Item 10, then, is a statement by the Minister for Health and Social Services on the impact of a 'no deal' Brexit on our health and care services. And I call on the Minister for Health and Social Services, Vaughan Gething.

Thank you very much, Deputy Presiding Officer. When I first set out the potential impact of a 'no deal' Brexit for NHS and social care services in Wales in June last year, some Members in this Chamber accused me of scaremongering and political mischief making. Yet, two and a half years after the European Union referendum, and less than 70 days before the UK is due to leave the European Union, the prospect of a 'no deal' is now greater than ever. Barely a foundation stone of our future relationship with our closest and most important trading partners has been laid. Instead, just last week, we were hearing reports about increasing numbers of medicines affected by supply issues across the UK in the face of a 'no deal' Brexit.

The UK Government is responsible for maintaining the continuity of the supply of medicines, like so many areas, which will potentially impact upon the people of Wales. Although the number and type of medicines affected is relatively low, it is clear that the UK Government cannot provide full assurance that a 'no deal' Brexit will not affect business as usual. From a health and social care point of view, it matters more than ever that a 'no deal' Brexit should be taken off the table as a minimum.  

I continue to be concerned about the future supply of radioisotopes to Wales in the event of a 'no deal' scenario. Radioisotopes are essential for diagnostic and therapeutic use by our national health service. There are no sources within the UK, and supplies are routinely imported from other EU countries through the main cross-channel ports. Disruption from custom checks at our ports is likely to render radioisotopes useless for healthcare treatment. We are reliant on UK Government assurances that although the UK still plans to withdraw from Euratom, there will be no regulatory barrier to the continued import of radioisotopes post Brexit. However, a 'no deal' Brexit could lead to divergence in regulatory arrangements and standards between nations that could affect the import of radioisotopes. And, of course, it is the express desire of most 'no deal' advocates to have divergence in regulatory arrangements and standards.

Let nobody underestimate the impact of a 'no deal' Brexit—the impact that a 'no deal' Brexit will have on individual citizens and families. That includes, of course, European Union nationals living and working in the UK, or UK nationals, including many Welsh citizens, who have taken advantage of freedom of movement to live and work in the European Union. All will be affected.

Apart from the uncertainty over reciprocal healthcare and settled status arrangements, a 'no deal' Brexit will inevitably lead to a tighter health and social care labour market across the UK. That will make it even harder for us to compete for staff, and of course a likely rise in costs. A 'no deal' Brexit will have a profound impact on all professions and all health and social care staff. The effect of changes to migration policy, particularly a policy that favours high skills and wages, will be most keenly felt in those parts of our health and social care sector that depend on relatively low-paid workers, such as workers providing domiciliary or residential care, who have a central role supporting some of the most vulnerable people in our society. So, let's be clear: disruption in our social care sector would not just affect vulnerable citizens within social care, it would inevitably lead to delayed discharges from hospitals and increased pressure upon our hospitals. That means pressure on our staff and on citizens themselves who still require health and social care.

The Welsh Government has been clear that a 'no deal' Brexit would cause serious and unavoidable harm to our health and care services, and that harm would extend to all sectors, including, of course, the at least 1,400 European Union nationals who we know work in our national health service. If we are to leave the European Union with minimum harm to our health and social care services, then there must be the certainty of a deal that ensures full and continued and unfettered access to the single market, and the development of a new migration system that links migration more closely to employment, whilst protecting those employees themselves from exploitation.

I'd now like to focus on the work that we have been doing to mitigate some of the substantial and known risks of a 'no deal' Brexit. We've been working closely with the NHS, the local authorities, professional and representative bodies to plan and prepare wherever possible. To support social care providers, we have commissioned Ipsos MORI to assess the composition of the social care and childcare workforce here in Wales. That research will help us to identify how many European Union workers are employed in the sector, so that we can support them and their employers, and it will also facilitate cost-effective planning for areas or roles where vulnerabilities are identified. 

