our members of the committee and our excellent support staff, who supported the work of the committee.
 
We wanted to look at trade and inward investment because of the significant recent changes in the way that the Welsh Government works in this area. In 2006, the Welsh Development Agency was abolished and replaced by International Business Wales, which formed part of the Department for the Economy and Transport. In 2010, International Business Wales was itself replaced by the integrated sector teams as part of a Government reorganisation. Then, in 2012, the Minister told the committee that a new major projects team had been established to take the lead on trade and inward investment. These changes also attracted the attention of the Welsh Affairs Select Committee at Westminster, which undertook a lengthy inquiry of its own into trade and inward investment, and published its report in 2012. In some key areas we agree with its findings.
 
The biggest issue that emerged in our inquiry was a lack of confidence in the arrangements that followed the abolition of the WDA. Several witnesses frankly felt that the WDA had been more effective. The Federation of Small Businesses said:
 
‘There can be little doubt that its successor organisations…failed to command the strength of brand that the WDA had achieved’.
 
Similarly, the Welsh Affairs Select Committee found that the WDA was still more widely recognised, years after its abolition, than the bodies that replaced it. Other witnesses thought that there had been a change of culture since the abolition of the WDA that had not been helpful. Professor Max Munday of Cardiff University pointed out that there had been
 
‘an element of entrepreneurial behaviour and risk-taking’
 
involved in attracting inward investment, and that this can be more difficult to accommodate in a ‘civil-service-oriented environment’.
 
The Government has responded by pointing out that the economic context has changed dramatically since the days of the WDA, and the First Minister told the committee that he believed that it was ‘fruitless’ to make such comparisons. We take the point, and our report notes that the expansion of the EU in particular has made it much harder for Wales to compete for inward investment. Nevertheless, we believe that there is scope for the Government to look again at whether the current in-house arrangements represent good practice and value for money.
 
It is therefore disappointing that the Government has rejected our recommendation to commission an independent evaluation in this regard. In its written response to the report, the Government points to big increases in inward investment over the last two years. We obviously welcome these improvements, but would ask the Minister to carefully consider the concerns that stakeholders expressed. The South Wales Chamber of Commerce spoke of
 
‘an underlying culture of trying to keep everything in-house’,
 
and the FSB believed that there was a ‘credibility gap’ in the advice that the Government now offers businesses.
 
One of the key themes of our inquiry was the relationship between the Welsh Government and UKTI. We were pleased to hear that this relationship is a strong one, but we also heard concerns that the sheer number of UKTI events makes it difficult for Wales to attend everything. Professor Gareth Morgan, chair of the life sciences sector panel, told us:
 
‘We have to be there. There is no substitute for that’.
 
We therefore recommend that the Welsh Government should explore options for involving the sector panels or the private sector in representing Wales at such events. The Government has accepted this recommendation in principle. Clearly, we welcome that, as well as its positive response to our recommendation on making more use of the private sector to attract inward investment.
 
Another development since the abolition of the WDA is a lack of clarity about Wales’s position on trade and inward investment, both in terms of our aspirations and the results that the Government delivers. The committee heard that it has become more difficult to monitor performance in this area, and several witnesses felt that there was ‘a lack of transparency’. The WDA had published yearly and half-yearly reports containing detailed information on progress made against individual targets. These reports stopped after the WDA was brought in-house, with the final one being published in December 2006.
 
Several of our recommendations ask for improvements in the statistical data that the Welsh Government collects and publishes in this area. We asked for transparent key performance indicators on inward investment to be published annually, and are disappointed that the Government has rejected this recommendation, arguing that commercial confidentiality prevents it from giving a fuller picture. The WDA used to publish more detail, and we feel that this is an area that the Minister could usefully look at again. Professor Munday described the data currently published on foreign direct investment as ‘almost completely useless’ and argued that the data led to misinterpretation of performance, such as the suggestion that inward investment increased by 191% in 2012-13. The Government repeats this assertion in its written response, but it was rejected by Professor Munday as being based on the number of projects rather than actual capital investment.
 
