Questions now from the party leaders. The leader of the opposition, Andrew R.T. Davies.

Thank you, Presiding Officer. Could I also extend a welcome to the new Member here today, and endorse the First Minister's comments about how welcome it is to see Steffan back in the Chamber here, and wish him well in the weeks and months ahead? And I'd also offer my congratulations to David Melding, who was recognised in the new year's honours list—a very worthy contribution to Welsh democracy that has been recognised by the new year's honours list that was put out this year.

First Minister, we've all seen the pressures that have hit the Welsh NHS over the last couple of weeks, especially those specific winter pressures. Were they predictable and were they preventable? 

Well, first of all, I pay tribute to all our staff in all settings—the GPs, the paramedics, hospitals and social care—for their remarkable efforts in responding to these pressures. The winter is always a very challenging period. There will always be times when demand places our services under great pressure, needing local escalation. There was rigorous preparation in place, but the NHS in Wales has been under considerable pressure consistent with that being reported in other parts of the UK. There was a professional response, more resources were made available and the situation is now stabilising. 

Thank you, First Minister, for that answer. I do recognise that there are pressures across the whole of the United Kingdom as we've all seen in the news. My first question was were they predictable and were they preventable, some of the pressures unique to Wales, such as no GP out-of-hours service, as I'm led to believe, here in Cardiff over the festive period. There were chronic waiting times over and above what we've seen in other parts of the NHS in the United Kingdom. In Ysbyty Glan Clwyd, for example, less than 50 per cent of patients who presented at A&E were seen within the Government's own four-hour wait time, and we already knew that wait times were excessive here in Wales as opposed to other parts of the United Kingdom. You and I can have a political ding-dong about this and it won't really advance the argument that much further. What people want to hear is what solutions the Government will be putting into place to stop some of these unique events that have been happening in Wales—that are specific to Wales—such as no out-of-hours provision whatsoever here in the capital city of Cardiff and, above all, those really long waits in A&Es, across A&E departments in Wales, as I highlighted to you? What are you doing? 

Well, first of all, in terms of A&E, it's not the case that the target is four hours before somebody is seen in A&E. The target is four hours until somebody is discharged or admitted from A&E, just to make that clear. He asks the question fairly: was this predictable? The answer to my mind is 'no' and I'll explain why. For example, when it came red ambulance calls, the figure for new year's eve was 54 per cent higher than new year's eve last year. Similar figures, though lower, were reported for new year's day and also for the Christmas period. Now, is that predictable? I'd argue it isn't. Nevertheless, a great deal of planning went into ensuring that the NHS was able to manage. There were great pressures. I pay tribute to staff and, of course, as I say, the situation is now stabilising. But we will be looking at why there was such a spike on new year's eve, just to give one example, compared to last year. Despite the great pressure that was placed on the health service, staff were still able to work hard to reach the targets that we had set, particularly the paramedic staff. Why it is that there was a spike like that compared with last year, it's something we'll have to look at. 

Thank you, First Minister. I, too, pay tribute to all the staff who were out over the festive period while many of us were enjoying the festive period, and, without that staff, our NHS would not work in whatever section of the service they work in.

But the point I made in my second contribution this afternoon, which is that if there is no out-of-hours provision whatsoever, then it's obvious that the ambulance service, for example, is going to see a spike in demand for its services. What I ask of you in my third question to you is: will we be in the same position this time next year, or what measures will you be taking specifically to address these pressures, which do happen year in, year out? I do take the point that you've pointed to a specific spike in the ambulance calls that were put in on new year's eve, but we are seeing little or no availability in some areas for out-of-hours provision, we are seeing continuing demand for A&E provision and obviously we are seeing a lack of bed space within our hospitals. Thirty per cent of beds have been lost since 1997 here in Wales. So, there does need to be a review of how the Government and the health boards respond to this crisis, and what we need to hear is when that review will be undertaken and whether we can really expect that this situation won't be replicated next year. 

