Yr eitem nesaf ar yr agenda yw’r datganiad gan Ysgrifennydd y Cabinet dros Iechyd, Llesiant a Chwaraeon ar arolwg iechyd Cymru. Rwy’n galw ar yr Ysgrifennydd Cabinet, Vaughan Gething, i wneud y datganiad.

Thank you, Presiding Officer. The Welsh health survey gives us an overview of the state of the nation’s health. It covers health status, health service use and health-related behaviour. I’m making a statement today on the headline messages, but there will be more learning and analysis of the survey later in the year.

The recently published Welsh health survey 2015 shows us that 19 per cent of adults currently smoke. That’s down from 26 per cent in 2003 to 2004. This significant reduction means that we have surpassed the Welsh Government aim to reduce smoking rates to 20 per cent by 2016. We are now well on track to achieve the ambitious target to reduce smoking levels to 16 per cent by 2020—and we didn’t always think that we’d get there. This progress is testament to the efforts of a range of professionals who have worked to discourage in particular young people from starting to smoke, and the advice and support given to smokers who want help to quit. I’m pleased to recognise that the people of Wales have embraced a change in culture so that smoke-free environments are now the norm.

It’s important that we maintain and enhance our efforts. We know that smoking kills and causes harm. We need to act so that young people do not start smoking and smokers who want to quit receive the best support available. With this in mind, we’re currently reviewing the tobacco control action plan to ensure that we continue to make every effort to further reduce smoking levels in Wales.

We have, for the first time, specific information about the number of e-cigarette users in Wales. Fifteen per cent of adults have ever tried e-cigarettes; with 6 per cent being current users, and 59 per cent of current users are also current smokers. These figures are comparable to the findings from surveys elsewhere in the UK, and we will continue to keep the evidence on e-cigarette use under review.

Whilst levels of alcohol consumption have not fallen this year, they do remain at the lowest levels since these questions were introduced in 2008. Overall, alcohol consumption amongst younger adults has reduced, but there has been a slight increase in older adults. Tackling alcohol misuse remains a priority for the Welsh Government and our actions will be set out in the new substance misuse delivery plan. The actions will include a strong focus on tackling the harms associated with risky drinking behaviours, particularly amongst older adults. We expect to publish that plan before the summer recess.

Our actions to reduce the harms caused by alcohol are underpinned by new UK chief medical officers’ guidelines, which were published in January this year. These include a single low-risk limit of 14 units a week for both men and women, and make clear that drinking any level of alcohol increases the risk of a range of cancers and other disease. The new guidelines also reinforce the message that there is no safe level of alcohol to drink during pregnancy.

We will continue to press the case for introducing a minimum unit price for alcohol in Wales. Such action would specifically target the heaviest drinkers to prevent the harms caused by excessive alcohol intake, whilst minimising the impact on moderate drinkers.

The survey also provides us with an indication of the proportion of the population who are either overweight or obese. The Minister for Social Services and Public Health highlighted last week that there has been a slow but steady increase in the number of adults classed as overweight or obese since the survey started in 2003-04. During this 11-year period, the proportion of adults classed as overweight or obese has risen from 54 per cent to 59 per cent, and obesity alone has increased from 18 per cent to 24 per cent. Levels also increase with deprivation and are highest in middle age.

Put simply, we know that the cause of people being overweight and obese is an imbalance between calories consumed and calories expended. So it’s not surprising that the data also show levels of physical activity are not improving, and only a third of adults report eating their five portions of fruit and vegetables each day, which is a widely used indicator of a healthy balanced diet.

Improving the well-being of people in Wales, and enabling them to eat better and move more is a key manifesto commitment for us, and my portfolio brings together a number of the components to take this agenda forward. The recently enacted Well-being of Future Generations (Wales) Act 2015 has at its core an intention to improve the health, social, economic, environmental and cultural well-being of Wales. To fulfil the ambitions of the Act, we will have to become a society in which physical and mental well-being is maximised and behaviours that benefit future health are understood. Increasing physical activity levels and improving our diet are key components to achieving the ambitions within the Act.

A national physical activity director has been jointly appointed by the Welsh Government, Sport Wales and Public Health Wales to develop recommendations to improve levels of physical activity.

