The next group of amendments relates to improving and protecting the health and well-being of young persons. Amendment 33 is the lead amendment in this group, and I call on Angela Burns to move and speak to the lead amendment and the other amendments in the group. Angela Burns.

Amendment 33 (Angela Burns) moved.

Diolch, Llywydd. The Welsh Conservatives have tabled this amendment inserting a new section into the Bill that seeks to ensure that Welsh Ministers have to produce a comprehensive report on an annual basis detailing progress made in the delivery of public health objectives, with emphasis on those that protect and improve the health and well-being of young persons. There is no doubt that ensuring people stay well and maintain a healthy lifestyle is of vital importance to the individual, and, consequently, is of enormous benefit to the public purse. Educating the younger generation is an obvious place to start. If we can prove their physical and mental health and sense of well-being, then we are all alleviating the pressures of the future. Public health researchers at Cardiff University found that following a healthy lifestyle—not smoking, maintaining a healthy body weight, limiting alcohol intake—are integral in curbing the likelihood of chronic illness.

This amendment also seeks to ensure that focus is maintained on the vital importance of public health to ensure that all Assembly Members are able to effectively scrutinise the outcomes of this legislation by virtue of an annual report, which will provide both Welsh Government and Assembly Members the opportunity to benchmark and monitor progress. The data produced by this exercise will also inform the wider debate over the acute challenges we face in public health. The OECD report 2016 identified that Wales lacked robust data-reporting mechanisms to accurately reflect key parameters needed to improve health services across Wales. When you consider that socioeconomic deprivation is directly linked to public health outcomes, personified by the fact that lung cancer prevalence is highest in south-east Wales valleys, it is clear that we need not only to collect data to improve public health outcomes, but we also need to promote a prevention-first strategy, in which children and young people are put to the forefront of public health messaging in Wales.

That recent OECD report acknowledged a 10-year decline in reporting across Wales. The report went on to stipulate that there is potential for community health councils to play a valuable role in reflecting the patient voice across Wales. It is critical now that the Welsh Government acts to not only strengthen its reporting arrangements, but widens the public engagement process. This is crucial in putting the role of an integrated health system that serves Wales collectively into place. This amendment would also help to promote collaboration between local health boards and local authorities with an emphasis on schooling and engagement. Central to this is ensuring that public health messaging from health boards and the effective marketing of public health initiatives is taken forward in collaboration with educational bodies. For example, when we seek to improve the health and well-being of young persons, we must recognise that inactivity is a hidden killer, contributing to one in six deaths in the UK, the same level as smoking. More than one in three people in Wales are inactive, failing to be active for more than 30 minutes a week. We already know that physically inactive individuals spend an average of 38 per cent more days in hospital, they make 5.5 per cent more GP visits, and access 13 per cent more specialist services and 12 per cent more nurse visits than an active individual. Yet the Welsh Government, despite its list of commitments to increase physical participation amongst Wales’s population, has cut its funding to physical activity programmes.

In the 2016-17 budget, the Welsh Government cut the delivery of effective sports and physical activity programmes from £26,891,000 to £22 million. This represents a real-terms decrease of 7 per cent. And the number of hours dedicated to PE at primary school level have also declined across Wales. In 2010-11, an average of 115 minutes per week were spent on PE lessons at primary school level. However, the latest statistics show that this currently stands at 100 minutes in 2014-15, and this is in contrast to the noted successes of the UK Government, who introduced the PE and sport premium, which was designed to help primary schools improve the quality of the PE and sports activity they offer their pupils, and they have invested over £450 million during the last three academic years.

This amendment would reinforce the importance of public health being integrated and promotes collaborative working, which, in turn, would lead to a more effective use of the budget and would ensure greater outcomes. Furthermore, it will drive a partnership between health professionals and schools to ensure that factors such as nutrition are also considered when schools are putting forward their lunch menus, because, despite all the talk, currently, healthy eating guidelines are not being achieved by many people in Wales. Guidelines promote eating at least five portions of fruit and vegetables each day with meals based on starchy carbohydrates like potatoes, rice, and pasta. However, these guidelines merely promote having a balanced diet. With regard to tackling obesity, there should be more detailed advice and targeted support available so people at risk of obesity can make informed decisions about their nutrition.