I started my statement this afternoon by referring to reports of medicine shortages. We have been focusing work on ensuring the availability of a supply of medicines, medical devices and clinical consumables in the event of a 'no deal' Brexit. In terms of medicines, as I said, we are essentially reliant on the work being undertaken by the UK Government and the pharmaceutical industry to ensure that stocks and dedicated transport routes are available. However, we are being rigorous in our interrogation of the data that is made available from the UK Government about the medicines most likely to be affected or where there is insufficient assurance from manufacturers. In terms of medical devices and clinical consumables—everything from pacemakers to incontinence pads to surgical gloves—we will use UK arrangements where that is the right thing to do, but we will also take additional steps where we have areas of concern, or where we feel we can provide the additional certainty that we need here in Wales. In doing so, we are considering how we look beyond 29 March, and to try to secure some lasting value from the measures that we are having to take to prepare for a 'no deal' Brexit.

I was pleased to welcome yesterday the publication of a very thorough and considered analysis by Public Health Wales about how Brexit could impact on all aspects of health and well-being in Wales over the short, medium and long term. The report focuses on the distinct political, social, cultural and economic challenges that Brexit poses to Wales. It will provide an invaluable reference and evidence base for service and community leaders as we move forward into even more uncertain times and the possibility of new international relationships. This is the only health impact assessment of Brexit that's been published anywhere within the UK. It is a further demonstration of how we're taking what we can from UK arrangements but also going further where that is the right thing to do.

Both of these initiatives are vitally important to our overall contingency plans and we will provide the additional assurance that we can, as we are as prepared as we reasonably can be, but, as yet, we still don’t know what form Brexit will take, with only nine weeks to go. 

On 23 June 2016, the people of Wales and, indeed, the UK voted by a majority to leave the European Union—the largest number of people ever voting across the UK since records began. Now, I have always believed, as I do today, that politicians, irrespective of party, have a fundamental duty to ensure that the will of our people is delivered. The legal default position, of course, is a 'no deal'.

Over the past two and a half years, I have been saddened here to see this Welsh Government prevaricate from its own devolved responsibilities, avoiding scrutiny in favour of causing mayhem by scaremongering, and now seeking to derail Brexit through issuing confused calls for both a general election and, indeed, a second referendum or—call it what you like—a people's vote. Instead, you should have been focused on preparing the devolved areas that you have responsibility for here, not least the health sector, from the outset. You are right in your statement: there is a nervousness in the Welsh healthcare sector, but this is not being helped by you yourself. For example, it is an astonishing fact that the Welsh NHS's share of the Welsh Government's £50 million EU transition fund fails to reflect your hyperbolic rhetoric. As you might recall, Minister, in October 2018, you announced that only—yes only—£210,000 of the £50 million fund will be used to prepare the health service in Wales for Brexit. Really? When considering that health and social care spans seven health boards, 22 local authorities, it is actually quite shocking that you have essentially allocated just around £7,200 per public body.

Sadly, lack of preparedness is a common theme when considering the Welsh health and social care sector, as has been picked up and acknowledged by one of your own Labour AMs, David Rees. Whilst you mentioned in your statement that you've commissioned Ipsos MORI to assess the composition of the social care and childcare workforce in Wales, it is a striking fact that this is only being done now. Thankfully, our UK Government is more organised and has acknowledged issues such as medicine and advised manufacturers to stockpile six weeks' worth of stock in the case of a 'no deal' scenario. It is also nice to know from the First Minister that the latest raft of 140 employees—interns—into the Welsh Government department to prepare for Brexit have, in fact, been funded by the UK Government. More so, the UK Government has no wish to prevent people from inside or outside the EU coming to work for our public services. The UK Government has—and don't deny it, they have guaranteed that there will be no change to the status of NHS staff if no deal is agreed. Finally, it seems—

Are we getting a question, please?