Well, of course, the review has been undertaken, in the sense that the parliamentary review is due, I understand, to publish its findings very soon, and that will look cross-party at ways in which the health service can be strengthened. In terms of GP cover, it is right to say that, in one part of Wales, there were problems on two dates, I understand—not in other parts of Wales, but there was severe pressure particularly there. He asks the question: do we need to look at the reason why there were particular spikes this year, compared to previous years? The answer is, 'Yes, that's something we do want to look at', because that will form part of the LHBs' preparedness for next winter. So, in terms of whether it is preventable, well, there's always pressure on the NHS this time of year, and there's always planning in order to look to deal with that pressure. Predictable? No, I don't think so, given the figures that we've seen on more than one date over the holiday period, when there was a significant increase in demand for ambulance calls, particularly compared to the previous year.

Plaid Cymru leader, Leanne Wood. 

Diolch. I'm going to continue with health, First Minister. You said that winter pressures are expected every year and you're right, and you should be planning for spikes in demand as well every year. Can you honestly say that you believe that the health service has performed well over the winter in dealing with those pressures and spikes? 

Yes, I do. I think the NHS staff have performed heroically and magnificently over the course of the winter. GPs, of course, are often in the front line. They have worked very hard. Paramedics, incredible, given the fact that they have responded so well to emergency calls, despite the enormous spike in those calls and, of course, hospitals and those who work in the social care sector. They continue to maintain an NHS of enormous scale that receives tens of thousands of contacts and calls every year. There was, of course, a visible peak of pressure into the new year and there were real challenges, but it is now pleasing to see a much improved and stable position that was reported at the end of last week.  

First Minister, the story that you tell is of a service that's under pressure but coping well, but there's another story as well and that's being told by the media, of hospitals being 'like a battlefield' for NHS staff. Both of those stories can't be true, and I think that you know that winter preparations have not been good enough. Isn't that why we had an apology from Vaughan Gething for cancelled operations? Isn't that why we are hearing the claim from the Royal College of Emergency Medicine that patient safety is being compromised daily, and that the solution is more capacity? The Welsh NHS needs more beds, it needs more nurses and it needs more doctors. The £10 million pounds announced over the weekend came with an admission that pressures across health and social care are above those anticipated. Why do you underestimate these pressures every year? Do you now accept that the Cabinet Secretary was wrong to make the claim in November that the service was in the best position possible to cope with the winter, and do you accept that you were wrong to cut the number of hospital beds? 

First of all, I think the Cabinet Secretary was correct. Nobody could have predicted the kind of figures that we've seen over the course of the holiday period; I don't think any Member in this Chamber could possibly have predicted that. She mentions beds, but it's more complicated than that, in my view. It's hugely important not in terms of looking at beds, but in terms of getting people out of hospital when they're ready and that's why, of course, it's hugely important that we invest in social care, which we have done, compared with England where social care funding has been cut. It is important that people are able to leave hospital when they are able to do so and that they have the right support to do so. So, it's not simply a question of the number of beds; it's a question of making sure that people are able to leave hospital when they can.   

You have an 85 per cent target for hospital beds and you breach that as a matter of routine, which means that patient safety is compromised. You are failing to meet that measure of patient safety, and that is unacceptable. And, First Minister, I have to say, I think you're being complacent. It's not just us; the Royal College of Emergency Medicine is also saying that NHS staffing needs to be increased, and it's in your gift to do that. Without nurses, without doctors and without specialists, there would be no NHS.

We've heard a lot of warm words over the Christmas period from politicians supporting front-line NHS staff, and you've just made a tribute yourself. If you really want to support front-line NHS staff then, First Minister, pay them properly. The pay cap means that nurses are still underpaid and it's in your gift to lift that pay cap. Workforce planning is one of the most important tools that you have at your disposal, yet you won't embrace the need for a new medical training school in the north. No Westminster Government will do this for us; it's your Labour Government's responsibility. A Labour Cabinet Secretary has now admitted responsibility for the lack of planning ahead of the winter pressures. It's time, First Minister, now that you did the same. Given that apology from the health Secretary, will you now accept responsibility for failing to train enough doctors for the Welsh NHS?

Far from it. We see that the recruitment campaign that we have put in place has been very successful in recruiting doctors. You can't recruit doctors at the drop of a hat, particularly A&E specialists, and it's hugely important that—. We have training facilities in place, but it's hugely important that the right professional atmosphere is in place to retain doctors and to attract them in the first place. It's not all about training people simply in Wales—we're not a medical autarky.

