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

Thank you, Presiding Officer. With your permission, could I extend a welcome to the new Member for Alyn and Deeside on behalf of the Welsh Conservatives in the National Assembly, and wish him well in his political career?

First Minister, last week Hywel Dda came forward with a projected deficit at the end of the financial year of some £70 million. This builds on two previous deficits of £47 million and £32 million in the previous two years. In October 2016, this health board was taken into targeted intervention, and that targeted intervention was worked by the Welsh Government to build a sound financial footing. What's gone wrong?

I should have welcomed our new Member as well—our youngest Member. I've done it personally, and I join the leader of the opposition in doing that.

Can I say that the health Secretary has made it clear to the Hywel Dda board that the level of deficit is unacceptable? He's also been clear that difficult decisions are needed to ensure the future sustainability of health services in Hywel Dda. The board were given a clear target to not exceed their planned deficit of £58.9 million, but it wasn't until December that they said they would miss this target. There are still significant concerns with financial management and reporting within the board, which we are following up in detail with them, and we are confident that the health board will still balance overall in the current year, even with this increased deficit in Hywel Dda.

First Minister, my question was: what's gone wrong? This is a health board that was put into—I think the words are—'targeted intervention' some 18 months ago, along with three other health boards, and obviously the special measures health board of Betsi up in the north. So, four of our health boards are under some form of Government intervention. This escalation in the deficit up to £70 million, building on two previous substantial deficits, clearly shows that that financial oversight—and it was specific to financial oversight, that the Welsh Government intervened—is not working in this health board. Now, we know there's a consultation about re-organisation of health services in Hywel Dda. We know, from the apology you gave last week, that you don't give apologies that easily, in fairness, in coming to this Chamber because of the misinformation that that health board handed over to you. Really, how can anyone have any confidence in the ability of the health board to deliver health services in west Wales for in excess of 10 per cent of the population of Wales? A £70 million deficit—how on earth is that deficit going to be brought back under control while maintaining services and getting on top of waiting lists?

I should have clarified that we are confident that the health budget will still balance overall, rather than the health board budget—just to make that clear. Look, all health boards across Wales have a duty to ensure safe and sustainable services. That means that they have to put forward suggestions for how that is to be done. I appeal to Members not to just oppose any changes as they arise, because there are difficult questions here. In fairness, the parliamentary review has looked at how we make the health system in Wales and the social care system more sustainable in the future. We need to have a serious examination of what should be provided where—sure, services as close to home as possible, but that might mean service changes in the future. These are issues that need to be looked at dispassionately and sensibly before any decisions are taken.

First Minister, you talk about Members looking at changes. One of your own Ministers has said that she would vote against any changes that would come forward from the consultation. So, from within your Government people are casting aspersions about the consultation process. I have put to you twice now the escalation in the deficit situation that Hywel Dda faces: £70 million, £148 million of deficit over three years. It's not unreasonable for people in west Wales—as I said, in excess of 10 per cent of the Welsh population—to rely on that local health board to deliver health services in rural locations. I really would appreciate—as I'm sure would many Members in this institution, along with members of communities down in west Wales—some road map that the Welsh Government might have to rescue this situation. The deficit is getting worse. Waiting times are getting worse. The ability to attract staff to fill vacancies is not succeeding. In fact, workforce planning is woefully inadequate in that part of Wales, as we know. So, the third question: can you give us a road map of what the Welsh Government will be doing with the health board to bring this deficit under control, so that people can have confidence that they will have a health service in this part of Wales?  

First, he's not correct in terms of what he's quoted the Minister as saying. Secondly, the health board has published a consultation, which contains various options—difficult, some of them; there is no question about that. But it's the health board's responsibility to come forward with proposals, and that's exactly what it has done. I have to say to the leader of the opposition: we have seen, for eight years, cuts in the Welsh budget. We could be £4 billion, by one estimate, better off if he had actually made representations to his Government in London, but he has sat there and done nothing. Ruth Davidson sits in the UK Cabinet. He isn't allowed through the door. The Northern Ireland Executive was given £1 billion, if I remember rightly, for health, or certainly hundreds of millions of pounds. Wales received nothing. There was no consequential. There was no extra money for Scotland and Wales. Can I suggest that, while we are sorting out the mechanics of how our health boards work, he actually does something—that he does what his Scottish colleague does and actually stand up for his own country?

The Plaid Cymru leader—

Can I move a point of order?

No, you've had—

The First Minister has misrepresented—

No, there is no point of order. Leanne Wood.

Diolch, Llywydd. First Minister, you stated last September that you wanted to see a justice system—and I quote—that was

'truly representative of Welsh needs.'

The priorities are to improve access to justice, to reduce crime and to promote rehabilitation. We know that your commission is due to report back in 2019, but that's a little bit late to ensure that justice policy can be devolved in a decisive and clear way in time for the next Welsh Parliament. Are you confident that the case for a distinctive Welsh justice system will be strengthened by your commission and that quick progress can be made if it reports back with compelling evidence for change?

