1. Will the Cabinet Secretary make a statement on the Chief Medical Officer’s latest report on the health of the nation? OAQ51659

Thank you for the question. I welcome the chief medical officer's report, which was launched today. It has a particular focus on harm from gambling as an emerging public health issue, and I look forward to making a full statement on the report and its recommendations next week.

Thank you, Cabinet Secretary. I look forward also to looking at the latest CMO report out today, but I'd like to refer to the last report, 'Rebalancing healthcare: Working in partnership to reduce social inequity', which draws attention to a major global theme that many health problems demonstrate a strong social gradient, and there's a higher prevalence of illness and early death in more economically disadvantaged groups and areas. Indeed, Professor Marmot, earlier this week, I heard was emphasising this point. I know that you've met Professor Marmot in a former capacity in terms of your role tackling poverty in Wales. Of equal relevance, of course, for the Welsh Government is the inverse care law, the principle that the availability of good medical or social care tends to vary inversely with the needs of the population served. This principle was proposed by south Wales GP Dr Julian Tudor Hart, and has been widely adopted as a steer for health policy. Can the Cabinet Secretary identify how he is addressing the need to reduce social inequity in health status and health provision in Wales?

I thank the Member for highlighting a hugely important issue for the future of healthcare in Wales and beyond today. This, of course, is a key aspect of prudent healthcare, which my immediate predecessor outlined, and that's continuing through the service. Prudent healthcare is a key aspect when looking at, for example, the NHS Wales Awards; we look for evidence of a prudent approach to running and delivering services. It's also been highlighted and reinforced in the recent parliamentary review as a key driver for our system. There are some positive things to look at here in Wales; it's not just a counsel of helplessness. If we look at Aneurin Bevan Local Health Board and Cwm Taf Local Health Board, they've both had inverse care law programmes, deliberately going out to communities with the greatest level of risk, those people who don't engage with their own health, and the results are really positive thus far as well. I think in a previous appearance before the health and social care committee—it's not called that; it's still got sport in its title—I'd indicated that I'd write to them with an update on the initial evaluation from those two programmes from both vice-chairs. I'd be happy to share that with all Members, because it does show that that practical approach is starting to have an impact. There are lessons to learn from that approach and others for our whole service to adopt across the country.

Cabinet Secretary, such is the plentitude, if I can put it that way, of gambling opportunities that we hear today that 16 per cent of children aged 11 to 15 gambled in the past week. I do find that quite shocking. I should say that I do gamble occasionally. But we've got a real problem with gambling addiction, and now we hear from the chief medical officer that it is one of the major public health concerns that we face. Are you likely to review the current position of the Welsh Government that there's no medical intervention available to meet gambling addiction?

We will, of course, look at all the evidence available about how to treat gambling addiction in the first place, but I want to come back to your first point about the prevalence of gambling and the ease with which gambling can take place. It's no longer, if you like, an unusual or regulated activity that people have to make an effort to physically go to. There's a challenge about online gambling in particular, and there's been a recent and well-run public debate on fixed-odds betting terminals as well. Now, we're about to have new powers under the Wales Act 2017 where we could potentially do something with our powers, up to a minimum stake of £10. You'll notice that, in the report published today, the chief medical officer recommends using our powers to their fullest extent. We need to consider also the ongoing review undertaken by the UK Government where they are talking about reducing the maximum stake down to £2. The chief medical officer has put evidence in supporting that, so we need to think about how our powers may be affected if the UK Government do take that step forward. I actually think that having that general approach across the UK would be a good thing, but I'm interested in how we use our powers in restricting gambling in a way that is sensible and proportionate, recognising the harm that takes place, and at the same time about the treatments we offer for people who are caught up in gambling addiction, because I do recognise the wide social harm it can and does cause.