Thank you, Deputy Presiding Officer. Across Wales, our health and social care services have faced significant pressures this winter. None of the challenges we face in Wales are unique to us; the same challenges exist right across the UK. It is testament to the compassion and commitment of our staff that the vast majority of people continue to receive the care they need in a compassionate, professional and timely manner, and I would like, once again, to thank and pay tribute to our hard-working staff for the dedication they have shown in managing and coping with the pressures across our health and care system over the last few months, and I am sure everyone here will share those sentiments.

Despite rigorous preparation across our system, there have been times when our services have seen exceptional levels of activity above and beyond what could reasonably have been anticipated. GPs' and primary care services, both in and out of hours, have seen increased activity, with twice as many patients being seen and treated following the Christmas period. So, to support GPs, I have already relaxed the quality and outcomes framework element of the GP contract until the end of March. This will help GPs and their teams to maintain focus on their most vulnerable and chronically sick patients.

The ambulance service has exceeded the 65 per cent red-call target every month since the clinical response model was introduced. December 2017 was above 70 per cent for the twenty-first consecutive month, despite receiving the highest recorded number of red calls. December 2017 was also the busiest December on record in accident and emergency departments across Wales, with 136 more attendances per day compared to the same month last year. More patients were treated, admitted or discharged within four hours than in any of the previous three Decembers, and that reflects the hard work of staff, who've maintained a typical wait of just over two hours before patients were admitted or discharged. December also saw the highest number of patients aged 85 and over being admitted to hospital from an A&E. As we know, older people often have more complex needs, requiring longer periods of assessment in A&E, and, if they are admitted, they are more likely stay longer in the hospital.

Dealing with pressure in our system is a year-round challenge. We see higher levels of attendance in the summer, but the highest proportion of people, and, in particular, vulnerable people, needing care are present in the winter. However, the monthly four-hour A&E performance in 2017 was better during every month than in 2016, with the exception of a very difficult December.

As Members will know, I have visited several A&E departments and spoken to clinicians in recent weeks to see the challenges faced by front-line staff for myself. The Minister for Children and Social Care has also been out speaking to staff on the ground, and we will both be doing more of this across Wales in the coming weeks. The extraordinary levels of demand this year have been compounded by an increase in patients suffering with flu, norovirus and respiratory illness attending GP practices and A&E. This flu season has seen the highest rates of illness since 2010-11, exacerbated by the cold snap across the UK in early December. Flu rates appear to have peaked, but they still remain high and the flu season will continue for a number of weeks yet.

There are, though, areas of our system that have improved despite the recent pressures. We've seen a 7 per cent reduction in delayed transfers of care in December, confirming that the total number of delays during 2017 was the lowest since our records began 12 years ago. Waiting times have stabilised in respect of referral to treatment and diagnostics, and we expect material improvements to the end of March. Health boards do have clear profiles to achieve this in place. As you know, we provided an additional £50 million to help health boards build on the progress made over the last two years, to reduce the number of patients waiting over 36 weeks, those waiting over eight weeks for diagnostics and those waiting over 14 weeks for therapy services by the end of March.

We continue to provide nearly £43 million to support our primary care services through the primary care fund, and our £60 million integrated care fund is being used to provide care and support closer to home, to keep people out of hospital, and to tackle delayed transfers of care. For example, the Môn enhanced care model in Anglesey is delivering care at home for acutely ill elderly patients. The Stay Well at Home service in Cwm Taf is using a multi-disciplinary hospital-based team to undertake assessments and commission support services to prevent unnecessary hospital admission, and indeed to help people to get back to their own homes in the first place.

We have recently provided an additional £10 million to support front-line services to take immediate action to improve care. Cwm Taf Local Health Board have extended GP practice opening hours on weekends to support the out-of-hours service, and there are early signs that is helping patients to avoid A&E. Hywel Dda has increased therapy, social worker and consultant resource to support weekend discharges, and Cardiff and Vale health board has commissioned additional rehabilitation beds to support patients with their ongoing care needs. Our early information indicates that 69 per cent of patients transferred to the unit have reduced care needs from the point of admission to being discharged.

The social care sector and staff play an equally important role in delivering care and have faced the same considerable pressures this winter. In recognition of that, I'm pleased to confirm that I have provided an additional £10 million to local authorities to address their most immediate priorities in this area. Following discussions with the Welsh Local Government Association and the Association of Directors of Social Services in Wales to identify those priorities, this extra money will be used to provide domiciliary care packages, care and repair services to enable quicker discharge from hospital and maintain independence at home, and for short-term and step-down residential care.

Although winter preparation has delivered a greater resilience across our system, there have been times where people have experienced longer waits than are acceptable. The national evaluation of planning and delivery for last winter identified a need to focus on planning for December and immediately after the festive period. So, health boards introduced initiatives this winter that focused on collaborative working and being proactive through escalation to address those pressures quickly and improve patient flow. There is some variation across Wales, but our early indications are that this has increased resilience, means that more patients are being sent home earlier in the day, it's reduced the average length of stay for patients who would typically wait in hospital in a bed for over a week, and health boards and their partners will be expected to evaluate their actions and share learning right across Wales.

There are areas of the system where the exceptional demand has meant, without additional planned actions, pressure would have escalated to critical levels. We've provided nearly £700,000 to the Welsh ambulance service to increase the number of clinicians in their contact centres to 30. This allowed patients to be safely treated over the telephone or to be diverted to other services, resulting in a substantial reduction of unnecessary ambulance journeys to hospital. But all of us can play our part in supporting the national health service. We need to make the right choices for ourselves, but also encourage our constituents to choose the appropriate advice or service when they are sick or injured.

I'll close by saying that winter is not over yet. I've seen some people suggesting that winter is over at the end of February. We should remind ourselves that, last year—there was an exceptionally cold March last year. So, winter does not neatly end at the end of February. Pressure remains in our system at this point in time, and there will inevitably be more difficult days to come. We will continue to work closely with our staff, across health and care services, to ensure the very best outcomes possible for our people by delivering the right care at the right time and in the right place.