Together with work on education and behaviour change, we are also working to influence the food environment. We are expanding nutritional standards in more settings, and we’re currently developing them for both care homes and early-years settings. We will also need to work with the food industry at both Welsh and UK levels. We need to influence the availability of healthier products and encourage the use of the UK Government’s front-of-pack nutrition labelling scheme and responsible promotion and marketing. My predecessor, of course, pressed for stronger UK Government action on sugar and a strengthening of the restriction on advertising of unhealthy foods to children. We were pleased to hear the announcement of the UK sugar levy. However, the levy in itself will not resolve all of our challenges around sugar consumption.

Whilst I am of course encouraged to see a decline in the number of adults smoking in Wales, overall it is clear that many of us continue to eat and drink too much and are not exercising enough. Supporting and encouraging people to take small steps to improve their lifestyle and reduce the risk of preventable illness remains a priority for the Welsh Government. However, this is not something the Welsh Government can do alone. It requires joint action from a wide range of organisations from the public, private and voluntary sectors and, of course, from individuals themselves.

The Deputy Presiding Officer (Ann Jones) took the Chair.

Plaid Cymru spokesperson, Rhun ap Iorwerth.

Thank you very much, Deputy Presiding Officer, and thank you for the statement. This is a very important survey. I appreciate that we’re only discussing the headlines today and I’m looking forward to a fuller analysis in due course.

There are positive signs here on the percentage that smoke, for example, with reduction continuing, but, of course, with a long way to go. I do support the further steps by the Government in this area in trying to hit the more ambitious targets, but as one who voted against the public health Bill because of the e-cigarettes element, I would encourage the Government to see e-cigarettes as an important tool against smoking. I’m pleased to see that the Government is keeping an open mind, as we heard from the Minister today. There is some light here in terms of over-consumption of alcohol. But if I could turn now to the negative elements in this report.

Os trown at yr elfen negyddol fawr sy’n dod allan o'r arolwg hwn, yr ystadegau ar ordewdra yw honno. Nid newydd ddechrau canu y mae’r clychau larwm ar ordewdra, maent bellach yn canu’n uchel iawn, a dylai hyn yn sicr fod yn ddigon byddarol i orfodi llywodraethau i redeg, nid i guddio, ond i fynd ar drywydd camau brys. Mae'n sgandal cenedlaethol, mae'n sefyllfa drychinebus, rwy’n meddwl y gallwn ni i gyd gytuno ar hynny, sy’n bygwth lles cenedlaethau'r presennol a'r dyfodol. Nodaf y camau a amlinellir gan y Gweinidog, gan gynnwys penodi cyfarwyddwr gweithgarwch corfforol cenedlaethol. Rwy’n gresynu, fodd bynnag, nad yw gordewdra ymysg plant yn cael sylw penodol na sylw manwl heddiw yn y datganiad hwn. Mae'n amlwg bod gennym epidemig gordewdra yng Nghymru ymysg plant ac mae angen mynd i'r afael â hyn ar frys mewn polisi ac o ran adnoddau. A yw'r Gweinidog yn rhannu fy awydd i geisio ffyrdd newydd o gynyddu cyllid yn sylweddol yn y maes hwn?

O ran brys, tybed pa wersi a ddysgwyd o strategaethau i derfynu ysmygu, oherwydd yn fy marn i ni allwn fforddio gadael i'r frwydr yn erbyn gordewdra ddigwydd ar amserlen debyg i'r mesurau lleihau ysmygu, sydd wedi cymryd degawdau i ddod i rym.

O ran pŵer trethiant, tybaco, ynghyd ag alcohol, wrth gwrs—maent wedi’u trethu’n drwm. Ac er iddi gymryd cryn dipyn o amser, rwy'n falch bod Llafur o'r diwedd wedi newid o ddilorni i gefnogi ein galwadau am ardoll ar ddiodydd llawn siwgr. A gaf i ofyn sut y mae'r Gweinidog yn awr yn bwriadu gweithio gyda Llywodraeth y DU ar gyfer cyflwyno’n gynnar yr ardoll y mae Llywodraeth y DU wedi addo ymchwilio iddi?

