I have to admit that this has been a difficult decision. I must make that point. On the one hand, we have a system of rights that we’re trying to extend, and, on the other, we have a sector that isn’t ready for meaningful rights, that is, face-to-face communication and provision in the primary care sector. The standards, as they currently exist, do actually contain some unfortunate discrimination between patients that are served by a GP surgery run by the health boards and those going to independent GP surgeries. There are also issues between in-patients and out-patients.

Despite a broad-ranging consultation on the draft version of the regulations, the final version wasn’t subject to a long period of consultation, and it includes a small number of significant changes. The responses to that brief consultation weren't of the same opinion either. Generally speaking, the standards as they currently stand are clear and can be applied in various different areas of Wales, but we cannot ignore the inherent inconsistencies forever.

We have to consider why these weaknesses have appeared in the regulations, and in the past I have said in this Assembly that challenging standards can push stubborn councils to take steps, for example. And, for large parts of the health service, I would say the same thing. They’ve known that standards were in the pipeline since 2010, and they should have been making preparations for them. Certainly, most of these standards as they currently exist could have been foreseen, and that’s why I would like to proceed with these standards now.

We can consider why some of the standards haven’t been included, when, from the point of view of rights, they should have been. Now, what I would ask is: why is it difficult to recruit practitioners of sufficient quality? Why is that more difficult than recruiting staff to councils? Because that’s what’s been happening, unfortunately. With so few key relevant practitioners able to speak Welsh in Wales, the right to a consultation through the medium of Welsh at the moment is something that cannot be enforced, and therefore it shouldn’t be worded as an inherent right. Unlike local authorities, the cohort of doctors and trainee doctors come from all parts of the world, and I don't see this as a question of the health service ignoring the inherent skills of the workforce; it’s a question of ensuring a workforce at all, whatever language they speak.

But we won’t accept this rationale forever. Minister, we will be supporting these regulations today because something needs to be done after so long, and there are over 100 standards that could be applied at once. But we will hold you to standard 110, and we will expect this to be a step towards any new set of standards in the future—the next part of the jigsaw, as you mentioned. We recognise that, although recruitment is still a problem, it's possible securing rights to face-to-face consultations across all disciplines will still be difficult, but we will expect them to be introduced in key areas such as dementia, mental health, children’s services and autism services at least as a result of standard 110, and, if possible, it should be done before the five years is up.

So, that’s why I was content to sign up to the committee’s report, because I am of the view that it’s possible to do something before the end of that five years, and that is to do something as soon as is reasonably practicable. We don’t have to wait for five years if there is a chance to do something sooner. Thank you.