The next statement is a statement by the Deputy Minister for Health and Social Services on the loneliness and isolation strategy, and I call on the Deputy Minister to make the statement—Julie Morgan.

Diolch, Llywydd, and thank you for this opportunity to update Members on the launch of Wales's first strategy for tackling loneliness and social isolation. Increasingly, we understand the impact that being lonely and/or socially isolated can have on our physical and mental health, and therefore the importance of the relationships we have with friends, family, colleagues and neighbours in giving us our sense of belonging and well-being. 

As a Government, we made a commitment to tackling loneliness and social isolation in 'Taking Wales Forward'. The importance of addressing these issues was also confirmed in December 2017 in the report by the Health, Social Care and Sport Committee. That report focused on the experiences of older people in Wales. However, it recognised that loneliness and social isolation can be experienced by many others too. The resulting Plenary debate on that report in February 2018 showed clear cross-party support for developing a strategy for Wales. I'm delighted to inform Members that 'Connected communities: a strategy for tackling loneliness and social isolation and building stronger social connections' was published earlier today.

This strategy is the first step in helping us to change how we think about loneliness and social isolation. It sets out our vision for a connected Wales—one where everyone has the opportunity to develop meaningful social relationships and where people are supported at those trigger points in life when they are most vulnerable, and also one where people feel able to say, 'I'm lonely', and not feel shame or stigma.

The consequences of loneliness and social isolation are stark. Research has shown that they can have an impact on our physical health, with links to an increased risk of coronary heart disease, stroke and high blood pressure. They can also affect our mental health, increasing the risk of depression, low self-esteem and stress. There are also economic consequences to consider. For example, the Eden Project estimates that disconnected communities could be costing us in Wales some £2.6 billion a year through increased demand on health services and policing, and a cost to employers due to stress and low self-esteem.

Recent figures have shown the extent of these issues. The 2017-18 National Survey for Wales showed 16 per cent of the population aged over 16 years reported feeling lonely, with those aged 16 to 24 more likely to report being lonely than those aged 75 or over. However, we know that loneliness and social isolation can be experienced by anyone of any age and from any background, from the young person moving away from home to start university to someone with a long-term health condition, or an older person caring for a loved one. In fact, we've probably all experienced these feelings at some point in our lives. It's when they become long-term and entrenched that they become problematic.

In line with the principles of the Well-being of Future Generations (Wales) Act 2015 and the Social Services and Well-being (Wales) Act 2014, the strategy focuses on approaches that reduce the risk of, or prevent, people of all ages from experiencing loneliness and/or social isolation, or that intervene early before they become entrenched. It contains a number of cross-cutting policies and commitments to benefit all of society and to seek to provide the basis for people to have greater opportunities for meaningful social contact. It also recognises those at greater risk of experiencing loneliness and social isolation, and the need to reduce the stigma attached to these issues so that people feel better equipped to talk about how they feel.

It establishes four priorities for action: increasing opportunities for people to connect; improving community infrastructure to support people to come together; establishing and maintaining cohesive and supportive communities; and finally building awareness and reducing stigma. These priorities were informed by our public consultation, consultation events and with significant engagement across Government and external stakeholders, and I'm very grateful to all those who have contributed. It's absolutely clear from the consultation response that Government alone cannot solve these issues, although it can foster the right conditions for connections within communities to flourish. The strategy therefore calls upon all parts of society to play a role. We need to change how we think and act upon loneliness and isolation within Government, public services, businesses, communities and as individuals in order to help tackle these issues.

To support this, I'm pleased to inform Members of our plan to launch, later this year, a £1.4 million loneliness and social isolation fund over three years. The fund will support community-based organisations to deliver and test out, or scale up, innovative approaches to tackling loneliness and social isolation. And we'll use these projects to help build our knowledge and contribute to the evidence base.

Our work in developing this strategy has clearly shown that all parts of Government have a role to play in tackling loneliness and isolation. We want to strengthen our cross-Government approach and take action to ensure that we embed consideration of these issues across policy making. To help us achieve this, we will establish a cross-Government advisory group, to also include external partners, to oversee implementation of the strategy, tackle emerging issues and consider what more can be done. We will also publish a report every two years on progress against delivering our commitments. I hope this strategy will build on the excellent work that I know already exists across Wales and help to take us forward. This is just the start; over the months and years ahead, we want to extend our understanding, improve our responses to loneliness and isolation, and ensure that we're taking all the steps necessary to tackle these issues. 

Llywydd, this Government remains committed to tackling loneliness and social isolation and to a more connected Wales, and I look forward to updating Members as we make progress to achieve this.