Make no mistake: messaging to children, young people, and, indeed, adults, needs to step up in effectiveness and cohesion. For example, we should note that the Welsh health survey, which measures the daily consumption of fruit and vegetables as an indicator of health and well-being, shows that just one in three people eat the recommended amount of fruit and vegetables each day, and there are questions as to whether current guidelines on healthy eating are actually able to promote healthy lifestyles and tackle obesity. The National Obesity Forum has produced a damning report that highlights that current dietary guidelines are failing to tackle the ever-growing challenge of obesity. The report criticises existing guidelines that promote low-fat diets and high-carbohydrate intake in order to have a balanced diet. Creative, informative, and motivational messaging is critical to helping to improve public health in Wales, and we need to ensure that public health messaging from health boards and effective marketing of public health initiatives are taken forward in collaboration with educational bodies.

This amendment, Minister, will also ensure greater data collection is taken forward in terms of identifying the parameters that allow better public health outcomes. Finally, this amendment will require Ministers to report progress to the National Assembly for Wales on a yearly basis and, as such, allow all Members here to benchmark and scrutinise Welsh Government progress in improving public health for the youngest in our society, and I ask Members to support it.

Plaid Cymru is pleased to support these amendments. We often hear about the difficulties that patients of all ages face when there is a variety of public bodies responsible for the services that they receive. This, of course, includes young people. They are no different. Indeed, one could argue that they are in more complex positions on occasion, if you add the school or educational institution as another layer of public service that plays a part in decisions on care and support for young persons.

I, like many here, I’m sure, have dealt with a number of cases in my constituency relating to mental health problems suffered by young people—some of them very serious problems—and the role of the school in the treatment and care provided is often centrally important. Therefore, collaboration is important. It doesn’t always happen as we would like to see it happen, and this amendment would at least lead to the need to report back on the level of collaboration that currently exists. I’m also pleased to see that the amendment specifically notes that reports should refer to obesity levels—something that we’ve already discussed here this afternoon—and to nutrition. It also emphasises the need for public health messages to be communicated effectively to young people, and communicated in a way that is seen as relevant to young people. Therefore, we are happy to support these amendments.

I was very struck by the points made by Angela Burns, and, before the Minister replies, I wondered if she could say whether the Government supports the approach of the Soil Association certification of school meals, and their approach to good food for all, which ensures that children are eating freshly produced produce rather than stuff that’s being brought in and cooked from chilled, and also with an emphasis on the schools actually ensuring that children are encouraged to eat new vegetables and fruit, and taste things that they may not get at home.

I call on the Minister, Rebecca Evans.

Thank you, and I thank Angela Burns for bringing forward the amendments in this group, and I do recognise the intention behind the amendments and share the view that improving and protecting the health and well-being of our young people should be at the forefront of public health policy in Wales, and, in response to Jenny Rathbone’s concerns as well, I would refer all Members to the letter that I sent recently to all Members of the National Assembly for Wales, which outlined our approach to nutritional standards, both in school settings and also hospital settings, and extending them to early years settings and care home settings in future as well.

I would, with regard to this amendment, however, emphasise that safeguarding the health of children and young people is already a central theme right across the Bill and across other policies and legislation. The Bill provides a series of important protections for children, for example by restricting smoking in settings such as school grounds and public playgrounds, and by protecting children from the potential harms caused by intimate piercing. In addition, the long-term focus of health impact assessments will be another important way of ensuring that the future health and well-being of children and young people is protected.

