Item 5 on the agenda is a statement by the Cabinet Secretary for Health, Well-being and Sport on the dementia action plan. I call on the Cabinet Secretary for Health, Well-being and Sport, Vaughan Gething.

Thank you, Deputy Presiding Officer. This statement today is timely, as we are currently in Dementia Awareness Week. I hope everyone is using this week to take action to raise awareness and offer both help and understanding to those who need it.

In October last year, on World Mental Health Day, I was pleased to launch the second delivery plan in support of our 10-year mental health strategy, ‘Together for Mental Health’. A key action within the delivery plan is the development of a dementia strategic action plan. This responds to a key commitment within our programme for government, to make Wales a dementia-friendly nation. We’ve come a long way in realising our commitment to create a dementia-friendly nation, but we recognise there is still more to do. As part of this, we’ve moved forward on developing a new dementia strategic action plan, as promised in ‘Taking Wales Forward’. So, I was pleased to launch the public 12-week consultation at Oldwell Court in Cardiff in January this year.

We should never forget that more people are living longer, and that is something to be celebrated. But, as life expectancy improves, we know more people will develop dementia. And dementia is one of the biggest healthcare challenges our generation faces. It is estimated that between 40,000 and 50,000 people in Wales are currently living with dementia. The impact of dementia in society is much wider when we consider carers and family members. Last year, we announced a number of priority areas on dementia and the steps we would take to address them, including providing more than £8 million of additional funding over the last two years to develop dementia services across Wales. This included work on dementia risk reduction, increasing public awareness, actions to improve diagnosis rates and ensuring support is available to people affected by dementia. And these messages have been built upon throughout our draft action plan. But, to ensure the plan is appropriate, it is crucial that we hear from people living with or affected by dementia, whether in a personal or a professional capacity, so that we understand what matters most to people. We must have a clear way forward to support people with dementia and the people close to them.

The views and experiences shared with us have been instrumental in creating the draft plan. A number of engagement events across Wales took place to hear from people living with dementia, family members, carers, health professionals, voluntary organisations and other people with an interest. This has been undertaken in partnership both with the Alzheimer’s Society and the Dementia Engagement and Empowerment Project, otherwise known as DEEP. Over 1,200 people personally affected by dementia took part throughout the consultation period, and our thanks go to those who have contributed to this work.

As I’ve previously said, no two people with dementia, or the people who support them, will have identical needs. Overwhelming feedback from the engagement undertaken is that people want support and services to be delivered with a rights-based approach, that that support should flexible to the different needs at different stages of living with the condition, and that action demonstrates a whole-pathway approach. Now, the plan supports this approach and contains a number of themes that require further action over the next five years. The themes were informed by feedback from the responses to the ‘Together for Mental Health’ delivery plan consultation in 2016, where dementia was cited, and the engagement with stakeholders undertaken prior to the formal consultation period, as well as from reviewing other relevant dementia strategies. The themes include: raising awareness of how to help people reduce their risk of developing dementia, or delay its onset; raising awareness and understanding of dementia through the expansion of dementia friends and dementia supportive communities and organisations; ensuring dementia is recognised appropriately and sensitively and that people have timely access to assessment and diagnosis; early support and treatment for people with dementia, their carers and families, following diagnosis; and the availability of increased support, whether in a person’s home, in hospital, or in a care home. 

The formal consultation closed on 3 April and we received 119 responses from a variety of stakeholders including the older person’s commissioner, a number of the royal colleges, and key stakeholders such as Care Council for Wales, the Welsh Local Government Association, the Alzheimer’s Society and DEEP. These responses, and feedback from the stakeholder events, are currently being analysed to inform the final report.

Respondents provided suggestions on how the final plan could be improved, and those suggestions included: strengthening the rights-based approach through the whole document; further emphasis of a cross-Government approach to include transport, housing and planning, as well as health and social care aspects; highlighting the importance of allied medical professions in supporting people with dementia and their families or carers; further emphasis and specific actions in relation to supporting people with protected characteristics; more focus on younger-onset dementia, palliative care, peer support and community-led approaches; more support for carers, including adding clear measures for respite provision; and more awareness of support already available, including promoting further the national dementia support helpline. Of course, many respondents also wanted to see a more ambitious diagnosis target. I recognise the importance of this and I’ve agreed that this matter will be kept under review. 