Another area where economic statistics can be improved is on gross domestic product. We recommend that the Government should commission GDP figures for Wales on the same basis and frequency as the rest of the United Kingdom. The Government has accepted this recommendation in part, and we look forward to the outcome of the review being undertaken by the chief economist and the chief statistician.
 
Similarly, we believe there is scope to improve the quality of export statistics in Wales. The Minister agreed that this was a concern, but our recommendation has only been accepted in part. While we understand that it is a complex and expensive business to separate Wales’s contribution to exports from that of the United Kingdom as a whole, we urge the Government to work with the Office for National Statistics to improve the data that it publishes in this area.
 
More worryingly, the Government rejected our recommendation that it should publish annual performance measures for the support it provides to exporters. A number of the small and medium-sized enterprises interviewed by the Assembly’s outreach team felt there was a lack of support from the Welsh Government. Indeed, some businesses were not even clear as to the Government’s policy or ambition on exports, with the Federation of Small Businesses pointing out that we lack targets in this area, unlike both the Scottish and United Kingdom Governments. The written response suggests that the Government is satisfied with its work to support exporters. If that is indeed the case, I would have thought that publishing annual performance indicators would be a useful tool for the Government to market the strength of its support to potential exporters.
 
Underlying many of these issues is the lack of a clear economic development strategy. The frequent changes to the support structures for trade and inward investment, and the decline in the quality of data used to measure performance, seem to be symptomatic of a general loss of focus. We heard evidence that questioned whether the Government had a strategy, and at the very least it would seem that more could be done to communicate the strategy to key partners.
 
In a similar vein, we heard several comments about the weakness of the Welsh brand when it comes to trade and inward investment. This chimes with evidence that we have taken for our current inquiry on tourism, where stakeholders also feel that they would benefit from a more coherent brand to help them promote their business. We are pleased to see from the written response that the Government is working on this, and we hope that the trade, inward investment and tourism brands will form part of a connected strategy.
 
Finally, may I thank the Minister for Economy, Science and Transport and the First Minister for their engagement with the committee on this inquiry? We appreciate that we have been looking at trade and inward investment during a period of great economic change, and we know that the Government is committed to responding to that change and maximising the benefits for Wales. We hope that our report will help the Government to do so, and although just one of our recommendations was accepted outright, we hope that the ideas that we have put forward, and the views of stakeholders that we have captured, will be a valuable resource for the Government in developing this work.
 
16:03
Nick RamsayBiography
No debate about improving our economic outlook can hope to be complete without recognising the invaluable contribution of inward investment to that debate. The Enterprise and Business Committee’s inquiry is therefore highly welcome, and the recommendations are certainly food for thought. Well, they are for some of us anyway. The Welsh Government seems less keen. In fact, it has been a long time since, looking through the Government’s response to a report, I have seen ‘reject’ or ‘accept in part’ appear so many times.
 
Now, let me be clear: I think the lessons that we can learn from this report are essential in improving exports and attracting foreign investment. Okay, some on the fringes may argue that we do not need to look outside our home-grown businesses, but those voices are few and far between.
 
The key thrust of this report is that the Welsh Government should set out a clear economic development strategy that clarifies its aspirations for trade and inward investment. The strategy should include the international markets and sectors it considers to be of strategic importance to Wales and outline how the Welsh Government supports Welsh businesses to exploit the opportunities in those markets. Now, that is obviously a polite, committee-speak way of saying that, if there is a strategy, the current strategy is confusing and may not only be actively discouraging potential future investors, but current investors too, that there are actually far too few clear goals or targets, and, furthermore, that the lack of transparency and communication between the Welsh Government and Welsh businesses is reflected by the exports themselves.
 
Let us face it. We all know, and it has already been touched upon: Wales had a powerful brand when it came to exports and inward investment. A brand that was called the Welsh Development Agency. Of course, the WDA did so well that it was abolished in 2006, and the rest is history. As the Federation of Small Businesses said:
 
‘There can be little doubt that its successor organisations, including International Business Wales, failed to command the strength of brand that the WDA had achieved.’
 
The FSB was not alone, of course. Other witnesses during this inquiry raised the same concern, which led to recommendation 1, asking for an independent evaluation by the Welsh Government to assess whether the current in-house approach represents good practice and value for money—an independent evaluation that could have shown the real state of Welsh inward investment and its export strategy. The Welsh Government has, of course, rejected this recommendation. I wonder why.
 