Yes, I'm coming to my questions now, Deputy Presiding Officer. You have a greater issue on your plate, as it seems that Wales continues to struggle to retain staff, regardless of their nationality. Indeed, the concerns of Oxford university's Nick Fahy include that there is a danger staff might relocate to England. Personally, I think this is unsurprising, as I already know that it's happening in north Wales, and that is due to your own incompetence of running the health service—a board that has been in special measures for three years.

Therefore, my questions to you are, Minister: will you clarify whether you will be assisting any companies financially with stockpiling costs, and, if so, whether that will be coming from the EU transition fund or that of the health department; (2) what work are you undertaking to allay fears of 'no deal' on healthcare staff, and are you really confident of retaining NHS staff Wales regardless of nationality whilst also resisting the over-reliance on agency staff; and (3), finally, will you explain whether you are considering securing more money to help prepare the health and social services sector? Across the UK, this is the only devolved Government where we've seen massive and savage cuts to our health service. So, I think any—[Interruption.]—any criticism now should be directed at this Welsh Government, and let the UK Government get on with Brexit. 

Minister. [Interruption.] Minister. There were three. 

I'd like to thank Janet Finch-Saunders for her interesting contribution. There were a range of assertions made that were non factual. I won't go through all of them. But let's deal with the three supposed questions.

Money for companies to help them with stockpiling: we expect to have the same financial arrangements in paying for equipment and medicines for use in the health service. There may however be additional costs that would be passed on. For example, if radioisotopes are flown into the United Kingdom because the customs arrangements after a 'no deal' arrangement mean that you can't actually bring radioisotopes in via the usual route of ports, there would be a cost that would almost certainly be passed on to the health service, and that would have an impact on budgets in every single nation of the United Kingdom. 

On settled status, it was a positive step that the Prime Minister finally saw sense and agreed that there would not be an application fee for people to apply for settled status. There is still the challenge about not understanding how the process will work for potentially vulnerable citizens who have lived in this country for a significant period of time and are already accessing health and care. People, understandably, across all parties in Parliament have concerns about a process run by the Home Office, in particular in light of its recent track record over Windrush citizens, some of whom were, of course, deported from the United Kingdom, some of whom were denied essential health and care treatment. There is still much more to do before people have full reassurance about settled status, and, of course, in the event of a 'no deal', that will have to be in place for a process to be run within just a few short weeks.

And there was the non-factual statement about health and social care funding. We regularly go around this in this Chamber. This Government funds health and social care services by a significant amount more—at least 8 per cent—than the United Kingdom Government does for England. The relative cuts in social care are significant. Don't take my word for it: look at the Conservative leadership of the Local Government Association in England and they will tell you how bad a deal social care has had within England. Also look to colleagues in the national health service in England and they will also tell you about the deal that they have had. We do much better by health and social care here in Wales, and there's simply no argument with the facts on the matter.

On your broader assertions about a lack of preparedness and causing mayhem, at some point you might want to turn on the television news. I don't know if you're aware of this particular phenomenon—there's something called Parliament, the United Kingdom Parliament, where people talk about Brexit on a regular basis. Ministers regularly resign from the Government because they can't agree with Government policy. Government Ministers regularly brief the media about disagreeing with Government policy. The Chancellor last week, actually, in a telephone call to a range of businesses, said that 'no deal' would be taken off the table, and the Prime Minister insists that isn't going to happen. So, Philip Hammond is brilliant for suggesting 'no deal' will not happen, but the pointy bearded Marxist Jeremy Corbyn is evil for suggesting 'no deal' has to come off the table. If you want to see mayhem, look at the United Kingdom Parliament, look at the United Kingdom Government. The shower of Brexit directly runs to the door of the United Kingdom Government. Theresa May is responsible for our position, after, of course, David Cameron, who started this all off in the first place. 

And on your point, your assertion, that the UK Government have guaranteed that—in the event of a 'no deal', that they have guaranteed the status of NHS staff, that is simply not true. At some point, I'd welcome Janet Finch-Saunders joining the rest of us on planet Earth and taking 'no deal' Brexit seriously.