The findings from the consultation will be incorporated appropriately into the final plan, and will be accompanied by a detailed action plan that includes measurable actions and targets to be achieved within the lifetime of the plan. Following a wealth of notable practice being provided within the consultation responses, we will also be publishing a compendium document that highlights practice examples across the pathway so we can learn from what is already happening. It is only by working together we can build a truly dementia-friendly Wales and combat other problems, such as loneliness and isolation. The public consultation has already helped us to learn from people’s experiences and expertise to develop what I’m confident will be a robust, evidence-based action plan.

But I don’t want it to end there. I want to see the third sector taking a more active role in the way services are shaped and delivered in the coming years, which should be a great example of prudent health and care principles in action. I want us to tackle the stigma attached to dementia and take away the fear that many may have through a lack of knowledge and information. We know from our consultation that there are a wealth of community projects spanning the country that look to raise awareness and understanding of dementia and that will help to reduce stigma. I want to see more communities in Wales becoming dementia friendly and provide help and support to all those who need it.

It is my hope, therefore, that at the three-year point of review, I, or my counterpart—whoever is providing the report—can stand up as I am here today and broadcast the progress and changes that we have made towards making Wales a genuinely dementia-friendly nation. I trust that Members from all parties will recognise the work undertaken to produce such a comprehensive document that reflects the voices of many people across Wales. We certainly will be listening to contributions made in today’s statement, ahead of our publishing the final plan in the summer. I want that final plan to be ambitious but achievable, and that we can continue to work in partnership in the future.

Thank you very much for your statement, Cabinet Secretary. I think Welsh Conservatives would be keen to support plans drawn up or even led by those who live with dementia, either first hand or as family members, friends or carers, and, as you say, other voluntary organisations and those who have an interest who took part in the consultation. We certainly support the rights-led approach, but I did want to press you, first of all, on the balance of the delivery mechanisms that have been referred to in the draft plan.

Now, most of the proposed key actions seem to be the responsibility of health boards, and in terms of direct medical intervention, I can see why that would be the case—diagnosis professionals, psychological and pharmaceutical support, and care for an individual, perhaps within a nursing home or another medical setting where they might be receiving assistance across a number of co-morbidities, shall we say. But with better diagnosis, there is greater scope, I think, for non-medical support, particularly early on. I think an over-emphasis on the health board, if you like, might almost be, for some people, like giving in to the fact that they’re going to need medical care. Even though that might be true later on, it certainly isn’t necessarily true early on. I’m wondering whether the early part of the support pathways that you refer to in here could be less about health board leadership and more about individuals and other partners who might be better at the whole, sort of, emotional, family support approach to things, rather than looking to the LHB for the lead all the time. I heard what you said about the third sector and I support what you say in that, actually, but the idea of co-production goes beyond even the third sector and we should be looking, perhaps, a little bit more to community structures, which include family, of course, or friends, to help with those early stages following diagnosis.

I wonder if you can tell me a little bit as well about what a future dementia support worker is going to look like. I appreciate we already have some working in a number of sectors at the moment, but the plan refers to specialist intervention for those who have dementia through alcohol or those with early onset dementia. Are we going to be talking about the same individual dementia support worker, or are we talking now about a range of dementia support workers for an individual? I’m guessing the answer to that is flexibility in responding directly to the needs of given individuals, but I’d appreciate a bit of steer on whether we’re going to need more dementia support workers, whether they will need different skills and, once again, whether they will necessarily come from within the health sector.

Clearly, a lot of work has gone into awareness raising in the general population, and I certainly welcome that, although I’m not entirely clear who is going to retain responsibility for that. But just as importantly, a lot of work seems to have gone into dementia awareness and training within the health and social services sector particularly. I’ve got two questions on the back of that.

The first is that general awareness training at population level means that a lot of us are more aware than we were before, but I think still very few of us will have the confidence or the knowledge to broach the subject with a neighbour or somebody we see regularly in the shop or the pub—somebody who’s outside our immediate family but still within our community—because not everybody is picked up through professional routes, particularly if they live alone. I’m wondering whether this plan is the place to help us, generally—you know, members of the public—be part of helping, certainly in early-stage dementia. Then the flip side of that is how more detailed training can reach public-facing activities outside the public sector—so, hospitality, retail, public transport—so that the rights you were talking about are actually capable of being fulfilled. I know there’s some fantastic examples of voluntary approaches to this, and we spoke about Tesco having its slow shopping day, for example. I think there’s more space for that.

