2. What assessment has the First Minister made of improvements to the health service over the past year? OAQ55089

I thank the Member for that question. Over the last 12 months, the Welsh NHS has treated more patients, more successfully, than at any time in its 70-year history. Record numbers of staff and record levels of investment lie behind these improvements.

I thank the First Minister for that reply, but I think most fair-minded people would say that that's a very partial answer to the question. The reality is that, in many respects, performance in the health service has got dramatically worse in the last 12 months. As far as Betsi Cadwaladr is concerned, a third of patients are now waiting over four hours for accident and emergency, compared with only 20 per cent four years ago; 22,000 patients have been left in the referral-to-treatment system over 36 weeks on recent figures, compared to only 15,000 six years ago; and there are many other failures that have regularly been shown up in this Chamber.

What's happened here is that we've normalised failure in the health service in Wales. It isn't the fault of those who work within the system; it's a failure of management and political control. Given that health consumes over half of the Welsh Government's budget, it's not just a failure of his Government that is involved here, but actually—in a growing number of people's minds—the failure of devolution itself. Is it any wonder, therefore, that 25 per cent of the people of Wales in a recent poll said that they thought that this place should be abolished? So, that, perhaps, will be his epitaph.

Well, Llywydd, the Member repeats this week what he said last week. I repeat my advice to him then: he lectures us whenever he has the opportunity on respecting the referendum of 2016, but two referendums have established this institution. On both occasions, people in Wales decided to set up a Senedd for Wales and, on the second occasion, to radically strengthen the powers that are discharged here. That is the verdict of the people of Wales on devolution, and that's why we meet here to discharge their instructions.

As far as what fair-minded people would say about the health service—I don't know whether he was hoping to persuade us that he himself would be covered by that definition—let me say to him that last year's satisfaction survey of the health service in Wales, not carried out by the Welsh Government but carried out entirely independently, found that 93 per cent of people in Wales were satisfied by the service they received in primary care and 93 per cent were satisfied by the service they received when they last visited a hospital. That's what fair-minded people in Wales report. 

A shortage of A&E consultants has been cited as the primary reason for the Cwm Taf health board proposing to cut our A&E services, and the shortage is part of a UK trend, so we're told. The implications of centralisation, such as increased travel times, high levels of ill health, or the overcrowding at other hospitals, seem to be secondary considerations.

With that in mind, I want to ask you about publicly available figures showing A&E consultant numbers across the various health boards since 2013, the year before the decisions were taken as part of the south Wales programme. The figures show three health boards significantly increased A&E consultants between 2013 and 2018. Aneurin Bevan health board added a third more A&E consultants. Cardiff and the Vale increased their A&E consultant numbers by more than 50 per cent. Neither health board has a consultant-led A&E unit under threat.

Does this not show that the Labour Government-backed south Wales programme was a self-fulfilling prophecy? That programme has acted as a block on recruitment and explains why both yourselves and the health board have failed to fill consultant vacancies at the Royal Glamorgan Hospital. Given those failures, will you now commit as First Minister and leader of this Labour Government that 24-hour consultant-led services will be maintained at the Royal Glamorgan Hospital? You can give that commitment and you can give our A&E a future. Will you do that now?

Well, Llywydd, what the figures quoted by Leanne Wood demonstrate is that this is a mobile workforce in a shortage profession where people who are able to be A&E consultants themselves make decisions about where they go to work. Nobody, neither she nor I, is in a position to direct people to take up jobs. People apply and they decide. As you have seen, people do that. That's just the nature of the way that people are recruited in a shortage profession. [Interruption.]

It would help a lot, I think, if Members were willing to listen to the answer rather than shouting across it all the time. That's three Members on the Plaid Cymru benches who have tried to interrupt me in this one answer.

So, there's a mobile workforce and people go to jobs that they decide to apply for. The south Wales programme to which Leanne Wood referred was a massive clinically led programme that had buy-in from health boards and clinicians right across south Wales. It was not a programme led by the Government; it was a programme led by doctors and clinicians in the health service. And the answer, in the position of the Royal Glamorgan Hospital, at the end is—when clinicians have had the advice they need, when they've answered the questions that they need to answer—that that is a decision that is best made by doctors and not a decision made by politicians.

First Minister, work is now well underway on the new £4 million Mountain Ash primary healthcare centre, and this is great news for the local community, bringing a range of services together and replacing existing GP facilities that were outdated and, frankly, not fit for purpose. In what other ways is the Welsh Government supporting to help deliver improvements to primary healthcare in the Cynon Valley?

I thank Vikki Howells for that, Llywydd. I was being told just a couple of days ago, by the leader of RCT council, about the excitement that the new £4 million health centre is creating in Mountain Ash, one of 19 new primary care centres that this Government is funding during this Assembly term. It will bring together current GP surgeries in a new facility that, as well as providing better facilities for existing staff, will allow that centre to attract that wider range of clinical professionals that we know are required to go on sustaining primary care all across Wales. It will be a multidisciplinary team in the new Mountain Ash primary care centre, and that will guarantee that services for people in that community will be safe, secure, and sustainable for years to come.