I'd like to thank the Minister for his statement. In the statement, he sets out some of the issues and problems very clearly, and those concerns are concerns with which we in this part of the house would want to associate ourselves. I suppose I must admit to being a little bit disappointed that there's a lack of detail in some of his response, but I would also acknowledge that we have an awful lot of 'no deal' Brexit business to get through this afternoon and it may not have been possible for him to set out in detail everything that he may have wished to cover. So, I will explore, if I may, with your permission, some of the issues that he's raised a little further.

With regard to the issue of radioisotopes, this is actually, as he says, a serious potential risk. Not that anyone is going to voluntarily not wish to sell them to the Welsh NHS anymore, but there are, as he rightly highlights, practical issues—which can be overcome, though with considerable expense—and of course there are the legal issues. Now, Professor Wyn Owen has warned us that there is a danger that, if there is no agreement, suppliers will either take the view that they'll carry on supplying the UK until told not to, which would be fine in the short term, or they won't supply until they receive legal clarification that they are allowed to do so. So, I'm hoping that the Minister will be able to provide us with a little more detail about the discussions that he's had with the relevant persons in the UK Government to ensure that this legal position is clarified in the event of a 'no deal' Brexit, and I would encourage him to consider, given the current state of the UK Government, which appears to be unable to organise itself out of a wet paper bag—I'd ask him to consider being prepared to deal directly with Brussels on this particular issue. Obviously, we need a UK-wide solution, but, if that's not forthcoming, I'm sure the Minister would agree with me that we cannot afford to leave the people dependent on these services and the Welsh NHS without the necessary supplies.

The Minister mentions in his statement the work that's ongoing—the research—to look at the composition of the social care and childcare workforce in Wales. This will be very useful, but I'm hoping that the Minister can provide us with some details this afternoon about the timescale for that work, because it, obviously, is a matter of urgency to identify where those gaps may be forthcoming, and, if we end up with problems in the social care workforce, that will inevitably have a knock-on effect, of course, into healthcare, because we won't be able to discharge people from hospitals.

With regard to the points he raises in terms of medicines, and he speaks about being essentially reliant on work being undertaken by the UK Government—and I'm not sanguine, I'm not reassured, by that, though I realise that, at some levels, that is necessary—I wonder if the Minister can share with us this afternoon, or perhaps he would write to Members in due course, any details that he is identifying about medicines that are likely to be affected, and whether or not he is satisfied, as things stand, with the assurances that are being received from manufacturers. Similarly, with regard to the medical devices and consumables, in the Minister's statement he said he will take additional steps in areas where he has concern. I wonder if he's in a position to give us any early indications today about what those areas of concern might be, and what contingency steps are in place.

Now, the Minister refers, rightly, to the very good Public Health Wales report that many of us received today or yesterday. I would commend it as a valuable piece of work, though in one aspect I would beg to disagree. One of the possible positive outcomes of a 'no deal' Brexit that they highlight is a possible reduction in the consumption of alcohol. Well, for myself, I think a 'no deal' Brexit is more likely, frankly, to drive me to drink, if you'll forgive my levity, Deputy Presiding Officer.

But I'd like to call the Minister's attention to a couple of the recommendations. There are nine in the report—further areas for work. Recommendation 7 says that further research is needed on the impact of Brexit on mental health and well-being, community resilience, particularly highlighting children and young adults, and farmers and rural communities, the port areas, and black and ethnic minority groups. Can the Minister say whether he's yet been able to have, or his officials have been able to have, any discussions with Public Health Wales about what that research should look like and who should be carrying that out? And, similarly, with regard to recommendation 9, where Public Health Wales highlight the fact that the public health workforce currently lacks the experience and skills to influence and contribute to trade agreements, they say that the public health system should consider how to build knowledge, skills and capacity to ensure that health and well-being are considered at the forefront of such processes. Again, I'd be grateful if the Minister can inform us either what steps are already in place to start responding to that recommendation, or what further steps he will take, because it does seem that that may be crucial.