Then, finally, the draft plan—and I think I’m quoting your speech here—says more support for carers, including ‘clear measures for respite provision’ for carers. I agree, but this is an area of policy where the words ‘rights based’ are, sort of, in many cases, simply just words, and identifying needs under the social services Act doesn’t always translate into actual support for carers—that’s an observation, it’s not a criticism. So, my question on that is: what are your thoughts on how we might all work, actually, to help deliver on rights for carers in terms of respite, and that’s cross sector and, as far as Welsh Government is concerned, cross portfolio? Thank you.

Thank you for that series of questions. Of course, to be very clear, we’ve got national manifesto commitments on improving respite care for carers. You can expect us to make progress on that in the course of this Government. On your general point about awareness generally, which I think is a completely fair one, across the public—. It’s something about what is a generally dementia-friendly community, it isn’t just about a handful of individuals or just about public services, it is about public-facing interactions, and that does include individuals and companies as well as public services. That’s recognised in what we try to achieve in having generally dementia-friendly communities.

You asked a particular point about what a future care worker or a specialist support worker looks like and, of course, that will be something for us to develop in understanding the needs of individuals and how we can understand how we actually commission and provide that, whether it’s through the statutory sector or the voluntary sector. Examples are, for example, an understanding that is being developed through work undertaken in Wales of people, for example, who have alcohol-related dementia and what we can do to support those people in a particular and specific field as well. So, there is specific work that we are undertaking to try and understand what that could and should look like.

Then, of course, we come back to the broader question of how we commission that support and how it is then practically provided. And here I think this goes back to your opening salvo of questions about the role for the NHS and who’s going to be responsible for delivering the actions we set out in the plan. Well, of course, from a Government point of view, if we set out that it must be the third sector who undertake a range of activities, it’s difficult for individuals in this place, or even the public, to hold us to account for what the third sector do and don’t do of their own volition. There is something about us understanding the balance in the action plan, what will set out what the Government, or organisations in Government, could reasonably expect to take responsibility for will do. But it also comes back to the point that this has been drawn up as part of the pre-consultation within the sector and with individuals. So, much of what you will see in here directly comes from those organisations and individuals that said, ‘This is what we want to see’. I think that’s a good thing. It does show that we have really listened to what people have had to say, but they recognise, too, that there is this balance in non-medical support that is to be provided, and getting that right in the future.

So, it’s about the commissioning and the understanding of needs in the first place. Again, you see that process taking place within the architecture drawn up by the social services and well-being Act, but you will see that as we go on to deliver this. As I said in my speech, there is a cross-Government approach that is needed to do that, but also an approach to outside Government, to local government, to the third sector, and, of course, as you rightly mentioned, individuals and communities.

It’s good to be able to note that it is Dementia Awareness Week, and I congratulate everyone involved with activities this week. It was nice to see our friends from the Alzheimer’s Society Wales here in the Assembly today, and there are events happening across Wales—I had an e-mail this afternoon drawing my attention to an event in Llangefni town hall between 10 a.m. and 4 p.m. on Thursday. This is great—people are talking about dementia, but raising awareness about dementia is not all we need. More people are coming to understand and are being involved with people with dementia, but what we need is to raise awareness more of the deficiencies there are in the care for patients with dementia and in the sustenance for their families and their carers.

I would like to pay tribute here to Beti George who has done so much to draw my attention to these issues. Beti shared her story in terms of caring for her partner, David Parry-Jones, in a very emotional programme on the BBC recently—‘Lost for Words’. Very sadly, Beti lost David last month, and I know that we all here sympathise with Beti. But we have to all commit not to slacken our determination to have a strategy that genuinely tries to create a Wales that is proud to say, ‘Yes, we’re doing all that we can for dementia sufferers and their families’.

Rydym ar lwybr a allai ein harwain at fod yn genedl sy'n deall dementia—o ddifrif—sy’n gallu dweud ein bod ni bob amser yn gofalu hyd eithaf ein gallu am y rhai â dementia, ac yn rhoi cymorth i'w gofalwyr a'u teuluoedd. Mae gennym strategaeth sy'n cael ei chreu, a strategaeth a allai, fel y dywedais, fod yn rhywbeth sydd wirioneddol yn caniatáu i Gymru roi ei stamp ar y mater hwn sy’n rhan mor boenus o fywydau cymaint o bobl. Ond mae'n golygu, wrth gwrs, ymateb i'r ymgynghoriad, fel y gwnaethom yn y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon. Rydym wedi ystyried ein bod ni, drwy'r gwaith yr ydym wedi’i wneud, yn rhanddeiliad allweddol yn y gwaith o greu’r strategaeth honno yr ydym ni i gyd ei hangen.

