Questions now from the party leaders. The Plaid Cymru leader, Adam Price.  

Thank you, Llywydd. First Minister, I have a right to ask you a question in Welsh in this Parliament, but my 84-year-old father doesn’t have a right to ask a question in Welsh to his GP, his optician, his pharmacist or his dentist. Now, five years ago, you said personally that the core of the case for improving the use of the Welsh language in primary care is the possibility that it’s only in their first language that a patient who is vulnerable can express him or herself in full. Today, a cross-party committee of this Senedd, including Labour Members, state that there’s been very little, if any, progress made by the regulations that you’ve just published in terms of giving people in Wales the right to receive health services in the language of their choice. Why, after 84 years, is my father still treated as a second-class citizen?

Well, may I say once again, Llywydd, in my view, it is very important to receive services through the medium of Welsh, particularly in the health sector, and that is why we recently published new standards at the end of May, which extend to primary healthcare. Of course, it’s a long-term project to grow people within the workforce who are ready and have the skills to deliver those services through the medium of Welsh. But, as a Government, we’ve been working with people in the field, with the royal colleges, with the health boards, to persuade people who are ready and able to deliver services through the medium of Welsh to do so in the first place, and also to attract more people into the field.

Yesterday, I visited the university at Aberystwyth and I met with people there who have just succeeded in securing again the right to train in the field of nursing, and developing people who are able to deliver services through the medium of Welsh is a central part of their work.

So, we are making progress, but there's more to be done, of course. But the fundamental point is that people have the right to use the Welsh language and to receive public services through the medium of Welsh, and it's something that we support, naturally, as a Government. 

But, Minister, you yourself have identified this as a huge vacuum five years ago. Where have you been? The committee itself says that we are still as far away from delivering equality in terms of language choice as we were at the beginning of this Assembly. There's been no progress.

And may I turn to another issue that is centrally important to the future of the language, namely employment? In those areas where the Welsh language is the community language, among the major employers are our universities, and we have heard recently about the grave financial problems at Trinity Saint David and at Bangor. Now, in the past, when we have raised problems within individual universities, your Government has said, 'Well, they're independent organisations and we can't intervene.' Given how grave the situation is now and how grave the financial crisis is within the sector, could I ask you to confirm whether you, as the UK Government has declared, would allow a university institution in Wales to go bust?

Well, Llywydd, I want to go back to the first point the Member raised because I don't agree with him at all that there has been no progress in relation to the provision of Welsh language services in the health sector. It's one, I think, of the really heartening things that has changed in the last decade that when I go into hospitals in any part of Wales now I see members of staff wearing visible signs that tell you that they are able and prepared to provide a service through the medium of Welsh. We have to encourage those people, we have to support those people, we have to find more of them, of course, but it doesn't help the cause of doing that to act as though those people who have been part of the real effort through the 'Mwy na geiriau' programme—if we dismiss their efforts and act as though nothing at all has been achieved. A great deal has been achieved. The position is very different to what it was. That isn't to say, and particularly in areas like psychiatry, that there isn't a lot more that we want to do, but we bring about improvement by encouraging people who are willing to be part of that effort rather than dismissing their efforts as though they had made no difference.

Now, when my colleague the education Minister says to Members that higher education institutions are independent bodies, they have to be that. It is simply not right that we should ever seek to interfere in the decisions that they make. As a Government, we have worked hard to sustain the sector here in Wales. We've worked with the sector in order to be able to do that. That's why I was, when I went to Aberystwyth yesterday, determined to meet with the vice-chancellor and her colleagues to hear about the work that they are doing and what we can do to support them in their efforts. It's why the education Minister met with the Higher Education Funding Council for Wales earlier today in order to carry on that effort. We understand that there are challenges. Of course there are challenges, a decade into austerity, in every part of what the public service tries to achieve in Wales, and higher education is no different. But the difference between the higher education sector in England and that in Wales is that we work with the sector with the aim always of supporting it rather than simply saying that market forces will apply and that those who go to the wall will go to the wall regardless.

Many people will feel particularly uncomfortable in seeing universities in Wales making hundreds of staff redundant while at the same time paying salaries to their vice-chancellors, who, according to the latest HEFCW figures, earn £254,000 on average. Now, outwith the university sector, the salary of the chief executive of the Development Bank of Wales is among the highest in the public sector, and that, I suppose, reflects the importance of the role. In light of that, can you tell us why you, as a Government, as a matter of policy, have set a precedent in agreeing that the post holder can undertake a non-executive employed position beyond his full-time employment in the bank?

Well, Llywydd, let me say that I am not in favour of those who are paid at the top of our public services being paid at levels that separate them from the rest of their workforce. It's why the Welsh Government has a ratio that's amongst the narrowest in all public sector bodies in Wales between what is paid at the top of the range and those people who are paid less in our public service itself. That is true in the higher education sector as well, although the decisions that are made about the salaries of vice-chancellors are absolutely not decisions made by Ministers, nor should they be interfered with by Ministers.

