1. Questions to the First Minister – in the Senedd at 1:44 pm on 3 March 2020.
Questions now from the party leaders. Plaid Cymru leader, Adam Price.
Diolch, Llywydd. As a worst-case scenario, up to 80 per cent of the Scottish population could contract the COVID-19 coronavirus, with 250,000 needing hospital treatment, according to their chief medical officer. Yesterday, First Minister, you said that your Government is working for the best and preparing for the worst. What assessment has the Welsh Government made of a worst-case scenario here? And what are the corresponding figures for Wales?
Well, Llywydd, the Chief Medical Officer for England has confirmed the 80 per cent figure this morning. The range is expected to be in the 50 to 80 per cent part of the spectrum and 80 per cent would be higher than the population in the province of China that has been most seriously affected, so these are realistic worst-case scenarios. And if the worst were to take place, then up to 80 per cent of the Welsh population would be affected as well, so that is the figure that planning is using through our chief medical officer and the emergency co-ordinating arrangements that we have. It's not a prediction, it's not what we think will happen; it is an assumption for planning purposes that that 80 per cent figure mentioned in Scotland, confirmed today in London, is the same figure that we are working to here in Wales.
Thank you. The four nations action plan published today shows that Wales has not yet put certain measures in place. In Scotland and Northern Ireland, the virus is now classified as a notifiable disease. Why isn't it here? In England emergency powers are already in place to allow the police to direct and detain a person who does not comply with a request to be isolated if suspected of carrying the virus, and those powers will be extended to medical and public health professionals. Will this happen here? And can we have a daily rather than a weekly public update, as happens in Scotland, of the number of positive and negative coronavirus tests?
Can I, Llywydd, first of all assure the Member that there is a daily update provided in Wales—provided every day on the Public Health Wales website—and we intend that that will continue? As far as the powers of detention are concerned, we continue to work with the UK Government and with the Scottish and Northern Ireland Governments on potential legislation that may need to be brought forward, so that if the worst were to happen, the Governments would have the necessary powers to be able to respond to a disease that has moved beyond the containment and delay phase. We will report that to the National Assembly here, of course, and make sure that there are opportunities for Members to scrutinise those powers, should they become necessary.
We report all the time, Llywydd, on the number of people who have been tested here in Wales. It's now hundreds of people. The arrangements we have are very robust. We have a particular approach here in Wales, which I think has been very successful, of treating people with suspected coronavirus in the community, and 95 per cent of testing in Wales is carried out in people's homes. All of that is recorded, all of that is published. The information is robust and the method of responding to need I think has been successful.
The latest UK Government assessment is that up to a fifth of the workforce may be off sick during the peak in an epidemic. The number of people on zero-hours contracts in Wales between June 2018 and July 2019 increased by 35 per cent, and only one in seven of them gets sick pay. What funds do the four Governments intend to set up to ensure that people on such contracts—agency staff in the NHS and universal benefit claimants—do not have to choose between their health or paying their bills?
It's an important point the Member raises, of course. In the meeting that I attended and my colleague Vaughan Gething attended of the national COBRA meeting yesterday, issues of sick pay were discussed, and I know that thought is being given to the way in which that system operates, so that if the worst were to happen, people would not find themselves in the position of feeling obliged to go to work, because without being in work, there is no income available to them.
Leader of the opposition, Paul Davies.
Diolch, Llywydd. Can I take this opportunity to thank you, First Minister, for your briefing on the coronavirus outbreak this morning? I'm pleased to see Governments and agencies working together to tackle this virus, and I'm sure you'll agree with me that it's vitally important that agencies and Governments continue to work together in the public interest.
Now, it's critical, of course, that our primary care services are able to cope with any new demand as a result of this development, and as you know, services across Wales are somewhat stretched, with a Wales Audit Office report showing that plans to address pressure in primary care have been patchy and slow. In responding to the 2020-21 Welsh Government draft budget debate, the Health, Social Care and Sport Committee has also made it clear that greater clarity about the funding for primary care and community activity is needed in future budget rounds so we can ensure that the level of resources reaching front-line primary care services is sufficient. As the first case of coronavirus in Wales has now been confirmed, can you tell us how the Welsh Government is monitoring the developments around the spread of coronavirus to ensure that the people of Wales are as informed as possible? Can you also tell us whether you are confident that the Welsh primary care sector has the capacity and resources needed in the event that the number of cases substantially increases, and whether there is any flexibility in the Welsh Government's budget so that additional resources could be allocated efficiently should coronavirus spread and become much more of a wider public health issue in the future?