Recommendation 4: let us look at that. That has been given the boot as well by the Welsh Government. Asking for key performance indicators to be published every year—not an unreasonable request, you might think. It is a request that would not be necessary if there were enough data on investments made in Wales at this point in time anyway. The data that we have are misunderstood. The Welsh Government says that there has been a whacking 191% increase in inward investment. It sounds great, does it not? The only problem is that there has not been, has there? That figure is actually based on the number of projects or jobs, but not on actual capital investment. That is a lot lower.
 
To be fair to be UKTI, this is not its job. The Welsh Government needs to collect data on this, and that is not happening at the moment. It is not just transparency on data. We could look at transparency on the priority sector approach as well. The Federation of Small Businesses complains that there is a difficulty in ascertaining what the sector panels do and how they are supporting businesses. Cardiff Business School has said that the key sector approach adopted by the Welsh Government is causing confusion among inward investors—not ideal. There is, Minister, a general fear that, by targeting specific areas, other parts of the economy will suffer unnecessarily. I really do think that you need to address these concerns.
 
Recommendation 7? Well, that calls on the Welsh Government to publish annual key performance measures for the support it provides to exporters, such as details of trade missions and fairs, and their relative costs. Recommendation 7—rejected, of course. The South Wales Chamber of Commerce thinks that the missions are not representing value for money. Other witnesses characterise the missions as limiting and focusing on big companies, rather than on real-life business that wants to export. Now, the Government might well think that, on the face of it, those larger companies are more important. However, supporting Welsh SMEs to export their products and services abroad would have an influence on the statistics in the long term. So, SMEs, as we say in so many debates, definitely need more support. However, no, that recommendation was rejected by the Government.
 
In conclusion, this report has raised some interesting questions. Wales definitely needs a strong brand to survive in an increasingly competitive market—a single, coherent brand that will show what Wales does. This is not rocket science. Let us get regular, detailed information on the budgets, targets and outcomes of the inward investment and export activity.
 
16:08
Rhun ap IorwerthBiography
Thank you for the opportunity to speak in this debate on the committee report and to make a few comments on the Government’s responses. There were 10 recommendations in all. I will start with recommendation 1, calling for an independent evaluation to assess whether the current in-house approach was working. It is a recommendation, as we have heard, that was rejected. There was clear evidence from the committee’s work to show that, since taking inward investment in-house, the marketing message overseas has been inconsistent. Many of the witnesses said that it not only muddied the message but also restricted risk-taking. I am not going to focus this afternoon on the demise of the WDA, but the Welsh Government rejects the recommendation, it seems, because, it says, statistics show that Wales is performing well. Let me tell you what Professor Max Munday, director of the Welsh economy research unit, told us about those statistics. To be blunt, he said,
 
‘The sort of figures that we use…are almost completely useless’.
 
So, I will jump to recommendation 4, calling for the Welsh Government to develop and publish annually a set of transparent key performance indicators. Professor Munday’s comments make the rejection of that recommendation rather surprising and obviously disappointing. Simply stating the number of projects attracted to Wales does not give us a proper understanding of the progress made in making Wales an attractive business destination. Neither does the numbers of jobs created and safeguarded on their own, important as they are.
 
The same goes for recommendation 5, calling for improving the quality and timeliness of the economic statistics available to us. The Government has accepted this recommendation in part. The wording of the Government’s response suggests that the part that it does not accept is to work with the ONS to produce GDP figures for Wales on the same basis and frequency as it does for the UK as a whole. The response states:
 
‘production of a quarterly indicator of GVA at low cost is feasible, but the case for such an indicator is less strong than many assume’.
 
The latest data we have for Wales are GVA for 2012 and GDP for 2011. Does the Minister really think that that is acceptable? It is not possible to run a country without the tools to analyse your progress, and it certainly is not possible to scrutinise the Government’s performance without these indicators. There is a reason the ONS publishes quarterly statistics for the UK: because they are essential statistics. The ONS can do so for Wales at low cost, the Minister admits, but it is only the Welsh Govern