Finally, recommendation 3 is about leadership, and the recommendation is that leadership across the totality of Brexit issues needs to continue to provide overall direction to Wales's response. I do hope the Minister will assure us that he will continue to take a very clear personal role in leadership in this regard, with the health and social care sector. His statement indicates that we will be continuing, at present, to place a great deal of reliance on UK arrangements and plans. Given some of the things that the Minister has said in the past, I'm surprised that he's any more sanguine than I am that these UK arrangements and plans will deliver. Can I seek his assurance today that, given the chaos that is Brexit in Westminster at present, he stands ready to make sure that any direct representations that need to be made on Wales's behalf in the field of health and care are made by him? 

Thank you for the comments and the series of questions. I certainly can't provide all the detail that I would be able to. I would take up the time of several other Ministers. We could have the whole afternoon simply talking about all of the various different areas that will affect the health and social care system if there is a 'no deal' Brexit.

On radioisotopes, I've repeatedly made this point about the challenge not just of actually providing radioisotopes into the country physically, but challenges about regulation on whether manufacturers can legally import radioisotopes into the United Kingdom, especially if the United Kingdom does continue with its current proposal to withdraw from Euratom and there is a 'no deal' Brexit. There are ongoing conversations about that. The British Medical Association themselves, for example, have produced a briefing raising some challenges about that. The UK Government currently say that they have in place—or they're confident they will have in place—arrangements to make sure that the supply of radioisotopes can continue. It is in their interests, not just ours, for that to happen.

That brings me on to my point about those matters that are UK responsibilities, and the broader question of leadership. There are some areas—for example, the regulation of staff and medicines—where these are actually UK responsibilities. The challenge is how open the relationship is between the UK Government and the devolved Governments across the United Kingdom, and how information is shared and used. While, of course, we have varying views on what should happen in the coming weeks and after 29 March, it is in all of our interests for the health and social care systems across the UK to share as much information as possible, in whatever form of Brexit may or may not take place. So, I am keen that not just the conversations that take place between officials continue, but that there is direct contact between Ministers.

I have previously written to Matt Hancock. I know that Jeane Freeman, the Scottish Cabinet Secretary for health, well-being and sport, has also written requesting a face-to-face meeting. I've written again to do so as well. It stands in contrast to other members of the Government here in Wales. Lesley Griffiths and Kirsty Williams have had direct contact with ministerial counterparts. Not everyone will envy Lesley Griffiths her direct meetings with Michael Gove, but there is direct contact that needs to take place between the national Governments of the United Kingdom. I certainly will continue to pursue that because there is a leadership responsibility for all of us and, of course, for me here in Wales.

On the ongoing conversation with Public Health Wales and taking forward their recommendations, you'll understand that the significant report was published at the start of this week, on Monday. I have read the executive summary. I have considered a range of parts of the report, but I won't try to pretend to you that I have taken forward all of the recommendations. There is, of course, an ongoing conversation taking place about the response of the health and care system here in Wales, bearing in mind that recommendations have been made. But, I am happy to update the Chamber as we formulate a fuller response that will, of course, have to evolve, given that the Brexit question is far from settled as we speak.

On social care and the challenges of the social care workforce, I'm expecting to provide further updates to the taskforce that will meet more regularly now. We met last week. We will certainly need to meet in early February, and we are looking at a date, again not just to share information but to make choices. I will undertake to make sure that we update the Chamber on information, as and when we can share it, to make sure you are aware of the steps and measures that we are taking across the whole system. I'm also doing the same on updating on medicines—medicines management and supply issues, and the assurances we received, and the reality of those, including the conversations that we do have with representatives of the pharmaceutical industry here in Wales as well.