Efallai y bydd y Gweinidog yn gwybod bod y Swyddfa Seneddol Gwyddoniaeth a Thechnoleg wedi cyhoeddi adroddiad heddiw ar siwgr a gordewdra. Mae'n galw am gyfyngu ar faint o siwgr y mae pobl yn ei gymryd. Mae'n galw—corff arall eto—am gyflwyno ardoll. Mae hefyd yn tynnu sylw at nodweddion tebyg yn y dulliau gweithredu gan y diwydiant bwyd a'r diwydiant tybaco i ohirio cyflwyno rheoleiddio. Felly, a gaf i ofyn yn olaf a fyddai Ysgrifennydd y Cabinet yn rhoi sylwadau ar y camau y byddai'n hoffi eu cymryd, neu y mae’n eu cymryd, i ymdrin â'r ymdrechion hyn i rwystro gweithredu gan y Llywodraeth?

I thank the Member for his series of comments and questions and the broadly positive start, and I too look forward to seeing more learning from the survey as it undergoes more analysis to help inform where we are and where we want to be.

I’ll start with your point about e-cigarettes. Just to reiterate that we continue to keep the evidence on e-cigarette use under review, both in terms of their prevalence and the way that their used, their impact potentially on young people and the way in which they’re marketed and the flavourings, but in particular the impact of e-cigarette use. We’ve heard a number of reports about the impact of e-cigarette use itself, with the statement that they are 20 per cent less harmful than tobacco, but of course that doesn’t mean to say that they are harm free. So, there is a need to understand what they’re used for, the prevalence and what the impact is. We don’t yet understand what the long-term use of them will be, but we will continue to look at the evidence and be led by evidence on this issue.

I’ll deal with your points about food, nutrition and sugar together, if I may. Just to slightly tweak where we are, it wasn’t that we rubbished the idea of a sugar levy; it was the idea about how it could be hypothecated. We were never in favour of hypothecating the use of a sugar levy in the way that it was initially presented, but there was never any disagreement between our two parties that a levy on high-sugar-content products could and should be considered. What we have now is a sugar levy on drinks, but it doesn’t consider every other part of food as well. Part of the action my predecessor has urged the UK Government to undertake is to do more to promote alternatives to sugar, which we promote ourselves in Wales, but to also look again at regulation for sugar in more than just fizzy drinks.

This goes back to the point that food, nutrition and many of the regulatory powers over food and nutrition and nutrition standards are not devolved. There’s a balance of what we can and can’t do, which is why we do still need to work with the UK Government. I can confirm that there are conversations ongoing between Governments about the introduction of the levy that’s been proposed and how that might or might not work, and that work will be taken forward between both my department and also that of the Secretary for Finance and Local Government as well. I hope that we can come back and tell Assembly Members more when we’ve actually had more constructive conversations, to be able to tell you something more than the fact that we are talking at this point.

I want to deal with your point about obesity. We’ve recognised for some time as a country that we have a significant challenge with obesity—the impact on public health outcomes on a whole range of disease and health condition indicators and the impact it has on people’s day-to-day lives, the reality that it is more prevalent in more deprived communities than in others. So, there is no room for any complacency. Part of the difficulty is that it goes back to this point of how we use these results to understand what we need to do more of and how we work more successfully alongside the public to encourage them to make choices for themselves, but not in such a way that we seem to be preaching or nannying the public and telling them what they must do. We have to make healthier choices easier choices. If we look at children, for example, just over one in four children are either overweight or obese. That’s our understanding of the child measurement programme, which means that about 73 per cent are a healthy weight. But our problem is that we’ve not seen the sort of reductions in overweight and obese children that we wish to see, and to combat that we need to see what happens pre school, during school and outside school as well, and we need a culture change broadly across society and within families as well—so an understanding of what the impact is upon a child of an unhealthy diet and the impact on the child of not undertaking enough exercise. So, there is a range of different things for us to do, but just because the picture is complex, it does not mean that we should not wish to do something about it and that we will not wish to do something about it. It’s as I said at the end of my initial statement: this is about the public, voluntary organisations, the public and private sectors and individuals themselves understanding and reinforcing what they could and should do and how we make those choices easier for them and the fairly immediate health impacts and health gain that people can see in being a healthier weight.

Conservative spokesperson, Angela Burns.

Thank you, Deputy Presiding Officer. Minister, I’d like to thank you for this statement. I too very much welcome some of the news contained within it. I’m delighted to see that smoking has definitely gone down to 19 per cent of adults from 26 per cent. It is interesting to note that that’s a complete correlation with the number of people who use e-cigarettes. I’m delighted to hear the comments you made to Rhun ap Iorwerth because I’m rather hoping that, with a new Cabinet Secretary in place, we might have a fresh view on this vaping issue, because, if it helps people to give up smoking, it is surely worth considering rather than the somewhat obdurate resistance to it last time around.