The Deputy Presiding Officer took the Chair.

I'd like to thank you for the statement here today. Around 29 per cent of the population report feeling socially lonely, 91,000 people feel consistently lonely, and the situation is at its worst for our older people. Over half of the people aged 60 to 74, and just under half of people over the age of 75, report feeling lonely. That's pretty sad, really, isn't it? Loneliness is associated with sleep problems, abnormal stress response, high blood pressure, poor quality of life, frailty, depression and increased risk of heart attacks, strokes, depression and dementia. In fact, Age UK has reported that loneliness can be as harmful to our health as smoking 15 cigarettes a day. 

Now, as the older people's commissioner noted in the 'State of the Nation' report, Wales is falling behind other parts of the UK. The UK Government introduced a Minister for loneliness in January 2018. Scotland launched its loneliness strategy in December 2018. And, whilst welcoming the publication of the strategy today, I would appreciate just a reason, really, why there was such a delay on the one here in Wales.

I would like to note, though, that I do agree with you that the strategy is just the start. The British Red Cross estimates that each older person who requires services as a result of loneliness and isolation could cost £12,000 per person over the next 15 years. Therefore, I welcome the fact that the strategy will be supported by a £1.4 million loneliness and social isolation fund, and a new single advice fund of £8.4 million.

One question that I do have for you, Minister, and that is: we know that social isolation is helped by people being able to be mobile, to be able to catch a bus, go off to see shops in another town, go off to see their doctor, and the community bus service is really integral, yet, in Wales, we've seen so many of our community bus services actually withdrawn, so I wondered what you are doing to work with the Minister and Deputy to see how we can actually just enforce the fact that, really, taking something away like that is hardly feeding into the prevention and intervention agenda. It's foolhardy and it's not a cost-worthy initiative. What steps will you take to ensure that the new, innovative approaches you will be investing in have strong evidence to ensure that they succeed?

I do agree with the four priorities, but I have some questions about the key commitments. Priority 3, people need a health and social care system that provides well-being and community engagement: we only have to look at my own health board to see how, in some respects—. I know, people coming in through the door of my office, it is often they who feel very badly let down by the health service, and sometimes, the integration in health and social care that was a fundamental part of the social care and well-being Act that we all sat through scrutinising in 2014, which came in 2016—. We still have lots of concerns in the community about the lack of join-up, especially when somebody needs to leave hospital and they need a discharge; quite often, it can take weeks for that actual referral to be made so that people can go home and not be in hospital.

Two, will your strategy look at making more finance available to help deal with the restrictions on domiciliary care visits to enable more time for interactions between carers and housebound clients? I was pleased to see priority 3 highlight the Making Every Contact Count initiative. The Welsh NHS Confederation has written to me stating their belief that more work can be done around that particular agenda. I agree, and the respondents to your consultation highlighted that further work to build the capacity of health professionals to understand the trigger points and the effective support available should be a key priority.

Another question: in addition to exploring the potential for developing specific training, what clear actions can you outline today that will help empower health services and local authority staff to recognise the role that they have in supporting residents making positive changes to their physical and mental health and well-being? As you know, you've rightly pointed out previously that younger people are very likely to report feeling lonely. Your consultation highlighted that many feel that schools have a key role to play. This has fed into the strategy before us today, including priorities 1 and 4. 

Calls have also been made, though, for pastoral sessions to be introduced into the school curriculum concentrating on loneliness and social isolation. Having studied the health and well-being area of learning in the curriculum, I believe that schools could consider taking steps to help tackle loneliness. What steps will you be taking to ensure that pastoral sessions focused on loneliness and social isolation are undertaken by every school?

Finally, you are right that a cross-Government approach is needed, and I would like to think, and you certainly have my support, that it should be a cross-party initiative. I am concerned that other portfolios may not be feeding into the agenda as much as you are. You will be establishing an advisory group to oversee the implementation of the strategy, so I wonder whether you have considered asking your Welsh Government colleagues to consult the group on every relevant legislative proposal that is presented to this Assembly, because, quite often, those legislative proposals, actually, whilst doing good in some parts, can impact negatively on other areas. So, what I'm looking for is more joined-up thinking between Welsh Government Ministers as regards this particular strategy. Thank you.

I thank Janet Finch-Saunders for her contribution and also for her support for the strategy, and I'll be very happy to work together on the strategy. She said that all people can feel lonely at all ages, and I think that is a very important point—that we cannot say it's just older people who feel lonely, because Janet Finch-Saunders gave the figures for younger people. I totally agree that loneliness and isolation are as harmful as smoking, as Janet Finch-Saunders said.

