Questions now from the party leaders. The leader of Plaid Cymru, Leanne Wood.

Diolch, Lywydd. First Minister, do you agree that cuts to disability benefits and changes to assessments brought in by Westminster Governments have gone too far and are now harming people who are in genuine need?

There’s no question at all in my mind that what’s been done by the UK Government with regard to benefits has targeted the most vulnerable. The bedroom tax is one example of that, and she has mentioned another example there. From my perspective, society is judged according to how well it looks after its most vulnerable, not by targeting its most vulnerable.

Thank you, First Minister. The Ken Loach film ‘I, Daniel Blake’ is resonating with people everywhere. I’m sure you’ll be aware that that film explores hardship, the root causes of hardship and how the system seems to be rigged against those people who are most in need of help. A major part of the hardship experienced by disabled people has come down to flaws in the way in which assessments are carried out. Will the First Minister accept that general practitioners and doctors should be the people making assessments of disability, and that there should be no barriers for disabled people to getting the support that they deserve?

I could not disagree with either of those comments that she’s made. GPs are perfectly well qualified to make an assessment as to whether somebody should qualify for a particular benefit or not. Similarly, of course, I do worry about the fact that those people who are having to go through a number of obstacles in order to claim a benefit are being dissuaded from doing so, and that means greater hardship for them. There are some who may not even want to go through that process in the first place, despite the fact that they may be entitled to benefits. That is where we are, unfortunately, at the moment as a society, where those people who most people would accept need help from the state are being dissuaded from getting that help.

I share your concerns, First Minister, and I’m glad that you agree with my position. I’ll give you an opportunity to demonstrate how much you agree. I’ve got a constituent who is claiming employment support allowance and wishes to claim a disability grant in order to enter education. Her GP is demanding that she pays a charge of £95 for completing the forms. Without those forms, she won’t get the grant and, therefore, won’t be able to study. I’ve had it confirmed that students may have to pay to get disabled students grants, and that GPs may charge for this work, which the British Medical Association guidance suggests could be a charge of £90 for 20 minutes’ work. That’s what they say is appropriate, and that is more than you are earning as First Minister. Do you think it’s appropriate that the NHS that you’ve been running for 17 years is putting substantial financial barriers in the way of disabled people trying to improve their lives? And will you commit to getting rid of these charges as soon as is possible?

Well, this is the difficulty with the independent contractor model: GPs do charge for services that go beyond the contract, which is why, of course, as Members have heard me say in this Chamber before, there are other models that we need to consider in the future. She has raised an important point on behalf of her constituent. If she writes to me with more details about the case she has raised, I will, of course, write back to her with a personal response.

The leader of the Welsh Conservatives, Andrew R.T. Davies.

Thank you very much, Presiding Officer. First Minister, the Government announced last week that an extra £50 million was to be made available for winter pressures—something we hope will actually alleviate some of the pressures that the acute or primary sectors faced this summer, so that people don’t have the waits they’ve historically had to endure. One of the things that people do dread undertaking these days is ringing their local GP surgery to try to get an appointment, especially an appointment on that particular day, because obviously the demand is so great. Can you tell me exactly how that £50 million or what part of that £50 million will go into general practice to alleviate the pressures that general practice in particular is facing in accommodating the extra demand that it is facing?

Well, GP surgeries organise themselves in different ways. Some do offer appointments on that day, and I’ve seen them. Others, for reasons that they have to explain, will wait for a week or two, or sometimes even longer. That’s not acceptable for the people who they serve, but the money for winter pressures is designed, of course, to ensure that the health service is able to deal with any pressures that may arise as a result of colder weather, where people come in with respiratory conditions, for example. We know that if they’re admitted to accident and emergency departments with respiratory conditions, they tend to be admitted and wait longer in hospital. And we know that the health boards, as they have done in years gone by, are planning for winter pressures, and the money will be available in order for them to be able to meet those pressures.

It wasn’t a trick question, First Minister; I genuinely do want to see this money used to help people get the appointments they require. Forty per cent of people do say that they have problems in getting an appointment on the day that they ring their surgeries up, whatever part of Wales they live in. So, I’d be really grateful if you could say exactly how the improvements can be brought forward in general practice, with this additional money—the £50 million that will go into the acute and the primary sector—to alleviate some of those pressures, but, importantly, how, over the lifetime of this Assembly, with the budget that you have, you will increase the availability of services within the primary sector and get more GPs into surgeries, wherever they may choose to operate in Wales, because that clearly isn’t happening at the moment.

It’s not just about GPs; it’s about all the services that the health service offers. For example, people can be diverted away from needing to go into hospital if they get support at home through social services, which is why, of course, we’ve made sure that the social services budget has not been cut to the extent that it has been elsewhere. We’ve ensured, of course, that where GP practices no longer exist, that the health board takes those practices over and they offer a better service, actually—they offer a better and more holistic service than what has gone on before, as the people of Prestatyn will explain. But, of course, we know that there’ll be many people who have to be admitted to hospital, and it’s hugely important that that money is available for the hospitals to deal with any extra increases in A&E admissions.

