The following amendments have been selected: amendment 1 in the name of Rebecca Evans, amendments 2, 3 and 4 in the name of Darren Millar, and amendment 5 in the name of Caroline Jones. If amendment 1 is agreed amendments 2, 3 and 4 will be deselected.

We now move to item 11, and can I just remind Members again of the timings? I have been generous in the last half-hour debate. I will not be as generous in this half-hour debate because you have all been told what the timings are. So, item 11 is a Plaid Cymru debate and it's on Betsi Cadwaladr University Health Board's new rotas, and I call on Llyr Gruffydd to move the motion. Llyr. 

Motion NDM7179 Rhun ap Iorwerth

To propose that the National Assembly for Wales:

1. Opposes Betsi Cadwaladr University Health Board’s decision to introduce new rotas that will extend shifts for nursing staff from January 2020.

2. Believes this is a damaging and retrograde step—particularly at a time when more than one in ten nursing posts in the health board is vacant.

3. Notes that BCUHB has been in special measures for the past four years and is therefore under the direct control of the Minister for Health and Social Services.

4. Calls on the Welsh Government to overturn the decision and protect nurses’ working conditions.

Motion moved.

Thank you, Dirprwy Lywydd. Now, last week, of course, Betsi Cadwaladr University Health Board decided that they would force nurses, midwives and healthcare support workers to extend their shifts for no extra pay. The plan was to enforce an extra 30-minute unpaid break per shift, even though many nurses, of course, don't have time to take their breaks as it is. And by the health board's own admission, it would have meant nurses working an extra unpaid shift per month to make up their hours. Now, the decision was meant to save around about £25,000 a month. Not an inconsiderable sum, you might say, but, of course, when you put it in context, the board is already spending over £1 million a month on agency nurses, then it's a relatively tiny amount of financial saving, but the health board was willing to destroy the goodwill of nursing staff that keep our NHS working.

I, as I'm sure many of you have, have received hundreds of messages in the last few weeks from the nurses, the patients and their families who would potentially have been affected by this. Those people working on the front line were saying—I'll quote one nurse—

'This will be the final nail in the coffin for nurses working for Betsi. We already work on understaffed wards, so we're lucky if we take a break, and this will mean lots of nurses moving away from the nursing profession and I will be one of them.'

Another nurse told me:

'This decrease in pay would involve me working an extra 6-hour shift a month, causing significant childcare issues and increased costs for this. I feel the people responsible want more and more out of an already-struggling workforce'.

And, of course, don't forget that over 1,000 nurses in Betsi Cadwaladr health board are aged 55 and over, and if you lose that group of experienced and dedicated professionals because of this misguided attempt—I have to say—to save a few pounds, then you will clearly reap what you sow. One in 10 nursing posts at Betsi are currently vacant, meaning that overstretched nurses and staff are already having to work extra hours anyway.

Now, this proposal has wrecked morale in a workforce already on the brink, and many nurses, as I quoted, have said that they will quit, some saying that they would retire early, others suggesting that they might even have to take sick leave if the scheme was introduced. Plaid Cymru and the unions have fought this tooth and nail. We collected, as a party, over 3,500 names on a petition. Unite as well collected the petition; collectively, I think it's over 8,000 names between us. And the union, of course, were even talking of balloting members on possible industrial action, even strike action. Now, what does that say when dedicated health professionals are saying 'enough is enough' and would consider the unthinkable and take strike action to safeguard their working conditions? And that, of course, was the context in which we, Plaid Cymru, brought this motion before the National Assembly today. A situation that nurses, midwives, healthcare support workers, patients and so many others of us find intolerable.