She referred to other countries, and mentioned that there was a Minister for loneliness in the Westminster Government. The sort of approach we want to have here, really, is that we want everybody to own it. So, rather than have a Minister for loneliness, we want to ensure that all departments accept that they have a responsibility for tackling the issue of loneliness.

She mentions delay in terms of producing the strategy. I'm pleased she welcomes it, now that it has come, but we did have 230 responses to the consultation, which was a very high consultation response. We also held a number of stakeholder meetings. So, in fact, there was an awful lot to consider, and I think the time it's taken has meant that we have a more considered response today.

I'm pleased that she welcomes the funds. In terms of transport, obviously that is one of the issues where we hope to work with the Minister for Economy and Transport, because I absolutely agree that having connections—you need transport, sometimes, and you need accessible transport.

In terms of the health service, bringing health and social care together was, obviously, one of the key issues of the Act, as she said. I think there has been progress through the regional partnership boards and through the intermediate care fund—there have been joint projects. You know, it's obviously taking time for this to happen, but I do believe the progress that is there.

Making every contact count, I think that is something that is absolutely vital, because there are so many vital moments that you can use to take this agenda forward. And, of course, the schools, again, a very important area, and I know she'll be aware of the increase in funding for the counselling that is provided in schools, and also, of course, we are working towards bringing in the whole-school approach. The advisory group, I will keep the Chamber updated about the advisory group as it's developed.

Thank you to the Deputy Minister for the statement. I was a member of the health committee two years and a bit back when we published that report, and you, Deputy Minister, were a member of the committee at the time. It was a committee consultation that made quite an impression on me when one realises the impact on health, which is similar to smoking, as we've already heard, but it also made it clear to me that there are steps that the Government can take. Of course, the steps being taken are ones that I welcome. What I always want to know is whether there is more that can be done.

I think I have some four questions here. The figures are very striking, aren’t they? There are more young people between 16 and 24 who are likely to report feeling lonely than there are people over 75. That contradicts the perception that we may have. But, given those figures, we know that that age group or a percentage of them face huge pressures to succeed in education, they are more likely to face problems such as online bullying than older generations, and they also face a future in terms of Brexit and climate change that they didn't choose for themselves. There are all sorts of pressures on them. So it’s not surprising perhaps that they are reporting feeling lonely and isolated. I wonder whether your strategy intends to tackle this specifically, for example, by working with FE colleges, universities, and so on, in order to ensure that they can do what they can as sectors to help.

Secondly, in terms of housing, would the Government accept that when we talk about house building, we should be talking about building communities? Would the Minister agree with me that housing developments should include community resources too, and would she be willing to speak to her fellow Ministers to ensure that planning legislation is strengthened in order to ensure that this does happen?

If I could move on to my next question, whatever age group you're talking about and whatever generation you're talking about, there is an elephant in the room here too in terms of there being one major problem, and that is the major cuts in local government funding over the past decade. We have seen cuts to day centres, we have seen cuts in public transport that so many people rely on, and we've seen higher prices charged for the use of leisure and sports facilities, and so and so forth. So, I would ask whether £1.4 million over three years is truly going to make a dent in this problem. Shouldn't we be really ensuring that local government is funded properly, so that they can make better decisions in order to tackle loneliness and isolation?

Finally, there is a new advisory group to be established, and that will be asked to report back on progress every two years. Now, it’s a three-year programme; that’s the funding that’s being announced today, so by the time the first report will be published, there will be less than a year left to focus on identifying the schemes that work well and possibly scaling those up. So, is this kind of advisory group the best way of ensuring best practice in delivering real results in this area?

Thank you very much and thank you for your support for the strategy. Certainly, the impact on health you clearly recognised—as bad as smoking cigarettes. I mean, it's very stark, and I'm very pleased that you welcome the steps.

In terms of young people aged 16 to 24, I think it's absolutely crucial that we do work to help identify those young people, and so, I would certainly see us working with the further education colleges and the universities. I think it's also very important the fact that we have a re-launched youth service and increased funding that the Government has given to the youth service. Because I think the youth service is an area where young people can lose the feeling of isolation, and I think youth workers, with their particular skills, are able to work very closely with young people and to address these issues. So, I think the youth service is very important, and I'm very pleased the Government has been able to increase the funding for the youth service.