Tri chwestiwn: fe ddywedasoch y bydd canfyddiadau'r ymgynghoriad yn cael eu hymgorffori yn y cynllun terfynol. A yw hyn yn golygu eich bod yn derbyn bod y gostyngiad yn nifer y nosweithiau o ofal seibiant angen ei atal a’i wrthdroi? Oherwydd mae hynny'n rhywbeth sydd wedi dod drwodd yn glir iawn, yn sicr i ni fel pwyllgor, wrth ymateb i'r ddogfen ymgynghori gychwynnol.

Rydych chi hefyd wedi tynnu sylw at bwysigrwydd y trydydd sector, ond mae hyn yn rhywbeth sy’n cael ei ddweud dro ar ôl tro. Nid yw'r trefniadau ariannu yma yn arbennig o ffafriol i gynllunio gwasanaeth hirdymor a chadw'r staff gorau. Felly, pa newidiadau y byddwch chi’n disgwyl i awdurdodau lleol eu gwneud wrth gomisiynu gwasanaethau fel y gellir cynllunio ar gyfer y tymor hir?

Ac yn olaf, mae mater penodol iawn, ac un sydd o ddiddordeb i mi—rydym ni’n gwybod y gall dysgu iaith arall helpu i atal dementia. Pa gamau y mae'r Llywodraeth yn eu cymryd i sicrhau bod pobl yn deall hyn ac yn cael cyfle i ddysgu iaith arall—gallai fod yn Gymraeg neu fe allai fod yn iaith arall?

Thank you. To be honest, I don’t think we’re going to cover in the strategy the opportunity to learn an alternative language specifically, but there is a range of activities that we understand people can undertake to help to reduce their risk of actually acquiring dementia or to delay the onset of it, and that is absolutely part of the work that we’re undertaking. We’ll continue to work with communities and individuals to promote awareness of that, and, hopefully, to encourage people to take ownership of the choices that they could and should make for themselves.

I’m really clear that we will take account of the consultation, we’ll take account of the report that the committee has provided and we’ll take account of what is said in today’s debate. As in any consultation, we’ll have a range of ideas that we could and should take account of and do something with. There will also be parts that we simply can’t, but there’s got to be some honesty in actually saying, ‘This is a meaningful exercise’. I think that Members and, indeed, stakeholders will see how they’ve had an influence on the final plan when it’s published.

Again, I hear what’s said, both by yourself and Suzy Davies, on respite for carers, and I’m really clear that this is a commitment that the Government has itself about improving the availability of respite care.

On your point about longer-term commissioning of services, there needs to be some honesty about this amongst people in this Chamber, regardless of our party background. When local authorities have annual budgets to plan for and to manage, when we don’t know the scale of the cuts that we face and what that means in terms of budget planning for ourselves, let alone other actors and agents within the country, it’s very difficult to then say, ‘We require someone else to plan on a much longer-term basis’.

The Llywydd took the Chair.

The unavoidable truth is that the situation is dynamic, because we don’t know what we are going to get within this place to then divide up to then pass on to actors and agents outside here, but having a strategy and a shape for what we want to achieve should help that in framing how those commissioning decisions are made, where they’re made individually by local authorities, of whatever political leadership—this is a challenge across the country; it’s not just for your party, mine or any other—it’s all parties and independents that are running local government in Wales at this point in time. It’s also a challenge for health boards in working with their partners as well in trying to decide and determine how they properly meet the action plan and the focus and the attention that we will have with it. So, there’s an honest point there, even though I think that everyone in this Chamber would want to be able to see these services planned on a much longer-term basis, consistent with the strategy and to have real and achievable outcome measures. We’ll do what we could and should do in designing a strategy to help with the best use of those resources.

It was wonderful today to attend Dementia Awareness Week—an event outside the Senedd. Thank you for your statement, Cabinet Secretary. The goal of making Wales a dementia-friendly nation is one that we all share. Dementia is now the leading cause of death in Wales, and the number of people affected by dementia is expected to rise by around 40 per cent in the next decade.