But, of course, things have changed. Late this afternoon, news broke that Betsi Cadwaladr University Health Board have shelved the proposals in a clear victory to those of us who have been campaigning for this, and, of course, a huge relief to those who would have been so affected by these proposals. But there are so many questions, now, to be asked. How did it come to this? Why did the board not see the folly of its ways sooner? Plaid Cymru brought a debate on this very issue to this National Assembly a few weeks ago; the Minister could have stopped it then, but he chose to back the board. There are big questions about this whole process and how meaningful, really, was the consultation process. So, I look forward to hearing what the Minister has to say about this whole debacle and how a health board under his direct control was allowed to pursue these proposals in the first place. And I will be looking, Minister, in your response, for a guarantee that this will not be allowed to happen again. If you give us that, then I probably won't move this motion to a vote this afternoon, but, if you don't, then, clearly, we will need a statement from this National Assembly making it clear that this proposal was wholly unacceptable and that we will not tolerate such a proposal again in the future.

Diolch. I have selected five amendments to the motion. If amendment 1 is agreed, amendments 2, 3 and 4 will be deselected. I call on the Minister for Health and Social Services to formally move amendment 1, tabled in the name of Rebecca Evans.

Amendment 1—Rebecca Evans

Delete all and replace with:

To propose that the National Assembly for Wales:

1. Values the NHS workforce and our social partnership working arrangements in Betsi Cadwaladr University Health Board (BCUHB), and in all health boards across Wales.

2. Notes that BCUHB continues to engage with nursing staff and their trades unions on changes to nursing rotas.

Amendment 1 moved.

Formally.

Thank you. I call on Mark Isherwood to move amendments 2, 3 and 4, tabled in the name of Darren Millar. Mark.

Amendment 2—Darren Millar

Insert as new point after point 2 and renumber accordingly:

Further regrets that the number of working days lost due to stress and mental health related issues within the health board has increased by 20 per cent since 2014.

Amendment 3—Darren Millar

In point 3, delete 'the past' and replace with 'more than'.

Amendment 4—Darren Millar

Insert as new point after point 3 and renumber accordingly: 

Regrets that the Minister for Health and Social Services has failed to prevent this decision from being made.

Amendments 2, 3 and 4 moved.

Yes. Well, we regret that the Minister for Health and Social Services has failed until now to prevent this decision from being made. We further regret that the number of working days lost due to stress and mental health-related issues in Betsi Cadwaladr University Health Board has increased by 20 per cent since 2014. And we note that the health board has been in special measures for more than four years and is therefore under the direct control of the Minister. I move amendments 2, 3 and 4 accordingly.

Effective management understands that stress and burnout are primary causes of high staff absenteeism, as are the low morale and lack of motivation that occur when staff feel undervalued and under-appreciated. Yesterday, the health board's chief executive wrote to members regarding the changes to shifts for nurses and healthcare support workers, stating:

'Staff should not be paid for breaks other than in those circumstances set out.'

He added that the health board had consulted its staff and trade union partners over the proposed changes. However, the Unite union's regional co-ordinating officer stated yesterday that staff are angry and are willing to take industrial action, which he had never heard nurses say before. 

Many nurses have written to me and the following quotes are theirs:

'If Betsi proceeds with their current plans they risk alienating further the staff they depend on. Also recruitment to fill vacant posts with are already difficult to fill and will be negatively affected.'

'I do not know how someone working fulltime with a family will be able to manage. I am seriously considering leaving my profession and I know of many others thinking of doing the same, which will not help the national shortage problem.'

'The change is reactive and has small chance of helping to redress the agency budget, and will have a knock on effect...on staff engagement...that will lead to greater difficulties in the long term'.

'In a 12 and a half hour shift...breaks are vital but due to the workload we wouldn't always take our breaks or they would be disturbed or shorter than needed. Making the breaks unpaid will not change this'.

'I am almost always the only Band 7 midwife on a night shift. This means that I am never able to take my break. I never claim time back...if this proposed change comes into force, I will be claiming every second extra that I work and I am sure that all of my colleagues will too'.

When I wrote to this health Minister with these concerns, he replied that neither he nor his officials can intervene in operational matters. Well, if special measures is to mean anything, the Welsh Government must take responsibility and act. Or has it now blinked? Because the local press announced just two hours ago that the health board has now, belatedly, u-turned.