Housing, yes, I have had a meeting with many Government Ministers, actually, about this strategy because it is crucial that we do see it as a whole-Government strategy and that every department needs to be involved. I went, this morning, to Newport, where I was in a complex—Pobl—where a community hub was provided along with the accommodation for apartments within the building, and also with small bungalows outside. And we were able to meet the residents and also meet the Reality Theatre who work with tackling stigma, and it was very impressive. You could see that this housing development had really included the things that people need to have good lives in terms of having somewhere to meet, somewhere where they can share experiences. So, I think housing is absolutely crucial, and we can do a lot more, I think, in terms of developing suitable housing.

Then, major cuts in local government, of course that is a huge issue and we know that many facilities have been lost, but we have been able to provide some funding, through the ICF, for local hubs, and I think they are certainly developing in a way that does provide support for people in the community. And £1.4 million is a 'dent', as you said, compared to what is needed, but what we are saying, really, is that this strategy is for every department and for all the spending that happens. And all the spending and all the initiatives that take place, we want to be sure that loneliness and isolation is part of that spending. So, the £1.4 million is to provide for some experimental small projects, which we will obviously evaluate in this new advisory group. I mean, the new advisory group will have external people on it who will bring some expertise of working in the field, and I think we will have to see how that group develops.

I really welcome your statement today, but I want to particularly focus on 16 to 24-year-olds and loneliness, and to recognise, as it says in your statement, that 60 per cent of that population do suffer some loneliness at some stage in their lives. Unemployment, of course, is a main driver for that, and there are things that the Welsh Government is doing in terms of training and education that will help keep young people engaged in the workplace or any other opportunities and chances that they have. And some of those are going to perhaps be volunteering in, particularly, community activities where they live.

It's already been said that local authorities, investment in community provision for young people, has seen, over the years, some budget cuts due to the austerity agenda, and that, again, does feed in to this isolation and loneliness, and particularly in rural areas like the area that I cover.

But one area where community activity is probably extremely prominent is sport, and that is fantastic, in the main, for young males in particular, but we all know that the evidence shows us—and there's been plenty of evidence presented—that young women around the age of 15 or 16 do, in the main, drop out of actively being engaged in sport. So, I wonder whether this group might look at, perhaps, some way of engaging, or keeping young girls engaged in that.

I welcome the £1.4 million that the Government is going to invest within the next three years, and I do welcome the advisory group that will work right across all of the Government. I would identify—and Rhun has already identified—that cyber bullying is probably the major part of isolation. When young people, or anybody, but I'm talking particularly about young people, feel bullied even in their home, where in the past young people would have been able to shut the door and know that they felt quite safe, cyber bullying actually impacts right into where they exist and how they live. So, I'd be really interested to see if any work is being done around that and whether the Government would look at any possible schemes that would encourage exchanging ideas or maybe even some equipment that would allow young people to have opportunities to trial some activities that might otherwise be unavailable to them because of poverty.

I thank Joyce Watson for those very helpful comments. Again, she emphasised 16 to 24-year-olds, which I think is a crucial area. Obviously, some of those young people will still be in school and so I think it is very important that we continue our work in terms of mental health on the whole-school approach, and that is something that the Government is following up with the task and finish group. As I said in my response to Rhun ap Iorwerth, the work with training colleges and education is crucial. 

She mentioned volunteering, and I think that is an area that we've certainly identified as somewhere people can lose the feeling of isolation and loneliness as well as making a huge contribution to society. So, the Government does fund the Wales Council for Voluntary Action to encourage and train volunteers and to provide expertise on this subject. Certainly, volunteering is an area that I do see as crucial as a way forward. 

Joyce Watson also mentioned rural areas, and I think that that is an important point, because I think that research that has been done into loneliness and isolation in rural areas, as compared to city areas, has shown very little difference, but what we do know is, of course, in rural areas is the connectedness, which I've already mentioned—how important it is to have the transport available. So, there is that particular issue in the rural areas. 

And now sport: sport is obviously a great opportunity for health, for enjoyment, and I think the research does show that it does help you to deal with depression, isolation and loneliness. So, certainly, sport is something that we will be working very closely on with Sport Wales and hoping to include on the questionnaires and research that they do a question about loneliness and isolation. Of course, we must make sure that everybody who benefits from sport is across every part of society. She makes the very important point about engaging young women. 

And then finally, the final point, I think, was on cyber bullying. That is a very important point about people feeling isolated and lonely in their own homes, and I think this is an area that we certainly would want to follow up. 