Whilst I understand the good intentions behind these amendments, I believe they are inappropriate for a number of reasons. The well-being of future generations Act requires a public body in Wales to collaborate with others to meet its objectives and also to report annually on the progress made in meeting its objectives. Among the objectives that the public bodies listed in Angela Burns’s amendment should be considering and reporting on are public health issues relevant to young people, such as obesity, nutrition and mental health. These amendments would, therefore, effectively duplicate requirements in other legislation. Elements of these amendments also seem to duplicate other work being taken forward under this Bill—for example through the national obesity strategy that will be developed as a result of the amendments agreed earlier this afternoon.

The national obesity strategy amendments require the Welsh Ministers to publish a strategy on preventing obesity and reducing obesity levels in Wales, and this would include—but wouldn’t be limited to—obesity levels in young people. In addition, the Cabinet Secretary for Health, Well-being and Sport has committed to developing a children’s health plan to describe the national priority areas that health services should be addressing to improve outcomes for children and young people in Wales. It’s envisaged that the plan will be published for consultation before the end of the year, and an annual progress report will also be published. This important work will provide another way of achieving the desired effect of these amendments, and of providing strategic direction in a broader sense than these amendments would achieve.

Finally, in terms of outcomes, there’s already a range of mechanisms in place in Wales that enable us to monitor trends in the health and well-being of young people and children. For example, the annual reports of the chief medical officer and various surveys provide us with valuable information in this regard. So, taking all of these things together, the amendments in this group risk duplicating some of the existing and planned work without adding extra value, and for these reasons I’m unable to support the amendments in this group and would ask Members to reject them.

I call on Angela Burns to reply to the debate. Angela Burns.

Thank you very much indeed. I’m very disappointed to have your response, Minister. I do not believe that the fragmented approach that you’re having of looking at the various outcomes for child health will have the desired effect of these amendments. Time and time and time again this Assembly sits and talks about public health issues. We all bang on about how much smoking people are doing, how overweight people are, how unhealthy we are, and what a time bomb it is to the future of our NHS and how we’re going to have to deal, in five, 10, 15 and 20 years’ time with an increase in chronic conditions that will—to be frank—cripple the NHS if we’re not careful. [Interruption.] Sorry, I have a real frog in my throat today. I wish it would go. Yet, this simple amendment is actually targeted at our young people—the future of Wales. This simple amendment asks that, every year, the Welsh Government should bring forward to this Chamber, for all of these Assembly Members who talk on this issue week after week, month after month, year after year, the ability to actually look at whether or not we are delivering true public health measures to young people, to make a difference, to alleviate that time bomb that may be going off in five or 10 years’ time.

There are varying pieces of legislation out there at the moment. You know, we can run through them all: the well-being of future generations Act, the imminent additional learning needs Bill, this Bill. Let me just take one: the healthy eating Measure. I remember being an Assembly Member and sitting on the committee that brought that forward. Has it actually made a significant difference to the food quality in schools in Wales? No. My children have just left primary school, and for the years that they were there, as they were in a school that didn’t have its own kitchen and had to have everything shipped in, they never saw a green vegetable. Thankfully, they had a parent who would make them eat broccoli in the evenings, but if I didn’t do that, they wouldn’t know what a green vegetable is. So, we’re not—despite all of our intent and our bits of legislation squirrelled away here and squirrelled away there, we are losing that focus. So, this amendment was purely to bring that focus.

I am very sad that you’ve decided that you can’t accept it, because the Welsh Government has never had a problem with the fragmentation of policy intent in numerous Bills, and you’ve never had a problem before with repetition. So, why you’ve got a problem on this issue, I think, is really sad, and I believe you’re missing a trick, and we are going to lose focus on really making that change to the lives of young people in Wales.

If amendment 33 is not agreed to, amendment 34 falls. The question is that amendment 33 be agreed to. Does any Member object? [Objection.] We’ll proceed to an electronic vote. Open the vote. Close the vote. In favour 24, no abstentions, and 27 against. Therefore, the amendment is not agreed.

Amendment 33 not agreed: For 24, Against 27, Abstain 0.

Result of the vote on amendment 33.

Amendment 34 fell.