On clinical consumables, there are different products that are regularly used between the health system in Wales, England and Scotland, so a range of those things will be available on a UK basis. We'll need to make sure that all of the various clinical consumables we would want to continue to use in Wales are available. So, I am definitely looking at arrangements to make that available, and for the necessary amounts of stock to be available too. And I’ll have more to say when I'm able to make a definitive decision on that in the coming weeks as well. So, you can expect to hear more updates in writing from me over the coming weeks.

Thank you, Minister, for your statement; it’s very important that we highlight the issues about health and social care and other aspects. One of the things very often forgotten in this Brexit argument, because we talk about goods—but here we have services, and they are very heavily affected, and I appreciate the comments you've made already. If I could just ask a couple of quick points on this, because this is an area that all of us will be affected by—every single one of us benefits from the health service one way or another. You talked about, and you did highlight, the possible increased costs as a consequence of the delays that may arise, and you mentioned an example of the flights of radioisotopes coming in, but we were told by the Association of the British Pharmaceutical Industry that, actually, they are spending a lot of money on stockpiling. They have to invest in new warehouses, stockpiling, information and storage, and cold storage in particular. Have you had discussions with the UK Government as to who is going to help fund that cost? Because, undoubtedly, the organisations will want to pass those costs on, and this is something that, clearly, is a UK Government issue, which you highlighted.

Also, we haven’t talked about clinical trials. One of the things that we may lose out on is clinical trials. Steffan Lewis raised this very much in his arguments about Brexit. Have you had discussions about the implications for clinical trials in Wales? We have benefited hugely from those, and we are likely to lose out very quickly, particularly in a 'no deal' scenario. And what will implications be for existing clinical trials and future ones planned?

You talked about your social care workforce. When the committee looked at this very carefully, we were concerned about the lack of Welsh data on the social care workforce. Have you undertaken more work in collecting the data on the social care workforce so that we are clearly aware of where they are and where the gaps will be if there’s a problem with the workforce in that situation, and particularly in relation to qualifications, and matching qualifications? I know that there’s been a statutory instrument on that. I have tried to look at it on the UK Government’s webpage, and I had trouble getting at it, and I’m not clear exactly where we are with that.

And on the Healthcare (International Arrangements) Bill, that is something that should be in place by March 29, if we are going to leave without a deal. Where are we on that, and where are we with reciprocal arrangements if that isn’t in place?

Thank you for those questions. I’ll deal with your last point first, on reciprocal healthcare arrangements. Between the different Governments in the United Kingdom, I think there’s an agreement that we want reciprocal healthcare arrangements to continue. The challenge still is having a piece of legislation that we all can support. At present—you’ll have seen the report on this, it's a draft report or a final report from the Health, Social Care and Sport Committee, where I’m not currently in a position to recommend to the Assembly that we give legislative consent. So, that’s about the drafting of the current piece of legislation and the powers the UK Government seem to take, which I think are well beyond what is necessary to make sure that those arrangements remain in place. If there is no deal and there is no alternative legislation in place, then potentially those arrangements fall away, and that obviously affects European Union nationals in the UK, as well as UK nationals within the European Union and the wider European economic area. I will, of course, update Members when there is any further progress on the Bill, and when, I hope, amendments are laid within Parliament that we can support to resolve the issue.

On your point about data and the social care workforce, that’s what we’re looking to have covered by the Ipsos MORI research, so that we understand the range of risks that we are potentially carrying, but also, of course, there is the broader point about wanting to make sure that European Union citizens feel generally welcomed here in Wales and have a Government that is on their side. A number of workers across health and care have already voted with their feet and left, with the changing environment that exists. It is part of our job to make sure those people understand that there is a Government here in Wales that wants them to continue, not just to work and provide services, but actually to live as part of the communities of Wales.

On your broader point about clinical trials, this is something that goes across a range of areas, including higher education. It goes across some of the challenges on attracting and keeping staff within our higher education and our healthcare systems, but also on data sharing as well across different borders. And the challenge here is that much of the data sharing that we have is overseen by a range of data protection Orders, and there is a role for the European Court of Justice in overseeing a range of that information, including, of course, on the broader point about public health data sharing as well, so that we actually have proper disease resilience and intelligence across the European Union. Now, that's part of the challenge of red lines, because if there is absolutely no role for the European Court of Justice, it has a much wider impact than simply keeping some people happy on a limited range of areas; it has a significant impact across health, social care and many wider areas as well. 