Thank you. I call on Mandy Jones to move amendment 5, tabled in the name of Caroline Jones.

Amendment 5—Caroline Jones

Add as new point at end of motion:

Further calls on the Welsh Government to ensure that Betsi Cadwaladr University Health Board and other health boards across Wales do not attempt to circumvent the Nurse Staffing Levels (Wales) Act 2016 by reclassifying working patterns.

Amendment 5 moved.

Moved. Okay, a quick change of speech in a minute.

My group will be voting for this motion today, and the Brexit Party has also tabled an amendment in the name of Caroline Jones that calls on the Welsh Government to ensure that Betsi Cadwaladr University Health Board and other health boards across Wales do not attempt to circumvent the Nurse Staffing Levels (Wales) Act 2016 by reclassifying working patterns.

Minister, I've had a number of constituents contact my office over your controversial changes to rotas. My office has had nurses in tears, saying that they can't afford to do the extra shifts, the extra journeys to work. It's the childcare costs; it's even down to laundry. I find it outrageous that these changes were supposed to be made when an NHS manager in north Wales is being paid at a rate of almost £2,000 per day and allowed to work from home in Marbella. In this day and age, nurses shouldn't be in a situation like that. It's a profession we should all be proud of.

I will be looking forward to what the Minister has to say now that the health board have actually turned around this in the last couple of hours this afternoon, and, hopefully, squashed this debacle. But it is now clear that the biggest danger to workers' rights is not Brexit, but this Labour Government, who have failed to prevent this decision from being made in the first place.

Betsi Cadwaladr University Health Board's intention to introduce these new rotas had caused huge controversy locally, and that is entirely understandable. And I'm extremely pleased that there has been a change of heart now—we heard of it only around an hour ago. Had this gone ahead, it would have been exceptionally damaging and would have taken advantage of those nurses who do work so very hard and very often go way beyond the requirements of their posts. I am pleased that the decision has been overturned, but, from here on in, I urge the health board and the Government to give due respect to our nurses.

I received a letter this week from a nurse working in a hospital in north Wales, and, although the decision has been overturned, it's worth you hearing what she had to say: 'I've worked as a trained nurse for over 28 years, and I am appalled by the changes to the nurse rotas that are to be introduced after Christmas. I feel so strongly that I did have to write to you about the issue. Everyone is furious with the changes in the pipeline and I haven't spoken to any nurse who is in favour of this. Morale within nursing is very low already. No other body would accept such changes, which would mean the loss of goodwill, and certainly the goodwill of nurses is at the very heart of public services.' And, at the end of her letter, she asks what can we do to overturn this decision. Well, this nurse will be exceptionally pleased to hear that there has been a change as people raised their voices, as people came together to oppose and to campaign and support each other. And Plaid Cymru is proud to have worked with the unions in order to overturn this decision, which was absurd from the very outset.

I do urge the Government and the health board to learn lessons from this debacle—and it is a debacle. We must, from here on in, work along with the unions representing the staff at Betsi Cadwaladr University Health Board. Consultation must happen in a far more meaningful manner when changes are proposed. There is a great deal of bridge-mending work to be done now, and we must restore this relationship, and there's a huge amount of work to restore trust. And that's what worries me—that this whole chapter, which should have been avoided in the first instance, is damaging to the morale of nurses and to that relationship, and we must work very hard now in order to restore that situation. These nurses work so very hard for the benefit of their patients, and they must be fully respected from here on in.

Thank you to Plaid for bringing this motion. I'll be voting in favour of the motion, as I support our nurses, and I really don't think it's fair that their working conditions should worsen. The NHS has been built on the back of the nursing staff. Nursing is an incredibly pressurised, difficult job, and nurses need all the support that we can give them. And the proposals that came out of Betsi Cadwaladr relating to the rotas are, in my opinion, unbelievable. I'm glad that they've decided to shelve the proposals, but the thinking behind these proposals is worrying in itself. It would seem to be a counter-productive thing to do to change the working conditions of nurses to their detriment when the board is desperate to recruit nurses and other staff. And, despite Betsi shelving the proposals now, I'm sorry, I think the damage has already been done. Other Members have spoken about the reduction in, the worsening, morale, but it's going to make employment in Betsi Cadwaladr all the less attractive at a time when the board is in dire need of quality staff, and needs to make itself as attractive as possible to recruits.