It is important that we adopt a whole approach, which involves listening to people with dementia regarding their needs and the views of family members, professionals and carers. It is therefore pleasing that there has been much collaboration with the Alzheimer’s Society and the dementia engagement and empowerment project team. Only by collating information, which must be ongoing, can we reach people with such individual needs.

Regarding the draft dementia strategy itself, I have a few questions relating to the high-level performance measures. You have set the target of ensuring two thirds of dementia sufferers have a formal diagnosis. Can you tell me when we may be able to see if this target is realistic and if, indeed, we are going to be on track to reach this target?

The strategy sets a target for the percentage of NHS staff who come into contact with the public also being trained in dementia care. The target is for three quarters of the workforce by 2019, and I’d like to ask when we can expect to see 100 per cent of NHS staff trained in the appropriate level of dementia care.

The Welsh Government rightly want to see a reduction in the percentage of people with dementia who are prescribed anti-psychotic medication. However, you haven’t indicated a target for that reduction, and, granted, there may be a few cases whereby this is necessary, but all the experts agree that we should not be using these medicines to treat dementia. So, Cabinet Secretary, will you be using guidance to ensure that anti-psychotics are only used when strictly necessary?

You have previously highlighted that dementia can strike at any age and, indeed, the role that alcohol can play. We need to better educate the public about the risks of alcohol-related dementia and brain damage. So, Cabinet Secretary, what plans do you have to increase public awareness about the fact that alcohol misuse can lead to dementia? Finally, Cabinet Secretary, what plans do you have to improve access to substance misuse clinics, so that we can hopefully prevent more people from developing alcohol-related dementia in future?

Dementia is one of the biggest health challenges facing our nation, and it is, therefore, vital that we get this strategy right. I look forward to seeing and working with you, Cabinet Secretary, to share our shared aim of a dementia-friendly nation. Thank you.

Thank you for the comments and questions. I’ll start with your point about the diagnosis target. The draft indicates that it’s for the life of the plan. I indicated in my opening remarks that it’s something I’m prepared to keep under review, because I do know that a number of actors and stakeholders wanted there to be a more ambitious target, but I’m determined that we have a stretching but an honest target. I don’t think it would be helpful to set an aspirational target that can’t be achieved in the life of the plan. I want something that is real and achievable, but as I say, stretching, and recognises the need for further improvement. That helps me to deal with your point about the number of staff trained. We’ve set the target already that we think is stretching. What I won’t do today, to get me through a debate, is just pick out of the air a figure of ‘100 per cent of staff’ or ‘the maximum number of staff are, therefore, trained’. But, again, it is something for us to review and to consider as the plan carries on, and as we actually make real progress throughout the life of this plan towards achieving our aims and objectives.

The same goes for anti-psychotic drugs. We are confident that there needs to be a change and a challenge in the way that prescribing behaviour takes place. Each individual clinician has a responsibility for the judgment that they exercise and the care that they provide for an individual within their context. We want clarity on the ability to reduce the inappropriate prescribing of anti-psychotic drugs. But I’m not going to indicate today that there are any particular targets that will be set. That is part of what we need to consider in drawing up and coming to a final conclusion in the action plan. Again, I said that today is, at least in part, a listening exercise to Members about what we’ll actually have in the final plan, to think about whether a target will be helpful—will it get us to a point where we want to be—and then how we can appropriately measure the progress that we do or don’t make on getting different decisions made by practising clinicians.

Then, your final point about substance misuse prevention and recovery. You’ll know that Rebecca Evans leads on substance misuse policy and action for the Government. We’ve maintained investment in this area despite the reductions in the overall budget. That in itself is a marker of the reality that we recognise that this is a really important area, not just in terms of dementia reduction. I go back the points made at the front of this debate about the rise in dementia that we know that we face as a country. Some of that is related to age, but much of it is related to behaviour as well. All of us know that we make choices for ourselves that have a potential consequence. We know from the Caerphilly study, undertaken over a significant period of time on people living in the same sort of communities in Wales, that making different choices on the key behaviours and determinants of healthier outcomes—on smoking, alcohol, diet and exercise—have a significant impact, not just on obesity as we discovered earlier, and will come up later today when I hope that we will pass the Public Health (Wales) Bill, but equally in a whole range of other areas. There’s a significant impact from the choices that we make. Making different choices will be better for us in the here and now and not just for our future. It is one of our big challenges as a nation: whether we can collectively determine that we will make healthier choices for ourselves and for generations to come.