Turning over to the rest of the statement, I would like to particularly raise the issue of obesity to talk about diabetes. I was very surprised, actually, to read in the Welsh health survey that they said there was only a slight increase in diabetes, which does not chime with much of the rhetoric that we hear from various organisations saying that diabetes is sort of on the march in Wales. I wonder, Minister, if you would consider drilling down into those figures and perhaps seeing whether we can find out how many of those people have diabetes type 1 versus type 2, because, as you and I both know, type 2 is something that can be helped to be got rid of by having a better diet, better exercise and more advice and support, as opposed to type 1.

Also here on the correlation with young people being obese, I raised this on your statement last week about the declining amount of hours in school sports available. We need to recognise that, again, within this survey, it says that, actually, between 2004, when the survey started, and last year, 2015, the amount of exercise young people under the age of 16 take has decreased, rather than increased. So, we appear to be going backwards. So, I really would like to ask, Minister, what you’re going to be able to do to liaise with your colleague in education as to how we make sure that young people, particularly the very young, grow up with this healthy habit of good exercise that will help to combat this particular area. It can’t be done in isolation; we need an integrated view. That’s why I wonder: is that the reason why you’ve appointed a national physical activity director? Is this a new post with new money, or is this somebody who’s already in existence who’s going to be taking on this responsibility? Because, again, although I agree with the thrust of your argument here, I would have thought that, again, this is an educative role, and what we need to do is ensure that, within education, we really make young people, children, get to grips with understanding what constitutes good food, affordability, cooking skills, physical activity, getting over the bullying and the embarrassment that young women, in particular, face when they try to partake in sports. Would a national physical activity director be looking at all of that? And, again, when we look at areas of social deprivation—those are people who struggle to access sport—poverty, et cetera. So, again, I would have thought that that would have been worked through in all of the various social programmes that we have, rather than creating a whole new post. In short, should it not be embedded in Government policy, rather than having one tsar, or do you think that tsar will be able to have an effect, and how will you measure that tsar?

I thought that it was very interesting to see, again within the Welsh health survey, that they’re basically saying all our kids are pretty healthy. Yet, that’s not quite chiming with the children, young people and education’s report on the Designed to Smile programme in the last Assembly, where we found that some 41 per cent of Welsh five-year-olds have significant experience of tooth decay, some 8,000 children have to have anaesthetics in order to remove multiple decayed teeth, and you and I will both know that, in fact, it is through your mouth that you get so many illnesses, so many infections, and having bad teeth actually sets you up as an adult for ill health. So, I would like to know what you might be doing with the Designed to Smile programme and what you might be doing—because this is, if you like, a gateway into good health. Having good teeth equals good health, and I’m very surprised that it’s not been picked up in the health survey. As you’re going to be reconstituting this health survey, I wonder if you would consider whether or not you should be asking questions on the dentistry side of it.

Finally, I would like to just remark upon the fact that you are intending to relaunch this entire survey—future health surveys. You say that this is the last such Welsh health survey in this format, and I would like to know that in the new format—will you be having very similar questions so that we can still continue to plot a trajectory, or are you going to be starting from base with a whole new set, so we can’t year-on-year comparisons? I think that’s really important for us to know, because, ultimately, in our role of scrutiny, it is by being able to scrutinise your performance, year on year, that we can have a picture of the effect of the policies put forward by your Government. To be frank, Cabinet Secretary, your Government does have form in getting rid of inconvenient comparable statistics, and I would like to know if, going forward, there will still be able to be that comparative measure. Thank you.

Thank you for the series of questions. I would like to acknowledge the good news on smoking, in particular, although it’s not fair to say that it’s simply a direct correlation with e-cigarette use. As I said earlier, a part of the issue is that there are more and more young people becoming adults who don’t smoke, and that really does affect smoking prevalence rates—a really welcome cultural change that is happening, although I don’t have any complacency about the rates or prevalence of smoking amongst young people.