There are sectors where the public sector now operates where you are in a competitive market. That is true in the health service, we know, where scarce people have to be found to come to work in Wales. It's why we offer to our GPs—and in parts of Wales that the Member himself represents—additional finance and funding to get people to come and work in parts of Wales where otherwise we would not be able to attract people. It is just inevitable—we may not like it, but it is inevitable that where public services are competing for scarce resources and people who can choose wherever they want to go and work, the amount we pay them becomes part of the way in which we have to find ways of bringing people to discharge these really important responsibilities.

Leader of the opposition, Paul Davies. 

Diolch, Llywydd. First Minister, do you believe that healthcare services in Wales are meeting the needs of our young people?

I think that health services in Wales meet the needs of all our people to an extent that people beyond Wales regard as remarkable. Of course, that does not mean—and no doubt the Member's about to offer me an example of where there are things that we would like to see done better. Health services and young people have often been a struggle. There is long-standing research that tells you that a GP, for example, will spend less time with somebody under 20 than any other person that they see. So, making sure that the health service is properly geared to understand and meet the needs of young people is something that has been a long-term issue in health inequalities, and there will be examples, I've no doubt, of where there is more we would wish to do.

The First Minister's absolutely right: there are things that can be done better because there are concerns in Wales that there are currently only two child and adolescent mental health services centres open to young people in Wales, only offering a total of 27 beds. Now, the third sector has had their capacity reduced to 12 beds from 24, but due to concerns with standards at the centre back in July last year, Welsh patients were removed and the centre now only takes patients from England. As these centres are currently operating under restricted capacity or have admission restrictions in place, the child and adolescent mental health services centres in Wales are not effectively meeting the needs of high-risk patients. Some patients from Wales are being treated out-of-area, adding an additional burden on them and their families. Now, this limited capacity was actually raised back in 2013, and yet it seems to me that no progress has been made. Surely, First Minister, you agree with me that this is totally unacceptable. Can you therefore tell us what steps are you going to take to resolve this specific situation?

Well, Llywydd, as it happens, I don't agree with the Member. I take a very different view to the one, I think, I've heard him say about the need for tier 4 services in child and adolescent mental health. I definitely don't agree that we need more centres. What we need is to minimise the number of young people who end up needing a service of that sort. So, for me, the test of success is not that we have more beds that we need to take young people into, but that we have more community services, more crisis intervention services, and that we are able to move young people down the escalator of intervention.

So, I am very comfortable that we have a centre in north Wales and a centre in south Wales at Tŷ Llidiard. I think it was exactly the right decision to withdraw Welsh patients from the third centre to which the Member refers because that service was not fit-for-purpose and did not meet the needs of young people. The number of young people from Wales who we place outside Wales is falling. It's been falling over recent years, and I want to see it fall further, because while I'm willing to accept that there will be a small number of children from Wales whose needs are so exceptional and so significant that you have to find a service so specialist that a population of 3 million people cannot support it, I want to see as many young people from Wales looked after closer to their families and closer to their homes. That means bringing back children who are looked after in England to tier 4 services, and it means moving tier 4 services for young people in Wales back into the community and closer to people's homes.

So, I agree it's a really important area, and it's very good to have a chance to discuss it on the floor of the Assembly, but my solution to it is the opposite of the Member's solution—not adding more beds and putting more resource there, it's pulling people, de-escalating, strengthening community services and using those 27 beds only when we're certain that that is essential.

But surely we should be providing services here in Wales for those young people and we should be offering a wide range of services, including beds as well. So, surely, First Minister, you've got to accept that.

Now, further concerns have been raised around patient waiting times with me. A recent Healthcare Inspectorate Wales report found that an average of 57 per cent of patients waited no longer than four weeks. However, the inspectorate states that the majority of patients are waiting between four to 26 weeks for their first appointment. Now, a community health council report, which you're looking to scrap, has warned that young people would only feel that they would be seen if they committed a serious suicide attempt. A further report warned that accident and emergency departments are becoming the default option for cases of overdose and self-harm because of difficulties accessing support from a CAMHS centre or primary care.

Do you think that now is the right time to be scrapping CHCs, which are trusted by patients, and replacing them with national citizen voice bodies that might not feel they can be critical of the Welsh Government or the health boards as they will be appointed by you, funded by you and then won't want to be sacked by you? How will your citizen voice bodies speak up for patients, and especially these young people, at a time when they need it the most?

Well, Llywydd, CHCs are funded by the Welsh Government. Every criticism that he's just made could be equally levied at them, and, absolutely, those arrangements have not prevented CHCs from speaking up on behalf of patients.