On the swift change, that is a matter, of course, for the UK Government, but we would urge them to follow the recommendations in the report. We've tended to focus on what this would mean for the courts, the probation service and also, of course, the issue of the jurisdiction, which has been well debated in this Chamber. But, of course, if we look at the justice system, we have to develop a Welsh penal policy—something that we've never had before and something that we'd have to start from scratch. So, all these things have to be examined carefully as we look at the potential devolution of justice.

The jurisdiction point, to me, is unanswerable. This is the only jurisdiction anywhere in the world—common law jurisdiction—where there are two legislatures in the same jurisdiction. It makes no sense. I know people out there are not exactly rioting on the streets on this issue, but it makes no sense from a legal perspective. It means that people are misled when they look at the law. Some people believe that when a Bill is titled—and Simon Thomas brought this to the Chamber a few months ago—'this is the law of England and Wales'—. But it doesn’t apply in Wales. It causes confusion, it makes no sense, and it’s always been the case that where a legislature acquires primary powers, the jurisdiction always follows. That’s one issue, but then, of course, we get on to, ‘What should a Welsh penal policy look like in the future?’

I agree with you, First Minister, and that’s why it’s such a shame that the opportunity was missed when the last Wales Bill was going through.

There is one case that demonstrates to me in a very striking way why we must have control over our criminal justice system, and why that must happen soon. The case of Conner Marshall of Barry demonstrated huge failings in the probation system. He was brutally murdered by someone who was on probation and who was not being sufficiently supervised under the system that has been privatised since 2014. Conner’s murderer missed eight probation appointments. Now, there is a clear link between privatisation of the probation service, the pursuit of profit and poor performance in supervision and monitoring. There has been no improvement in probation outcomes since privatisation began. Staff numbers are down 30 per cent and reoffending rates are up.

First Minister, leaving Welsh probation services in the hands of Westminster has not worked. The case of Conner Marshall shows that the public is not safe under this system. Will you support Conner Marshall’s family’s call for an inquiry into the actions of Working Links in this case? And when Wales does gain responsibility for criminal justice policy, do you agree with me that probation services should be brought back under public control?

I'm not familiar with the case, but I will look at it and write back. I think that’s the proper way to deal with what the leader of Plaid Cymru has asked for.

We are in agreement a lot this afternoon. I couldn’t agree more with what she said. Why would you take a service that is designed to rehabilitate offenders and try and make a profit out of it? There is no sense in that, and I absolutely agree that—I say 'hopefully, when' and not 'if'—when we get control of the probation service, we can have a properly functioning, publicly run and accountable probation service in the future, not what we have now. Because clearly, to my mind, it’s not just that the case has not been made for a privately run probation service, it’s that it’s been something that I don’t think has been a great success—and she is somebody who, with her background, is passionate about probation and the need to rehabilitate offenders.

It does society no good at all if they do not have the means and ability to find a way to rehabilitate themselves and remove themselves as a nuisance or a danger to the public. In the future, I’d like to see a situation where it is in this Chamber and, of course, through the Welsh Government that the probation service is shaped in Wales.

Again, First Minister, I have to express regrets to you that we weren’t having this discussion before; we could have prevented the privatisation of the probation service.

I do now, though, want to turn to the question of superprisons. I’m appalled to see prisons held up as a tool for economic development when their main role is to deliver rehabilitation through custodial sentences. Prisoners now are being moved to Wales who are not from Wales to serve their custodial sentences, and that means that they are moved further away from their families and support networks, and, as you know, being close to your family and support network is a very important aspect of rehabilitation.

Figures this week show a concerning range of incidents that have taken place in HMP Berwyn within its first year of operation, which surely raises questions about the need for another superprison at Port Talbot. If we were developing a Welsh justice system, we would not need a new superprison. While prison services are not devolved, you can make the decision on the sale of Welsh Government land for the Port Talbot superprison. Will you now commit to using that land for sustainable economic development and not a prison? And will you make a commitment that you will not facilitate a superprison that doesn’t meet the needs of Wales?

We have had questions of the Ministry of Justice that have not yet been satisfactorily answered. We have taken no decision on the sale of the land. I know of the representations that have been made. In some ways, the issue is bound up with the commission for justice, in the sense of what should a Welsh penal policy, or a Welsh sentencing policy as well, look like in the future. It's right to say there are Welsh prisoners serving sentences a long way from home in England—in the category A prisons in England. How do we resolve that situation to ensure that people can serve their sentences closer to home, certainly towards the end of their sentences when they are closer to release and, we hope, rehabilitation? But as I say, as far as Baglan is concerned, no decision has been taken. We are not yet in a position where we feel confident that we can take a decision because the full information has not been provided. 

The leader of the UKIP group, Neil Hamilton.