On obesity and diabetes, and the relationship between the two, we are, of course, talking about obesity and its relationship, in particular, to type 2 diabetes, as opposed to type 1. That’s been the significant growth that we’ve seen. For all the fact that the rate of growth appears to have levelled off in the last year or two, that still leaves us with a huge problem, because we know that the more people we have living with type 2 diabetes, the more likely they are to call upon the health service, to live in periods of ill health and all of the significant complications that go with diabetes. We had the national Diabetes Week last week, and I don’t think we can ever tire of repeating that it isn’t a trivial condition. I visited the team in Ysbyty Gwynedd and looked at the work they’re doing—really impressive work—in Betsi Cadwaladr on having surgery as opposed to amputations. It’s pretty affecting to see the pictures of what’s happened with the surgery. If the alternative was an amputation, that has a major impact on someone’s life expectancy as well as their quality of life and their ability to work and get around socially. You know, the reality is that people lose their sight, they suffer amputations as a result of diabetes. It is a really, really serious condition, and that’s where the major concern comes about the impact on people’s quality of life, people’s ability to work and to live, and actually the cost it produces for health services. Already, about 10 per cent of NHS spend, we think, is spent on areas linked to diabetes.

On your points generally about school sports and physical activity, and the links between our work and that of both the children and communities portfolio and, of course, the education Secretary, we recognise that there are very obvious and direct links about how we encourage and make it easy for children to be physically active and, again, how we think about the nature of that activity. So, we don’t simply think about sport, important though that is as part of the picture, but physical activity going much further and much broader than that. That is the conversation that we are having, as we go through curriculum reform as well, to understand what that could look like and what we think that should look like, and then how we measure appropriate points to understand whether our children are being more physically active. But it goes back again to the point that I made at the start in response to Rhun ap Iorwerth as well: this is about what the Government could and should do, in all its forms, as well as what individuals will do as well. So, it’s not just the children but also the families, and the importance that they place on physical activity and, again, how easy we make it for them to undertake that activity as well.

The new post of physical activity director is a joint post, as I said earlier, but it does go to the core of not just what the Government want to see, but actually Sport Wales recognising that part of their mission is not just about elite sport. At least three out of the four main parts of their mission are broadly about participation and, if you like, the link into public health areas of activity. That’s what it’s about: grass-roots activity, not just about elite sport. I think there’s been a willingness in the last few years in Sport Wales to be more upfront about that being part of their mission and how they should be judged as well. So, this post is about trying to bring together what we could and should do across the different arms of Government. Sport Wales, as an Assembly sponsored public body, and then to ensure that we then have some meaningful targets and milestones. So, you will see something that will come back to try and give you and other Members an idea of where we think we are now and what we want to do in various parts of Government, and our partners as well.

I should also say, on your point about deprived communities, we have a range of specific programmes, from StreetGames to Communities First, but there’s also something here about mainstream governing bodies, for example the football at the moment. The Football Association of Wales—the biggest participation sport in Wales. It’s a fairly easy game to play; you don’t need a lot of equipment. So, it’s thinking about the way in which we use sport, and the easily accessible sport, to try and get people interested in activity. That isn’t always about organised league activity, it is about that broader message about sport being physical activity and recreation as part of what we want to see. That has to go into deprived communities. I actually suspect that some of our major sports have a slightly better story to tell than they’re able to present. I look forward to interrogate, with my colleague the Minister of public health, to understand what really is happening and whether they’re actually meeting their own missions that they have as well.

Finally, I take your point about Designed to Smile, but, actually, it’s been one of the programmes that are able to say that there’s been a closing of the gap between more deprived communities and others. That doesn’t say that it’s perfect, so we do want to understand what we need to do more of in the future.

Finally, on your point about the new survey, there will be a new survey as part of the new national survey—a more coherent way to undertake this information in one chunk rather than three or four major surveys. We still expect high-quality data that are useful both for the Government, in understanding what we are doing and what we wish to do, but it could be for the public and Members of this place to understand the impact that we’re having and to aid the process of scrutiny. There’s certainly no ambition to try and hide what we are doing. It is simply a way of ensuring that we have appropriate and high-quality data. If there is a reason to change the way those data are presented, we should be upfront about the reason for doing that. There is no desire to try and avoid comparability, but it may well be that we collect different sorts of data that are more relevant. If that’s what we’re going to do, we need to be upfront about it and explain that that’s what we’re going to do. But I would still expect that you’ll have plenty to be able to ask us about and scrutinise us on. I’ve got no doubt about that.

