I'd like to thank the Members who have brought forward this debate today, because I think it is extremely timely. I think it is worth rehearsing just a couple of the facts: that every week, nurses in Wales give the NHS extra hours to the value of 976 full-time nurses. If you say it quickly, it doesn't mean that much, but actually, if you slow it down and really think about it, you're talking about 976 extra bodies that our nurses just give freely of their own volition, because they have a commitment to the duty that they believe that they must discharge. So I'd like to thank all of those nurses for all that they do.

We know the Welsh NHS demonstrates a heavy reliance on the nurses' willingness to work overtime, but of course, endless work and endless overtime creates endless stress, and instead of incentivising our nurses to stay, instead of looking at how we might alleviate this, one of the things I have found particularly odd is that NHS Wales tries to discourage nurses from leaving by measures such as refusing to hire agency nurses who also work for health boards or trusts, or allowing nurses to move around. So you get this really perverse incentive where you might have a nurse, for example in Hywel Dda, who needs to earn a few extra hours but can't do them in Hywel Dda. He or she has to go across a border into another health board where they are registered to do those extra hours. To me, that seems absolutely illogical, especially when the health board that they are leaving is usually then going out to pay even more money to agency nurses. So much better to actually just pay people overtime to recognise the contribution that they give, to allow them to continue to work in the place where they feel the most comfortable.

There is a concern over training, but I am going to leave others to talk about that. I just did want to touch on how few registered nurses we have in the care home workforce in Wales, and I think that this is an area that's absolutely vital. Not only do we not have very many nurses in care homes—and as more and more care homes are dealing with people with more and more complex conditions, there's more need for nurses and more need for those medical professionals—not only do we not have enough of them, they're not even paid the same amount of money that a nurse in a hospital would be paid, or a nurse in the community would be paid, who is not in a care home. Again, I think we have to say that if you have reached this level in your nursing career, if you've got his much training under your belt, if you're in this band, then whether you're in this situation or that situation, there should be far more equity in the pay that you receive.

So, Minister, I wondered if you might be able to give us any information on what might be being considered in terms of those two main questions—question 1: how do we keep nurses and pay them overtime to do the overtime in the health board to which they belong rather than forcing them to travel and add to their stress, with travel hours to get to another heath board so that they could earn that extra money? And question 2: how do we make sure that nurses in care homes are not disadvantaged unfairly?

Finally, Deputy Presiding Officer, I just wanted to talk about flexible working, because there's been a really interesting report produced for London NHS Trust by Timewise, and it talks about putting in flexibility into a shift-based environment, and how it's affected by the variability or predictability of the schedule, the degree of input or control that an individual can exercise over that schedule, and the amount of advanced notice. And flexible working is really key. NHS Wales needs to find a way of tackling all of these three elements if we're going to attract and retain the staff we need to work in our shifts.

The top five causes of job dissatisfaction for UK hospital doctors and nurses very clearly said that for nurses, work-life balance came first for those aged under 35—much more important than pay—and second, for those who are 36 and over. It was second after pay. Flexible working could be a practical way to ease into retirement, and it could help to keep experienced staff on board for longer.

The project that was carried out in two English hospitals in 2017 looked at creating a team-based rostering process, and it looked at not just childcare, but all of the work-life balance needs, and their lead team collaborated, not just on rota production, but also on communicating and negotiation with groups. So, Minister, I believe that improving work-life balance and access to flexible working could have a direct impact on retention, particularly for younger clinical professionals whose expectations are very different to those of an older generation. So, I'd like to understand what concrete steps the Welsh Government are taking to improve work-life balance, and I would like to encourage you to look at this trial, this pilot, that was conducted in London, because it has been successful, and there may be positive lessons that we can learn to help retain these very, very valuable and hardworking people in our NHS.