On your point about additional funding for medicine supplies, that is a UK Government responsibility. We expect them to be good for the pledges they have already made about funding additional costs for medicines supply if that is necessary. Matt Hancock, the UK Government health Secretary, has said he is now the largest purchaser of fridges in the United Kingdom, so they are already purchasing and acquiring a range of stock. Because the 'no deal' Brexit has moved closer, every Government within the United Kingdom is not just spending time and the resource that we can't use in other areas, we're actually spending money, real cash on preparing for a 'no deal' Brexit that may not happen. That is part of our difficulty. We are spending money that we may not always be able to recover or make use of in a different way. So, I hope people do understand the seriousness of this issue for the country, but also for every Government within the United Kingdom and our use of public money on behalf of the people that we serve.

Thank you for your statement, Minister. 

If this Government is so concerned about the impact of Brexit on the Welsh NHS, is the Minister comfortable with the admission that the First Minister made to me in committee recently that the Welsh Government hasn't spoken to a single pharmaceutical company about the implications for supply of Brexit but, instead, has left it up to the UK Government? Is he comfortable with the situation, because, like me, he knows there's no real reason to be concerned about the supply of prescription drugs as a result of a 'no deal' departure?

There have been some supply problems in recent years, but they're attributed to increased demands from developing countries, an increase in the cost of raw materials and, even possibly, some deliberate market manipulation, and nothing to do with our impending Brexit. One politician recently confirmed that shortages are nothing to do with Brexit when she said, 

'Shortages have been a problem for some years. It's a fluctuating problem.' 

Now, that wasn't a Tory Brexiteer saying it—it was Sandra Gidley, a former MP for the remain-supporting Lib Dems, who is also a pharmacist. Of course, Welsh Government would have known this had they spoken to pharmaceutical companies, rather than just left it up to London. So, when are you going to have these conversations, Minister? Are you ever going to have them, and are you actually going to take control of the matter? 

Some people argue that patients are being tempted to stockpile ahead of Brexit and, if that's the case, then scaremongering remainers have no-one to blame but themselves for causing the ill to feel paranoid about their future supply, and Welsh Government should hang their heads in shame. Exploiting the vulnerable to further the remainer Welsh Government's devotion to the EU, and to thwarting the will of the Welsh people is nothing short of abuse.

And any argument that suggests that delays in importation due to no longer being in a customs union is utter twaddle. The World Trade Organization's pharmaceutical tariff elimination agreement guarantees that medical products will continue to be imported tariff-free, and that same agreement forbids the raising of non-tariff barriers. Not only would the EU be prevented from raising barriers to the import or export of medical products, so would the UK.

Furthermore, as a sovereign nation setting its own rules and practices at the border, in theory, we could decide to wave through every single incoming lorry if we felt so inclined, particularly shipments that are evidently pharmaceutical. Even in the customs union, some lorries are stopped and searched for illegal imports and illegal immigrants, but most are waved through regardless of their starting points.

Moving on to recruitment and staffing, this Government can't really tell us what effect leaving the EU will have on our staff because they haven't done anything to find out the international make-up of the staff of the NHS. They don't know how many of the staff that are of EU origin working in the NHS are clinically trained. That they don't know this is evident from the fact that they're only now starting to count them. They're now starting to count the number of EU people in social care, only weeks before we're due to leave. Why haven't you done this before? The referendum was over two years ago. 

