If I can deal with your last point first, we recognise that this being Wales and the weather vary in terms of the pressures that they drive. Cold weather tends not to produce a big spike in admissions at the time; it's actually roughly a week or so later when the cold weather produces the impact in terms of the additional number of people going in. We know that the first week of January is almost always a point of really large pressure right across primary care and the hospitals. There are parts that we really can predict and those that we can't accurately. We know that, as more of us live longer, we can expect there to be more pressure across the whole system and, in particular, through winter. That's why one of the encouraging things with the difference this year is the number of over-85s falling in emergency admissions terms, and that's really positive, but it does show that we need to do even more to support people in their own homes, and it's why there is such an understandable, not just direction of policy but a range of people across primary care and social care who are saying that they actually need to not just talk about the way we want more to be done there but how we actually resource those teams to deliver the care that we want to see delivered locally and sustained locally as well.

On your broader point about the three centres with particular challenge, there is a mixture of support and challenge. The support that is provided, not just in monetary terms but actually in advice from officials here has to be complemented with challenge at board level, and that absolutely happens. It's part of the conversation I recently had with health board chairs and trust chairs and chief execs last week. We went through their emergency department performance and in particular focusing on those areas where they recognise they have real and significant challenge, and there is the peer leadership and clinical leadership as well. There is a limit to what politicians demanding answers can actually do to help practice on the ground and indeed the broader whole system about how effective relationships are between health and social care and the third sector, because actually getting those relationships right is just as important as the clinical leadership in any emergency department.

So, there is never one single answer to resolve all of these issues, but you raise a point about the third sector, and actually the sustainability of those services, of course, matters to us as well as the third sector. When we're commissioning a service from the third sector, we want to know that the organisation is robust and able to deliver its service. We have key indicators about the service so they understand we're spending public money wisely, and the third sector don't take issue with that. They want some certainty about the future, and there's a limit to how much certainty we can provide. When you're living year to year on budgets in national Government, it's hard to give people the longer term funding cycles that they would want themselves, but actually we had a very constructive conversation with the third sector in Wales on exactly this topic around health and social care just a few weeks ago when I and the Deputy Minister met with the group convened by the Wales Council for Voluntary Action to look at all those people engaged in delivering and working around the health and social care sector.

And the encouraging point for the third sector to take is that, when you look at the way that 'A Healthier Wales' is not just written and what's in the language in it but actually the WCVA, the Welsh Local Government Association and the NHS Confederation here in Wales—the three key partners who co-produced that strategy—. So, they're absolutely at the start of the conversation, not being tagged on at the end. And they are also part of our regional partnership boards across the country. There's always third sector representation there. So, it's never a perfect point in time; there will always be a need to challenge and discuss what we're doing, but they're absolutely part of the conversation and part of the future as well.

On your two more detail points—on delayed transfers of care, yes, there are variations between health board partnerships. We publish those with the figures on a regular basis. I can say that the last two years have had the lowest levels of delayed transfers of care in the last 13 years since we started collecting these figures, and 2018 had a third lower delayed transfers of care than in 2006. So, actually, we are making real and sustained progress, and there's a positive comparison for Wales compared to England, where delayed transfers are moving in the opposite direction.

And on your point about the highest level of escalation, well, for those who aren't health geeks, we have four levels of escalation: level 1 being the lowest, level 4 being the highest—you may know this, others may not. And for the time we spent at level 4 for this January compared to last January, there is nearly a 12 percentage point difference. And, equally, when departments have been at level 4, they have de-escalated down to level 3 or lower on a much quicker basis as well. So, that is something that isn't because the Minister has said, 'You must do this', it's actually because there is greater grip and performance, and that is because our staff are in a better position, and it's also because the whole system in those areas is in a better position to deliver.