First Minister, we’ve actually seen the money going into general practice declining over the last four years—a £20 million decline over the last four years. That’s why the Royal College of General Practitioners have a campaign at the moment to increase the overall take of the NHS budget going into general practice up to 11 per cent of the budget by 2020. Can you commit to meeting that aspiration from the royal college and, indeed, will you commit to there being more general practitioners in Wales at the end of this Assembly term than there are at the moment? We understand these things do take time, but you have now four-and-a-half years left of the mandate where you can make those changes, you can make those investments that the royal college are talking about, and you can start to recruit the extra staff that are required to create that doorway into the NHS, given that the first point of contact for most people—90 per cent of people—is their general practice.

Well, the royal college of GPs look at it purely in terms of the number of GPs. That’s not sufficient. We have to look at other professionals, such as occupational therapists, such as community nurses. What we don’t want is for people simply to feel that they go and see their GP as the first port of call. That would go against what Choose Well has been saying. We ask people to go to see a pharmacist first, in many GP practices to see the nurse available at the practice, and then see the GP. What I wouldn’t want to do is be in a position where people think that they can avoid seeing a nurse or a pharmacist and go to a GP with a condition that could easily have been dealt with elsewhere. Yes, of course, we want to see sufficient numbers of GPs in Wales, but we also have to make sure there are other alternatives to seeing a GP in order to help take the pressure off GPs.

Leader of the UKIP group, Neil Hamilton.

Diolch, Lywydd. Further to the question from Gareth Bennett earlier on about President-elect Trump, will the First Minister acknowledge the vital importance to Wales of trade with the United States? Twenty-two per cent of our exports go to the United States. That amounts to nearly £3 billion a year. It’s the biggest single national destination for our exports, compared with Germany, for example, were we export about £1 billion—that’s a third in comparison. Therefore, whatever we may think about the individual who is about to become President of the United States, it’s vitally important for the Welsh Government to get on with the United States administration and to encourage them to invest in Wales and to trade with us as much as possible.

Well, it’s right to say that the US is a major market for us. The EU is twice as big as a market and in the same way as he’s right that we have to make sure that we continue to attract investment from the US and export to the US, we also have to make absolutely sure that we’re able to access the European single market on the same terms as now. Why would we want to jeopardise our position in the biggest single market that we have?

Well, nobody wants to do that, of course, and almost everybody in Britain at any rate wants to continue to trade with the EU on the same basis as we trade now, with tariff-free access. The danger with the EU is that the European Commission and protectionist forces inside the EU will want to put up trade barriers against us, which will be cutting off their nose to spite their face because they have a massive trade surplus with us. But as regards the United States, I want to return to this point because that was the point of my question, what is the Welsh Government going to do regardless of the domestic policies of President-elect Trump to encourage the United States Government to build upon the natural inclination to be friendly to Britain and to encourage trade between us? President Trump has business interests in the United Kingdom. He is, as we know from what he has said, prepared to put Britain at the front of the queue in negotiations for a free trade agreement. What is the Welsh Government going to do to encourage that process forward?

Well, he has said that he’ll put America first and any agreement with the UK will put America first and that’s what we must guard against in that respect. We will continue, as we have before, with our offices in the US, working with US companies and seeking to attract investment from the US. That will not change. Why would it change? I’m surprised when he said that nobody is advocating tariffs because I have heard people talking about tariffs. I heard David Davis talk about tariffs. I’ve heard Liam Fox talk about tariffs as if tariffs are unimportant. Why would we want to make it worse for us to access our biggest single market? That’s completely senseless. In the same way, regardless of the political situation in the US, we will continue to work with US companies, to attract investment from the US and promote Welsh produce in US markets. That won’t change.

Will the First Minister acknowledge that perhaps UKIP can assist in this process? He will no doubt have seen the charming photograph that appeared very recently of the interim leader of UKIP with the President-elect of the United States, and whatever he and I may think about both those individuals, nevertheless, insofar as we do have personal contacts that can be used for the benefit of Wales, then they ought to be used. In the ‘Taking Wales Forward’ document, which was issued by the Government not so long ago, it says:

‘Ours will be an open government, receptive to new ideas and willing to work with others.’

Is the First Minister willing to work with UKIP in the interests of Wales?

The only thing that Nigel Farage has run is away. He’s never run anything. He is an individual who has no experience in terms of running anything or in terms of diplomacy. The idea of Nigel Farage being a diplomat is the equivalent of giving a child a chainsaw it would seem to me. Yes, I did see the photographs of Nigel Farage, but without his poppy, on Remembrance Day—a point I made yesterday—even though Arron Banks, the money man, did have a poppy on. It’s one thing for UKIP to say how important it is to remember—and they’re correct in that sense. It’s one thing for Nigel Farage to say that he wants to be at the Cenotaph and that is a point that he is able to make. But, he was not at a remembrance parade yesterday, he was not even wearing a poppy. If Mark Reckless had done that, he’d have been criticised. If Neil Hamilton had done that, he’d have been criticised. If any one of us in this Chamber had done that, then we would have been criticised, but the great Nigel is beyond criticism. Well, I’m afraid yesterday he was hoist by his own petard. Somebody who lacks the wit to be photographed on Remembrance Sunday at an event, grinning, without a poppy, does not deserve to be given any kind of diplomatic role.