How can the Government say that they're worried about the impact of patient care in the event of Brexit, when they don't know how many staff are clinicians from the EU? And if the Minister knew this figure, he'd have said it today. On the day that respected political scientist Sir John Curtice says that remain voters don't have a better understanding of the EU than leavers, I would suggest that, for the sake of the public's respect for politicians, you stop the scaremongering. The public can see through it, just like they did on referendum day in 2016. Out of all the nations in the union, Wales spends the least on its health service and has the worst outcomes for patients. What are you going to do about that, Minister, or are you going to continue blaming it on Brexit? Welsh Government continues to bleat that Brexit in any form will be horrendously expensive and holds out its begging bowl to Westminster, asking for unspecified funds for unspecified costs.

It was illuminating that last week the First Minister had to admit that Welsh Government has not undertaken a reliable assessment of the actual cost of preparing for Brexit in any form. So, any assertions by that same Government as to the cost and implications of Brexit have no credibility in the context of Welsh Government's utter failure to do its homework and its decision instead to rely on guesstimates. When will you finally do a proper analysis, Minister?

And although the Welsh Government want us to sing, 'Don't blame it on the Minister, don't blame it on the First Minister, don't blame it on the Government. Blame it on Brexit', that doesn't wash—[Interruption.] That doesn't wash, since it's Labour who have ruined the Welsh NHS, all by themselves, and were doing so years before the referendum.

So, before you produce any more scaremongering tactics, just because you want an excuse to ignore the majority decision of Welsh voters to leave the EU, I suggest you actually do some research, talk to the people who are actually going to be doing the work of maintaining supplies, and stop trying to scare the sick and vulnerable. The people of Wales voted to leave the EU, the single market, and the customs union. You've had your instructions, when are you going to do as you're told?

Minister, I think I heard a question there, so—[Interruption.]

Are you a UKIP sympathiser now, Janet?

Very clearly.

It's a very interesting but utterly predictable contribution from Michelle Brown. To claim that the measures that we are taking to prepare for a 'no deal' Brexit and the information we're providing to the country is nothing short of abuse is extraordinary even for her. The challenges are real and serious and I'm setting out the measures that we're taking with partners in health and social care. This isn't just my view, it's not just the view of the NHS Confederation or the Welsh Local Government Association. You should talk to representative staff groups within the health service, talk to the Royal College of Midwives, talk to the Royal College of Nursing, talk to the British Medical Association about their view on Brexit. They're not scaremongering, they are genuinely concerned about the future of health and care services where their members work, but also where they and their families receive care as well. And I just think that, at some point, even members of UKIP have to accept that there are very real concerns about the impact of a 'no deal' Brexit.

Now, of course we discuss matters of medicine supply with industry representatives here in Wales. A member from the Association of the British Pharmaceutical Industry is a member of our taskforce group here in Wales, but it is a UK Government responsibility to safeguard medicine supply and regulation. That is why we have conversations with them about the measures that they are taking and the assurance they provide and the information that we think they should share with other national Governments within the United Kingdom.

I said in my statement that there are at least 1,400 European Union staff within the health service. It's not a condition of employment within the health service that you tell the employer which European Union country or other part of the world you come from, so it's optional for people to opt in. But there are at least 1,400 European Union nationals, and I for one am very grateful they have chosen to make their life here with us. 

On your final point—well, one of the points you made—about there being no real reason to be concerned about prescription medicine supply in the event of 'no deal' Brexit, well that is a staggering denial of reality. It is an unavoidable truth. I think 39 million items come into the United Kingdom on a regular basis from the European Union. That is not trivial matter. The customs challenge, of course, you've talked about, and said there would be no reason not to wave through—that simply isn't true. It's a basic point of World Trade Organization rules—you have to have customs checks. If you are going to operate on World Trade Organization terms, that is what you have to do. It is not optional. So, actually, you have to build in time to have checks to take place. And that interruption in the supply doesn't just affect the health service, it affects every other part of the economy and economic activity where supply takes place and has to cross borders. At some point, project reality has to bite. This Government is doing the right thing by our citizens and being responsible in preparing for all eventualities, including, of course, the catastrophic potential of a 'no deal' Brexit.

Thank you very much, Minister.