We're all very familiar with the story of Betsi Cadwaladr and the numerous ways it has fallen short of what patients in north Wales are entitled to expect from their NHS. And, further, we're all aware of how the Welsh NHS under Labour has decayed and is increasingly failing the Welsh people. This erosion of the working conditions of nurses, or rather the now-shelved proposals, would not have been proposed were it not for Labour's failure to solve the problems at the health board over the years it has been in special measures, and under the direct management of this Labour Government. It could also be seen as a cynical attempt to get the public to blame the problems on the staff and the nurses by saying that they're having too many breaks. But it's not the fault of front-line staff, and I resent that every time a criticism of the Welsh NHS is made in this place, the Minister and Government run and hide behind hard-working NHS staff to deflect the criticism that's rightly placed at the Minister's door. No, it's the fault of the board and the Welsh Labour Government, who've mismanaged it.   

Yesterday, Jeremy Corbyn warned the UK electorate that choosing the wrong Government would see an erosion of workers' rights and long-term damage to the NHS. Well, I have a message to English voters: if you want to see how modern Labour runs a health service, come and look at Betsi Cadwaladr in north Wales. Since Wales is the only UK nation whose NHS has proposed to worsen nurses' employment terms and conditions, at a health board that is being directly managed by a Labour Government, in the only UK nation run by Labour, I can only assume that Corbyn was warning people against voting for a Labour Government in Westminster. I would agree with him there.

But I have to say I am surprised at the acute case of amnesia that Plaid seem to be suffering, having proposed this motion—and I do agree with the motion and I appreciate them bringing it—because they've clearly forgotten that they have in the past undemocratically propped up the Labour establishment that's mismanaged the NHS, even though their own voters voted against that same party. If Plaid voters had wanted to help a Labour Government stay afloat, they would have voted Labour. After supporting a Labour Government for years while the NHS decayed, Plaid has to take its share of the blame for the scenario NHS workers and patients are now facing. Plaid have never been an opposition party, and Wales is suffering as a result. But I will support the motion because I support the nurses. I won't be supporting Labour's invitation to pat themselves on the back and allow them to bury their heads in the sand, and I will be supporting the Conservative and Brexit Party amendments. Thank you.

Can I call on the Minister for Health and Social Services? Vaughan Gething.

Thank you, Deputy Presiding Officer. I thank Members for their varied contributions. I want to make clear at the outset that we won't support the Conservative or Brexit Party amendments. As I noted during the debate on this issue on 18 September, staffing rotas are an operational matter, as they should be, and the responsibility of individual organisations—in this case, obviously, Betsi Cadwaladr university health board. Organisations need to consider rotas in light of their statutory duties to ensure that they're designed to meet service delivery requirements and the needs of staff, including in particular their well-being, and that they place patient need at the centre of the management of the workforce. 

The motion before us states the health board is under my direct control. As we've said many times before, the Welsh Government is not, under special measures, directly running the health board. The board and leadership team remain responsible for operational matters. This is a point that's been well made many times before, and I believe is well understood regardless of the drafting of the motion. 

During the debate in September, I set out my expectations that the health board would work closely with staff and trade unions on the proposed changes, consider and respond appropriately to all comments and concerns, and to consider any equality impact and all feedback before any final decision is made. I note that a draft equality impact assessment has been provided during the month of October. 

Over the nine weeks of consultation—we extended it following a request from trade union partners—there were 53 separate meetings held across the three localities. The response to the consultation, the equality impact assessment and the health board implementation plan were published last week, following discussion with the local partnership forum.