Secondly, it is hugely important to understand and I believe that the Cabinet Secretary and the local health boards have done their planning. If we look at the spike in demand that we saw, nobody could have predicted that spike in demand. And I have to say to her: I do not accept that we should allow the UK Government off the hook when it comes to the pay cap. Why on earth should the people of Wales have to fund the failure of a UK Government to lift the pay cap? How can we justify to the people who vote for us that we should pay for something that the UK Government should be paying for? I agree with her, I think the pay cap should lifted, but why should the people of Wales have to pay for it when the UK Government have the responsibility to do it? An increase in pay in the health service carries a price tag of hundreds of millions of pounds: where does the money come from? If we are to do that, then it means money coming out of the budget somewhere else.

I don't disagree with her. I agree with her on the pay cap. She and I are in the same position, but I cannot agree with her that, somehow, we should fill in a gap that the UK Government itself has actually created. Let the Tories pay to ensure the people of Wales are able to pay the staff of the NHS properly.

The leader of the UKIP group, Neil Hamilton.

Diolch yn fawr iawn, Llywydd. Can I start on a note of amity—which will certainly not continue—at least at the very beginning of the proceedings, and wish the First Minister, and indeed all his Ministers, a happy new year? And I do genuinely wish them success, although I think it's unlikely to be realised. And can I return to the point that was raised by Steffan Lewis earlier on? I'm sure everybody would agree with this too, and say that it's actually an inspiration to us all for him to be here today, and if it's not too frightening a prospect, I'm right behind him in his battle against his terrible disease.

I welcome the transition fund that the First Minister has announced, but does he not agree with me that that would be far more effective if the Welsh Government weren't so relentlessly pessimistic about the opportunities presented by Brexit? And can I ask him, in 2018, for a change of approach to this opportunity for the whole of Britain? And if he's more positive and uplifting about the future, then Welsh businesses themselves will have more confidence in the future, and investment will increase, and we will all be better off.

Well, first of all, can I wish him all the best as well, and to say to him that I congratulate him on the temporary expansion of his group? I know it didn't last very long, but there we are, back to the famous five.

In terms of the EU fund, businesses are saying to us that they're worried about Brexit. They're worried about the nature of the trading relationship with Europe; that's their major market, and why should it not be? More than 60 per cent of our exports go there, more than 90 per cent of our food and drink exports go there. It's fantasy to suggest that somehow a new market or markets will appear by next year in order to mop up all these exports. If we cannot get right our relationship with our nearest, biggest market, what hope have we got of conducting any kind of agreement with any other market or nation?

That has to be done first, and we don't know what Brexit will look like. Very good to see the UK Government is moving towards our ground, compared to where they were last year. Last year, they weren't going to pay for any kind of financial deal, they weren't interested in EU citizens, they weren't talking about a transitional period: they've done all that. We welcome the fact that they've moved towards the light in that sense, but I have to say to the Member: it's important to be realistic and not be a fantasist when it comes to Brexit. In the referendum, we were told time and time again by members of his own party, 'There will be a trade deal; we can be like Norway.' Now we're hearing, 'Well, don't worry about a trade deal.' Well, businesses are worried about the lack of a trade deal.

Well, can I respond to the First Minister's sally about the temporary expansion of our group? UKIP has done a great deal since the beginning of the year to entertain the country and cheer us all up. But, we are here to fight for what we believe in and we will continue the fight as we have done in the last year with a group of five.

But one of the opportunities that Brexit offers to us if we are not part of the single market is that we then secure control of regulation. He will have seen that, last week, the markets in financial instruments directive came into force throughout the whole of the EU. This is 7,000 pages long, it contains 1.4 million paragraphs, it's six times the size of the Bible, and it will require all financial firms that deal in shares, bonds, derivatives—indeed, all financial instruments—to acquire a huge mass of documentation, which they'll then have to publish and preserve for five years, imposing mammoth costs on financial services firms. If we're outside the single market, we can slim down that burden of regulation without any danger to the public at all. Dublin has made a great success out of expansion of its financial services businesses by having a tax advantage by reducing corporation tax. Does the First Minister agree with me that Cardiff, as a developing financial centre, could greatly benefit from a slimmed-down financial regulation system whilst properly serving the public interest? Ten per cent of people who work in Cardiff are in financial and professional services, they contribute £1.2 billion a year in gross value added and, indeed, in Wales as a whole it's £3 billion. So, will the First Minister agree with me that it would be a good thing if he were to look to have proportionate regulation in the financial services sector as a means of kick-starting the financial services industry here in Wales?