What we are aiming to do is to strengthen the citizen's voice in the Welsh NHS. The body that we are proposing will be entirely independent of Government and it will operate—and this is crucial in relation to the question that the Member asked me in the second of his questions—across the health and social care boundary, which CHCs don't. CHCs only operate within the health service. And the young people that he referred to—and I'm grateful to him for highlighting those issues this afternoon—those young people rely on services that are provided both by the health service and very often through social services departments as well. And the new organisation will be able to speak up for those young people across that whole spectrum in a way that the current system cannot. It is entirely designed to be properly independent, to be able to make whatever points it wants to make, and those proposals, Llywydd, are now here on the floor of the Assembly for Members to scrutinise. There will be a Stage 1 inquiry in front of committee, where witnesses can be called. I look forward to Members being able to explore all aspects of the Bill, including looking at how these proposals strengthen independence, strengthen patient voice, and extend it beyond the boundaries within which it is currently confined. I think we'll do a very good job on behalf of patients and young people too.

Leader of the Brexit Party, Mark Reckless.

This weekend, the South Wales Argus ran the headline:

'TRAFFIC is queuing and there are heavy delays on…the M4 around Newport.'

As they tweeted it, I suggested they might want to make it their pinned tweet in future. On this occasion, the AA reported that there were severe delays, with an average speed of 15 mph. The AA then said:

'there has not been an accident…the queues are the result of "usual traffic heading to Brynglas Tunnel".'

First Minister, by breaking your manifesto pledge to build a relief road for the M4, aren't you saying that Wales is closed for business under Labour?

Well, those people will be very glad, Llywydd, that they don't now have to wait five years and more for a solution to the difficulties that they faced, because my decision is not a decision that is not about addressing the difficulties that exist around the Brynglas tunnel, it is about finding alternative ways of addressing those problems, of addressing them far sooner than an M4 relief road ever would have done. I look forward to meeting Lord Burns tomorrow, who will chair the group that we have now set up to deliver those rapid ideas that will make a difference at the Brynglas tunnel. I think that will do far more for the people to which the Member referred, and I am determined to go on working with local representatives from the Newport area, including the city council, to make sure that we now move ahead, look to the future, find new solutions and address the issues that are there to be addressed.

That's not what you promised in your manifesto, is it?

The Minister behind you, Lee Waters, says that it's a bit of a cliché to suggest that Wales is closed for business—[Interruption.]

It is not what you put in your manifesto. It said—Labour manifesto—

'We will deliver a relief road for the M4'.

Okay—

You haven't done it—you've broken your promise.

—I can't hear the question; I don't think the First Minister can. Can you continue with your question in some silence?

So, what Lee Waters says was a cliché were not my words—it was the Confederation of British Industry Wales director Ian Price who said this cancellation

'sends the message that Wales is not open for business.'

'Economic growth will be stifled, confidence in the region will weaken and the cost of an eventual relief road will rise'.

Now, I don't often quote Welsh Secretary Alan Cairns, but I agree with him that this decision was hugely disappointing and a 'dark day' for Wales.

It was also the Secretary of State that we had to rely on to find anything out about what was going on with the inquiry and the report, finding out, actually, that the decision was a positive one from the inspector some weeks before Welsh Government told us. Now, does the First Minister not recognise that it was you who closed off effective debate about this report when it might actually have made a difference, by keeping it secret for several months while you were making your own decision? And is the UK Government not correct on the fundamental point that, were it not for 20 years of Labour-led devolution, this road would now be built?

Well, Llywydd, I don't know if there is a great deal to be learnt from the Member on manifestos. He stood for the Conservative Party on a manifesto; he abandoned that in an instant. He stood for the UKIP party on a manifesto; he walked away from that. I don't think there are any lessons anybody here is ever likely to take from him on the subject of staying true to things that you stood for in an election.

As far as the CBI is concerned, I was very pleased to meet with the chief executive of the CBI, the Federation of Small Businesses and the Trades Union Congress last week to talk exactly about the decision that has been made, and I want to thank them for the way in which they came to that meeting in an entirely constructive spirit. They came wanting to contribute to the new pool of ideas that are there to address the difficulties that are faced at the Brynglas tunnel. They came to say how keen they were to participate in the group that will now be established to come up with those solutions. I think it's hard to imagine a greater contrast between the constructive spirit in which the CBI and other colleagues came to that table and the carping tone that we have been offered by the Member again this afternoon.

He has no grasp at all of the way in which decisions are made in Government; he has no grasp at all of the proprieties that have to be observed in making those decisions. I am entirely comfortable that, in this case, the decision was properly made, respected the rules within which that decision had to be made, and that the decision that is now made is something that we need to gather round, get on with and make sure that we have solutions that we can put into place far more quickly than a relief road would ever have brought for people in Newport and the difficulties that I've said every time I've been asked I recognise are there and need to be solved.

Question 3 [OAQ54038] is withdrawn. Question 4—Andrew R.T. Davies.