I am of course, however, aware that there were ongoing concerns from trade unions on behalf of their members who work in north Wales, and that Unison, the RCN and Unite wrote jointly to the health board. I wrote to the chair of the health board last week, seeking assurance that they were continuing to engage with their staff and their trade union representatives to resolve outstanding concerns and to keep me updated on progress. 

In opposing the motion today, the Government has moved amendments that reiterate the value that we place on our nursing staff and social partnership working arrangements here in Wales, and my continuing expectation that the health board will engage with staff and their representatives to resolve concerns. We have a track record in Wales of finding a way to reach agreement on a way forward. I know that there is a further partnership forum meeting that has been arranged for Friday this week. I expect all parties to continue to work in good faith to resolve outstanding concerns, and, whilst discussions are ongoing, the health board have made clear today in response to the joint trade union letter that they will not progress the proposed changes. They state that they welcome the joint communication with Unison, the RCN and Unite, that they are absolutely committed to working together with their trade union partners, they will focus on partnership working and how to move forward together, and that to do so they will not progress the proposed changes, and that the meeting for this Friday will be entirely dedicated to this matter.

I'm genuinely proud of our partnership approach here in Wales. We know that it does not exist in every other part of the United Kingdom. The Members who refer to other ways of working across the UK should look at what our trade unions recognise and say about the way we undertake business here in Wales. So, I look forward to this issue being resolved in partnership, in line with my expectations, but much more importantly in line with our established way of working here in Wales. 

Thank you. Can I call on Llyr Gruffydd to reply to the debate?

Well, I didn't in any way there hear any regret or remorse about the fact that we got to where we got to on this issue. An apology might have been nice, yes, or at least some acknowledgement that it shouldn't have come to this—a second debate in this Chamber asking for that principle to establish that these proposals should not go forward. The Minister tells us it's an operational matter, but if it's wrong, then you should say so. That's what Unite the Union are saying, that's what the RCN are saying, that's what Plaid Cymru has been saying, that's what the nurses and the patients have been saying. And you're saying you don't want to get involved. There we are, that's your decision, but I think people will read into that what they wish. And then, in responding to some of the comments, you say that we should ask trade unions about how we operate here in Wales. Well, my previous comment stands, I think—the unions are telling you what they think about this proposal and they absolutely do not want it to happen.

We won’t be supporting the Labour amendment today because what it does essentially is to delete our motion in its entirety and present something that talks about the importance of engagement. That is important of course, but the very reason we’re bringing this motion forward today is to establish the principle that what is being proposed here is wrong in the first instance. We will be supporting all of the other amendments, by the way.

Siân Gwenllian was entirely right in saying that there are lessons to be learnt here. Although the decision has been overturned for the time being—and I say 'for the time being' because we may have to return to this if there’s an intention to reintroduce this—the damage has been done to a great extent in terms of undermining the workforce's confidence in the ability of the board to recognise and to listen to the voice of the workforce, and certainly from the point of view of the Minister to recognise that fact. It has certainly impacted morale, which was already low, and I’ve read some of the evidence, and others will have also read evidence, from those working on the front line, many of them on their knees because of the pressures and stress upon them, and yet the board expects more and more from them.

I have no doubt that this decision to withdraw this proposal in terms of nurse rotas in north Wales is a victory for Plaid Cymru, for the unions, for the nurses and the patients, too. I regret the fact that the Minister isn’t willing to accept that this was a mistake. We’ve been given no assurances at all that this will not be allowed to be reintroduced in future, and therefore, on that basis, I would ask Members that we move to a vote on this issue in order to establish the principle that we, as a National Assembly, do oppose the proposal put forward in order to ensure that there’s no possibility of that being considered again in the future.

Thank you. The proposal is to agree the motion without amendment. Does any Member object? [Objection.] Objection, therefore we proceed to a vote at voting time on this item. I am going to move to voting time unless three Members wish for the bell to be rung. No. Okay.

Voting deferred until voting time.