Diolch, Llywydd. With permission, I'd also like to welcome Jack Sargeant to the Assembly, and to congratulate him on the maturity of his opening speech, very confidently delivered, and we look forward to hearing a lot more of him.

The First Minister will know that lots of people in north Wales think the letters NHS stand for 'national health shambles'. Since 2010, the NHS has cut the number of beds in Wales by 18 per cent, but in Betsi Cadwaladr health board they've been cut by even more, down by 21 per cent. Ten days ago, the Betsi Cadwaladr senior staff met with Denbigh councillors to explain why they're cutting 10 beds in Denbigh hospital but only opening five in Ruthin. Last week, the Daily Post reported that health chiefs are blaming extraordinary ongoing pressures for patients sleeping in equipment rooms and in corridors in Llandudno General Hospital because of a lack of hospital beds. Margaret Cowan, who was visiting her father in that hospital, said:

'There used to be 12 wards in Llandudno, now we have only three left, the people of this town deserve to know what's going on.'

Can the First Minister tell the people of Wales what is going on in the national health service in Wales?

Well, funding it, and at a level higher than England. That's what happens with the health service in Wales, making sure that the money is available for health and social care. We're seeing social care collapsing in England. We're seeing councils—Tory councils—declaring themselves bankrupt in England. So, making sure the money is there.

Yes, there are challenges, and we know that, and those challenges will need to be met head on by the health boards. But he says 'national health shambles'. Perhaps he would like to put that to the doctors and nurses who work in the health service, both in north Wales and elsewhere. And let me remind him—and I'll take him there, perhaps, when it's built—of the sub-regional neonatal intensive care centre in Ysbyty Glan Clwyd, a major investment—a major investment—in Ysbyty Glan Clwyd—an investment decision that was taken by me at a time when it was being suggested that those services should move over the border. I made sure that an independent group of experts was brought together and a case was made to ensure that it was built in Ysbyty Glan Clwyd.

So, we will ensure that where those serices can be made available to the people of north Wales they are made available, and the SuRNICC is an example of that.

The First Minister knows that for every success there are masses of failures. Four of the health boards out of seven are in special measures or targeted interventions, as the leader of the opposition pointed out earlier on. The Welsh Labour Government has a direct responsibility for the state of the health service in Wales. The Cabinet Secretary chairs meetings of the Betsi Cadwaladr health board now and a statement was issued on 1 February saying that:

'The Welsh Government continues to work with BCUHB to ensure that services and patients are not adversely affected by the need to improve financial management.' 

We know, though, from the report that Deloitte made on the financial recovery group in Betsi that the governance structure is poorly defined and misunderstood by board members themselves. This financial recovery group meets in private, it doesn't publish any of its papers, it doesn't actually publish any minutes. There's a secret financial recovery review that is being hidden from members of the public. Why doesn't the First Minister take special measures himself to ensure that public confidence can be increased by being more open and transparent, just as in Hywel Dda we had problems only two weeks or so ago because of leaked reports? Why don't we have a more open and transparent health system? Why don't we make it more democratic? 

Well, I can say the Cabinet Secretary has increased the oversight from us on actions to reduce the forecast in terms of the finances, and to ensure that

'services and patients are not adversely affected by the need to improve financial management'.

We have said that. We expect the financial recovery actions to result in the health board meeting the revised forecast to the end of this year. We commissioned the Deloitte report in order to assist both the board an ourselves in terms of planning for the future, and the board is expected to demonstrate progress on the actions in that report to meet the recommendations set out by April of this year.

The First Minister will remember that last week, in my question on the agenda, I noted that the Deloitte report said that the financial and strategic planning at the health board is simplistic, with budgets generally rolled forward into the next year. Again, the leader of the opposition pointed out the disastrous financial performance of these boards. Part of this Deloitte report also said there is limited insight regarding how the health board's ultimately going to recover the financial position, and a distinct lack of secondary questioning from board members to facilitate detailed debate and discussion across key areas of risk, and executive level leadership capability and capacity needs to be enhanced.

Labour has been in charge of the health service in Wales for 20 years nearly, since 1999. Does he accept personal responsibility for presiding over a health service that in many parts of the country is worthy only of the third world?

That is a wholly outrageous comment. Let me just educate him a little so he looks beyond his own nose. The third world is an old-fashioned and discriminatory description anyway. We talk of the developing world these days. Let me tell you, there was a hospital in Uganda in Mbale serving several million people—it had seven consultants serving all those people. You could have an endoscopy there but if the endoscopy discovered some issue that had to be resolved, whether it was perhaps a stomach ulcer or worse, there was no treatment. People died of stomach cancer because they could not afford the treatment. Half the patients who entered that hospital went in there with malaria, which the doctors found very difficult to treat. Yes, they were able to perform miracles when it came to accident and emergency, but many, many people died of preventable illnesses. And he stands there and he compares the Welsh health service, with 1,000 consultants for three million people, with those conditions I saw in Mbale. He belittles the people of Mbale and Uganda by his appalling comments.