Thank you for your statement, Minister. As you are no doubt aware, tackling loneliness and isolation has been one of my top priorities and I'm pleased that you have also made it yours. I look forward to working with you on this subject. I was also proud to be part of the health committee, and we evidenced much, both inside and outside the Assembly. So, I was pleased with my interaction at that time. With around a third of our nation experiencing loneliness, we obviously have to act.

As you rightly point out, Minister, loneliness and isolation can have extensive impacts on our physical and mental well-being. Evidential studies have shown increased risk of heart attack, stroke and dementia from social isolation as well as high instances of depression, anxiety and sleep abnormalities.

Unfortunately, there are a multitude of reasons why someone can become socially isolated and lonely. We have to do all that we can to mitigate as many factors as we can. Loneliness and isolation are not defined by age, and whilst social media can enhance social interaction, it can also lead to bullying and people withdrawing from such activity.

So, Minister, your action plan’s top priority is to increase opportunities for people to connect. What discussions have you had with ministerial colleagues and local government about reversing and preventing the closure of libraries, day centres and leisure facilities? These community facilities are a lifeline for many, many people, particularly the elderly, and are key in preventing isolation.

I note from the strategy that you are giving focus to tackling digital exclusion. Whilst this is to be welcome and digital connectivity can play a role in tackling loneliness, I think we must err on the side of some caution here. Increasing digitisation can deny many elderly people meaningful human contact. So, Minister, what actions will you take to mitigate this risk? Staying with digital inclusion, Minister, what role do you see digital voice assistants playing in your strategy?

Community groups play an essential role in tackling isolation. The fantastic Hen Shed in Maesteg, which is in my region, is a great example of how voluntary groups can be at the forefront of our approach. So, Minister, what can your Government do to support groups like hen sheds and men’s sheds? Have you or your colleagues spoken to the Treasury to discuss what financial support can be offered such as VAT and business rates exemptions et cetera?

Finally, Minister, your strategy lists community infrastructure as its second priority. Apart from free rail travel for accompanied under-16s, there is scant mention of public transport. Minister, do you agree with me that good public transport links should be a priority in tackling isolation? What discussions have you had with the Minister for transport regarding measures to improve public transport links across Wales? Thank you. Diolch yn fawr.

I thank Caroline Jones for her contribution, and recognise that we were on the health committee together, along with Rhun ap Iorwerth, and the Chair is now here as well—and did that very outstanding report, I think, about loneliness and isolation, particularly in relation to older people. So, Caroline Jones recognises the health risks, and she says that there are many reasons why people suffer from loneliness and isolation. But I think it's important to remember that there are trigger points when it is much more likely that people will suffer in that way, such as retirement—retirement does cause isolation and loneliness—and bereavement. And there are many trigger points, which I think it is possible for us to become more aware of, which means that we will be able to tackle those issues better.

One of the things that we are very keen to do is to try to get rid of the stigma of loneliness and isolation, making it possible for people to be able to say, 'I'm lonely', without it seeming like it's something to be ashamed of. So, I think that is one of the things—as much as we can talk about loneliness and isolation. And we're using Public Health Wales, who are having a conversation about well-being, to see what we can find out about what the public is thinking and saying about these things in order to raise awareness. 

And then, of course, I have met with most of my ministerial colleagues to discuss how we can tackle these issues. Because, again, I've got to reiterate that this is a cross-Government approach, and it's certainly not something the Government alone can do—this is a whole-societal issue, so what Government can do is to try to lead the way and raise awareness, but we can't solve it. So, that's very important, I think, to remember.

The issue about the closure of local facilities has come up earlier on in this debate, and obviously it is a huge loss for many people who may have made the focus of their lives in a local community centre or a local library. But as I said, we are helping to fund the creation of hubs, which certainly is happening in Cardiff, where libraries are converting to hubs, and where there are places for people to come and get information and to mix and to have gardening classes and a whole range of things. I think that's the sort of thing we've got to really develop.

In terms of digital exclusion, yes, we are working to help people become more digitally included, and one of the inter-generational projects we've had, which is so important, is where young people go and help older people to be able to use digital means to keep in contact with their families, and to Skype their families who may live on the other side of the world. I think it's very important that we do that, but always bearing in mind, as she said, that there are some people who need other, more traditional means of having contact.

She mentions the importance of the voluntary groups—hen sheds, men's sheds, all the ones we know are doing such huge work in order to keep people connected and to keep people joined. Obviously, they are a key part of our strategy as we go forward, as indeed they are a key part of the Government's strategy. And, again, community infrastructure and good public transport links we know is one of the absolute key issues that we'll be addressing.

Thank you very much, Deputy Minister.