Can I thank the Cabinet Secretary for his statement? I’m really pleased that we are getting this opportunity in Dementia Awareness Week to again listen to the views of Members. I also welcome the fact that the Welsh Government is taking time to consider what has been a very well-responded-to consultation. I think it is absolutely the right approach to get this strategy right, although I would add that I think it is essential that what we come out with at the end of this process is a strategy that is sufficiently ambitious to meet the scale of the challenge we face in Wales with dementia.

I very much welcome what you’ve said about the strong emphasis on a rights-based approach, which I believe has come from the excellent input of the dementia engagement and empowerment project, and I do take this opportunity to pay tribute to those people who are living with dementia who I know have really transformed the work of Welsh Government on this issue.

I do have a few specific questions. The first is on diagnosis rates, and I heard what you were saying, but I make no apologies for repeating the point that 50 per cent would not be enough for a disease like cancer, and it shouldn’t be enough for people with dementia. I understand what you’re saying about the need to be realistic, but I would like to see the work that you are doing in keeping this under review aimed at a more ambitious diagnosis target. I’d also be interested to know in your response today to what extent diagnosis rates have come up as an issue in this consultation, because I know it was in the health committee’s response, it was certainly in my response on behalf of the cross-party group, and I’m guessing it was in a vast majority of the responses, that people want that ambition to be there for a better diagnosis rate target.

The issue of support workers has been mentioned by several people. My specific concern, as it has been throughout, is that we’re going to need more of them than the plan is proposing. So, I’d be interested to know how your thinking is evolving on that, because the 32 that are set out currently is not going to be enough, and I’d be interested to know whether you are re-evaluating that.

You will be aware—and I’m grateful to you for coming to the cross-party group to talk to us and to talk to people living with dementia—that palliative care and end-of-life care was a very important issue that came out of that meeting, and I’m pleased that that’s been picked up in the statement. I’d be grateful for an update on how your thinking is evolving on that.

I’m also grateful to you for picking up on the issues that I raised following the cross-party group on the Gypsy/Traveller community, and your acknowledgement that there hadn’t been enough work done to identify the needs of that community in relation to dementia. So, I would like to ask how that work has come on, because I know that you were looking to do more consultation with that community.

And just finally to say that today I’ve been up at Big Pit in my constituency, attending the launch of the new dementia-friendly underground tour, and I’m sure you’d want to join me in congratulating Big Pit and National Museum Wales on an excellent and groundbreaking initiative. But can I ask you, Cabinet Secretary, what you see the role of Government now being to actually make sure that all that good practice that we are seeing, resulting from really hard work in different communities in Wales—and there is a tremendous amount of good work going on out there—is actually being rolled out across Wales by Welsh Government? Thank you.

Thank you for the series of comments and questions. I’m pleased to hear you recognise we should get it right this year, and with sufficient ambition that is exactly what we’re attempting to deliver.

I just want to deal with your point about the end-of-life care and the link to that. In the previous statement, we did have a question from Julie Morgan about end-of-life care and the link in terms of the need to have improvement in end-of-life care for people living with dementia as well. And the points about advance care planning: you need to have that conversation at an early enough stage so that people make active choices, as opposed to having choices made for them, and people have to imagine what someone might have wanted or would have wanted. That’s a very difficult position for people to be placed into.

And I recognise the points you have made consistently about support workers, about understanding the need, about understanding the areas in which they can be used and about the resource. We’ve already committed a significant resource up to now, but the different choices that we will choose to make, having had a strategic decision about the action plan, then making sure resources accompany it to deliver on the aims and objectives.

Again, I recognise that you’ve been very consistent about diagnosis rates. It was a significant issue in the consultation. I tried to recognise that in my opening statement. It is important, again, that we have an ambitious and a stretching target, but one that is actually realistic. I want to see a real rate of improvement take place and I don’t want there to be excuses about not achieving a target. We have to have something that really can challenge, but really be delivered. It’s something that’s not just about the diagnosis taking place and the additional support and training that people need to make the diagnosis, but also about making sure that support is in place once that diagnosis has been made as well. I know that was an issue that was raised in the meeting with the cross-party group that I attended.