Finally for this statement, the UKIP spokesperson, Caroline Jones.

Diolch, Lywydd, and thank you for your statement, Cabinet Secretary. The Welsh health survey data once again highlight the need to improve public health messages. Of course, the challenges of increasing levels of obesity are not unique to Wales. However, it’s truly shocking to learn that nearly 60 per cent of Welsh adults are overweight or obese. Cabinet Secretary, with many schools selling off their playing fields, what assessment has the Welsh Government made of the impact this will have on physical activity rates amongst young people? We have many programmes where we encourage children to play, children to be active and children to walk more, but we have to provide them with facilities.

With regard to smoking, it is welcome news that the number of smokers continues to fall. I was pleased to see that the survey had, for the first time, included data on e-cigarettes, and that the Welsh Government is at last heeding the evidence. E-cigarettes are one of the most effective quitting aids in the smoker’s arsenal. Cabinet Secretary, with the demise of the Welsh health survey, how will the Welsh Government continue to gather evidence about e-cigarette use?

We on this side of the Chamber are disappointed that the Welsh health survey has been discontinued by the Welsh Government. Our objections are about its replacement, the national survey of Wales. We don’t believe, with its smaller sample size, that the data will be as robust. The Welsh health survey, over the course of each year, captured the views of around 15,000 adults and 3,000 children, with a minimum of 600 adults from each local authority in Wales. The national survey of Wales will only capture the views of around 12,000 adults. The survey takes place mainly over the summer, and it appears that there are no set minimums for collecting data from each local authority. Cabinet Secretary, can you assure us that, in future, the data collected on health will be as detailed and robust as that collected in the Welsh health survey? Cabinet Secretary, how will the Welsh Government be capturing the views of young people, who have a right, as we do, to have a say on our NHS? Finally, Cabinet Secretary, the Welsh Government undertook a consultation in 2014 to seek the views of users of the Welsh health survey. The vast majority of respondents were supportive of the survey. In fact, the only criticism was about the timeliness of releasing the data. With these points in mind, can you update us on why the decision was taken to end the survey? Thank you. Diolch yn fawr.

Thank you for those particular points and questions. On the selling of school playing fields, this is a Government that is investing in the infrastructure of our school estates, and I’ve visited a whole number of areas where we’re actually seeing an improvement in people’s ability to use outdoor space in particular for physical activity and recreation. There’s no excuse to be given for a lack of physical activity amongst school-age children in terms of school playing fields at this point in time. I actually think we need to concentrate on what we can positively do in the way that the curriculum works and the way that families work for schools, and with the broader message we have about the importance of physical activity and recreation, and to recognise that it isn’t simply an issue for schools. It is an issue that, by and large, most of these lessons about life are learned outside school, and it’s about that working alongside the family to understand the impact, the positive impact, of physical activity and recreation.

I’ve dealt with the e-cigarettes issue and I’ve been very clear: we’ll keep the evidence under review, and as I said earlier, you’ll have noticed in my statements that just under six in 10 e-cigarette users are also smokers as well. So, we need to understand if there is a relationship with quitting, and if there is not, we also need to understand the long-term impact on people’s health of e-cigarette use. That is part, I think, of what even those who were opposed to the measures of the previous public health Bill on e-cigarettes will have been concerned about: the way in which there was pretty clear evidence that some e-cigarette manufacturers were targeting young people in the way that the flavours were actively marketed. There are real and serious issues for us to consider here, so let’s not pretend that we should not do that. But as I said earlier, we’ll consider the evidence on e-cigarette use and their impact.

On the national survey and the ending of the specific Welsh health survey, we took a view on having a more efficient way of conducting information and understanding what the public think and do. I don’t think you could describe a national survey with detailed information of over 12,000 adults as not being something that is robust and high quality. It’s certainly our expectation that we’ll have a robust and high-quality national survey. If you ever have an opportunity—I don’t know if opportunity is the right word—but, if you have an opportunity to talk to a Welsh Government statistician, I think you’ll find that they’re very interested in the quality of their data and they can talk to you at length. I’d be very happy to arrange for you to have a very long session with a Welsh Government statistician to highlight their view on the national survey if you really are concerned about its impact and its usefulness for understanding health behaviours in the past and what it tells us about the future of our public services.

Thank you very much, Cabinet Secretary.