First of all, I don't begrudge his party's ability to provide us with entertainment, as he rightly pointed out. But, turning to the points that he makes, first of all, the issue is not devolved, as he knows, but, in terms of the principle of it, I don't agree with him that the point of Brexit is wholesale deregulation. Our financial services sector will still have to operate in the European market. If it doesn't follow the rules of the European market, it won't be able to operate there, and that will have enormous consequences for jobs, not just in Wales, but also in the rest of the UK, particularly the City. The City has been a place where a great deal of European operations have taken place. If the regulations in the UK are substantially different, people won't come to the UK, because they want to operate in a bigger market.

Secondly, we have to remember that the financial crash of 2007 was caused, at least in great part, by deregulation of financial services, and the fact that an opportunity was given to irresponsible financiers to play around with people's money, to lend to people who had no hope of paying them back, and the financial system collapsed as a result of it. So, from my perspective, yes, regulation has to be proportionate, but it has to be there because, bluntly, given what we saw in 2007-08, there are some who work in the large financial centres in this world who cannot be trusted with other people's money.

The First Minister knows that MiFID has nothing to do with the kind of conduct that caused the crash or made it far worse in 2008, when I remind the First Minister, of course, we had a Labour Government, a Labour Chancellor of the Exchequer, and a Labour Prime Minister who himself wanted a light-touch regulatory system. Of course, we all learnt great lessons from that. But, regulation such as MiFID II, which requires this vast amount of information storage and retrieval, is far too great for any regulatory body to be able to use effectively. So, it's imposing a vast cost upon firms and, therefore, the public at large, which ultimately bear the cost of all business taxes, for no practical benefit to anybody at all. The result of that is to drive financial services business away from Europe altogether to places like New York, Hong Kong, Singapore and so on and so forth.

So, for Britain, there's a great opportunity post Brexit, if we can't do a deal with the EU. And nobody ever guaranteed any kind of trade deal with the EU; nobody was able to do that. It's not in our gift to force the EU to enter into a deal with us, we just said that it was in their own self-interest, as indeed ours, to come to an agreement, but nobody can force them to do that. But if no such deal is available, then the world out there is much bigger than Europe: 85 per cent of the global economy is outside Europe. Should we not be positive about those opportunities, rather than relentlessly negative and saying that the future lies in what is a contracting part of the world economy?

Well, the thing is, he contradicts himself now, because he complains about a directive, but in the future, the UK will have no role at all in influencing those directives. The UK will have to accept them or not have access to the European market. The UK's voice is much diminished now compared to where it was in the past.

Secondly, he seems to think the world out there is a world that is open to trade with the UK. Other markets are equally as closed. If you look at the US, that is a market that does not trade freely with the rest of the world, nor does China, nor does India. There seems to be this thought among some in his party that, somehow, the world is just waiting to conduct free-trade agreements with the UK. That is certainly not what other countries are saying, and certainly not what the experience has been in the past. Six or seven years is the average timescale for agreeing a free-trade agreement. We have in the US a President who puts America first. Does he really think that we will have an equitable free-trade agreement with the US with a president who is open about his views on protecting American industry? Will we have, for example, a back-door TTIP as a result of the Trade Bill, which forces us to privatise large parts of the public sector—something that we will oppose tooth and nail?

But, ultimately, as I've said before, we are at present in the single market. I'd like us to stay in the single market or have full and unfettered access to the single market. We already have a great deal of convergence with it. If we cannot agree a deal with a market where we have so much in common to begin with, we have no chance of agreeing a deal with other markets that are much, much different, with different regulations that we would then have to try to harmonise. The European market is our biggest market, it's on our doorstep, we have a land border with it, we export 60 per cent of our exports to it. We cannot allow our policy on the European single market to be blinded by ridiculous, nationalist nonsense.