And finally, two points. I think the engagement with the Dementia Engagement and Empowerment Project has been a really important exercise, both before the consultation launch—the pre-consultation—and during the consultation as well. It’s really important, if we’re going to talk about co-production and the citizen being an equal partner in their healthcare, that that has meaning for the way we design policy as well. So, it isn’t just about having professional advocates speaking on behalf of people with dementia. People living directly with dementia themselves have been an important part of the design and delivery up to this point and they will be thereafter in the delivery of services.

And finally, I recognise the need to roll out good practice. That’s why we’ll have a compendium document to go with this to understand what is already taking place and where good practice exists, so that other people can look at how and why that’s being created. There is always a challenge in seeing whether good practice really does travel and can be introduced on a more system-wide basis. How often does good practice really relate to a set of circumstances in a locality and a group of inspiring individuals who coalesce by accident and by chance, rather than by actually designing the way the whole system should work? But to understand what that looks like so there’s a better prospect for that to actually take place.

Finally, to congratulate Big Pit on the dementia-friendly tour. I’d have loved to have been there with you this morning on the tour. I had one of my best days out at the national museum at Big Pit with my father-in-law. It’s a fantastic experience, and making sure that there is now a dementia-friendly tour is a big step forward.

Just a few quick points because most of them have been covered. Going on the risk reduction, I think the six points and ‘Together for a Dementia Friendly Wales’ are absolutely crucial, and I wondered what more the Cabinet Secretary could do to publicise those steps. I think, obviously, the very important one of trying new things—Rhun ap Iorwerth brought forward the idea of learning a language, the Welsh language—and I wanted to highlight, which I think I’ve mentioned in this Chamber before, singing for people with dementia and the Forget-me-Not Chorus, which covers Cardiff, the Vale and Newport and which is such an inspiring activity that involves people with dementia and, of course, their carers as well. So, I wondered if there were any plans to encourage and support activities like that, which are outside the health and social care sector completely. I believe that is done in conjunction with the Welsh National Opera, that particular activity.

I’m very glad to see he’s put such an emphasis on raising awareness. I think it’s very important that awareness is raised not only for the individuals and for public bodies, but also private companies. I’m sure many of us has seen what British Gas is doing in relation to this, which is trying very hard to become a dementia-friendly organisation. It’s been overwhelmed with offers from staff to be dementia champions. I think they had aimed for 15 and had 50 immediately. Now their engineers are having training, which means that when they go into people’s homes they are aware of all the issues related to dementia. I think there’s a huge job to do there, beyond the places we’ve got our natural levers with in the public sector. I don’t know if he had any plans to look at that.

The end-of-life care you’ve covered in your response to Lynne Neagle, but I wanted to reiterate my support for what Lynne Neagle said about the particular needs of the Gypsy and Traveller community. They do have a very early death rate compared to the rest of the public, and I really think that addressing the particular needs in relation to the dementia strategy are very important.

Thank you. It was remiss of me not to respond to Lynne Neagle’s point about the Gypsy/Traveller community. It is worth taking account of and thinking about how to take that forward—a recognised need that is not well covered. At a previous event of the cross-party group on Gypsies and Travellers I particularly recognised, with the research that was published, that there are still continuing deficits in our ability to provide adequate health and care provision with that particular community. Only some of that is about the cultural barriers that exist. Much of it is actually about the willingness of services to engage properly and effectively. I’m pleased you highlighted the example of British Gas. Other companies have been mentioned today, where awareness raising is taking place directly with staff, and about people understanding for themselves, and, within that large staff group, people will be directly affected. And there is often a generous response when the issue is discussed and debated within groups of people. Our challenge will be how successful we’ll be about getting more and more organisations to undertake that sort of approach.

I recognise that time has gone on and I want to try and be brief in answering the rest of your points. I am pleased that, earlier, you mentioned the point about trying something different. For some people, doing something different, like singing, is an important part of that, but it goes on to the second point of doing something to jog and retain memory and, often, music is an important part of triggering and retaining memory. And those other memories too, like the Sporting Memories that Lesley Griffiths was promoting earlier in the year as well—a really important example of understanding what has given meaning to someone’s life and enjoyment, as well. So, there are lots and lots of different areas that we want to try and promote, and, again, thinking about that good practice, where it exists. Often, much of that is easy to do and doesn’t require a great amount of money; it does require some time and understanding.

Thank you, Cabinet Secretary.