6. Will the First Minister make a statement on accident and emergency provision in South Wales Central? OAQ55023

I thank the Member for that. Accident and emergency departments across the United Kingdom, including in South Wales Central, have seen significant increases in demand over this winter season. While the system remains busy, it continues to respond every day to the needs of patients.

I appreciate that you've answered this question on several occasions so far this afternoon, but you can appreciate this is the major issue in my region at the moment: the provision of accident and emergency at the Royal Glamorgan Hospital.

Last week, in the topical question that was put to the health Minister, I made the point that strategic direction for the health service here in Wales is in the hands of the Welsh Government and the health Minister; day-to-day running is the health board, in this particular instance, Cwm Taf. You could stop the closure of A&E provision at Royal Glamorgan Hospital and instruct that health board to have a long-term plan to sustain the services there. The reason consultants haven't gone into the Royal Glamorgan Hospital is because it has had a closure notice over it since the south Wales programme was instigated back in 2014.

Will you now not live up to your responsibility as a Welsh Government and take hold of this situation? Because the strategic importance here is to maintain accident and emergency provision at the Royal Glamorgan Hospital. Or will you turn your back on the people who rely on that provision in that hospital and say 'no' and allow that provision to be taken away, against the wishes of your colleagues on your back bench and colleagues across this Chamber who've campaigned vigorously with local communities to maintain that service?

Well, Llywydd, I'm happy to answer another question on this matter, and I'll try and extract the serious point that I think was there in the Member's question. The strategic direction that the Welsh Government provides to the health service in Wales is that the services that are provided must be safe, they must be of a sufficient quality, and they must be sustainable.

I agree with the Member's point that the south Wales programme has provided the surrounding context for services at the Royal Glamorgan, and I agree, if this was the point that he was making, that when the local health board come to consider the future of those services at the Royal Glamorgan they need to revisit the context six years on from the south Wales programme, to make sure that the decisions are being made with the most up-to-date information that is available to them.

But people on the ground closest to those services, expert in the clinical work that an accident and emergency department has to carry out, have to be the people who, in the end, make decisions based on the strategic direction that the Government sets for them—and that is that those services must be safe, they must be sustainable, and they must be of sufficient quality. And I hope that we will listen to what the clinicians say to us on all of that, once they have been informed by all the views that local Members from all sides of this Chamber convey to the board on behalf of the populations they represent.

First Minister, it is a fact that there is a national shortage of A&E consultants across England and Wales, but it is my very firm belief that, in such challenging circumstances, health boards—and in particular, Cwm Taf Morgannwg University Health Board—must approach recruitment strategically if they are to be successful. For example, advertising for permanent not temporary positions, and drawing up contracts that mean that consultants are not tied to one hospital, but can be contractually obliged to move between two or more sites to help meet changing demands. Do you, First Minister, agree with me on that?

Llywydd, I do agree with the final point that the Member has made that we need to look at the contract. I hope that the British Medical Association will be willing to enter into discussions and negotiations with the Welsh Government about the hospital consultant contract here in Wales to see if there are new flexibilities that can be negotiated with the workforce. This is a workforce who are organised, who have unions who speak on their behalf, who have a contract that people have signed up to. I agree with what Vikki Howells has said, that the contract could do to be revisited, that we could do to have those discussions with the BMA about new flexibilities, and I hope that they will be willing to come to the table to conduct those negotiations.

First Minister, the Royal Glamorgan Hospital is in my constituency. In the Taff Ely area, there has been massive housing expansion and, over the course of the next decade or so, there is likely to be in the region of an extra 20,000 new homes. The demography has changed very significantly since the original south Wales programme. Do you agree with me that any clinical review of the provision of accident and emergency should take account of such significant demographic changes?

I thank the Member for that, and I echo the answer I gave earlier in this question, that in making decisions six years on from the south Wales programme it is important that those decisions are made in the most up-to-date set of understandings about the current context. Things will have changed in those six years, demographic trends will have changed, house building will have changed. I expect the health board to take account of all of those things as it makes decisions, so that its decisions are made, exactly as Mick Antoniw has said, in the light of contemporary circumstances.