I thank the leader of the opposition for those questions. On spread, there is clear advice available to patients in Wales and, as of today, any patient needing advice will be able to use the 111 number to get coronavirus advice at no charge to that individual. The advice is, if you think you have any vulnerability, not to go to the GP, not to go to an accident and emergency department, but to take advice through that number in the first instance.
In relation to the one individual who has been identified in Wales, of course Public Health Wales has immediately set about contact tracing, as it's called, to make sure that anybody who might have come into contact with that individual and therefore be additionally exposed to risk is known, that they're tested, and that they can receive the reassurance that they need.
Paul Davies makes a very important point about primary care. Should coronavirus move into a phase where delay and mitigation, as the plan suggests, become the primary response, then primary care will be in the front line to try and mitigate the need for hospitalisation. Yesterday the health Minister, myself and the chief medical officer talked about ways in which we might be able to remove some of the requirements that primary care currently operates within. So, often, as a result of debates here on this Assembly floor, GPs carry out routine monitoring on many conditions—diabetes, for example—where people are called in, monitored and so on. It may be that, if this becomes a more urgent situation, we may have to suspend some of that more routine work that GPs currently undertake in order to release their time to be able to respond to more urgent needs. As Paul Davies suggested, that has a budgetary consequence, because GPs are paid on the basis of carrying out that sort of activity. That's the nature of the contract that we have with them, so we would have to be able to make sure that our GPs know that, by not doing things that we currently expect of them to free up their time for more urgent stuff, they wouldn't be financially disadvantaged as a result, and there's flexibility in our budgets to make sure that we can do that.
Of course, it's particularly important that the Welsh Government is also in discussion with all healthcare settings to ensure that the entire health and social care sector is as fully informed as possible and understands exactly how it can best treat those in its care. Now, we know from the outbreak of coronavirus, for example in Seattle, that it has prompted calls for preventative measures in America's nursing homes and social care settings, where residents are at heightened risk of serious complications from the virus, because of the dual threat of age and close living conditions. Of course, the same goes for those residents living in social care settings in Wales, and so, First Minister, can you tell us what discussions has the Welsh Government specifically had with social care providers and contractors here in Wales, and what contingency plans is the Welsh Government currently working on to better safeguard those living in social care settings from coronavirus?
Well, again, thank you for that important point, because what we know about the virus is that its impact is more significant amongst older people and people's whose immune systems are already compromised because of other conditions. And those people are to be found in greater concentrations in residential care and nursing homes. So, Paul Davies is absolutely right to draw attention to the particular needs of that sector. Of course, the system is already alert to that, advice is being provided through the normal clinical and other means of contact with the sector. We will do more to make sure that we draw those key leaders in the sector—Care Forum Wales, for example—into these conversations.
There is a particular challenge here in Wales. Across our border, as I know the Member will know, residential care is largely provided by a small number of very large companies. In Wales the pattern is not like that. While we have some provision by corporate providers, we still have a sector that is dominated by small owners of one or two residential care homes. Getting messages out to people is a bigger challenge when you have larger numbers of people involved and people who may not necessarily be as attuned to dealing with demands as large companies who are well set up and equipped to do this.
So, we're very alert to the particular challenges that we may face here in Wales and we're taking action already to make sure that people at that front line have all the best information and are able to respond to the spread of this virus, were that to happen, into those sectors.
First Minister, with the threat of confirmed cases in Wales thought to rise over time, it is essential that the Welsh NHS is as fully staffed as possible to treat anyone who has symptoms of the virus. Sadly, we already know that the NHS is facing significant recruitment challenges, so can you tell us what immediate steps the Welsh Government is taking to address any recruitment matters within the Welsh NHS as a matter of urgency? Could you also tell us whether the Welsh Government is looking at the emergency registration of health professionals who have retired as a way of increasing the number of people who can help treat those affected by the coronavirus, and, if so, what safeguards the Welsh Government is putting in place for those retired doctors, given that they will also be vulnerable to the virus, given their age, and whether the Welsh Government is considering the introduction of emergency indemnity coverage, generally, for healthcare workers to provide care or diagnostic services?
Well, Llywydd, more people work in the Welsh NHS today than ever before in its history, and even during a decade of austerity, the number of people working in the Welsh NHS has risen by 10 per cent over that period. So, while there are recruitment challenges, of course, and in particular areas as well, in general the NHS in Wales recruits very well, and is very well staffed.
I referred in my answer to Adam Price to emergency legislation that is being discussed between the four Governments, and those discussions are not concluded. But I'm happy to give an assurance to the Member that those discussions are covering the emergency re-registration of staff who have recently retired or left the profession—and that's nurses and others, as well as doctors—in order to persuade those people to come back and help out in an emergency. It is important to offer them a series of protections, that their pensions won't be affected, that there will be indemnity cover for them put in place, and that there may be a need for retraining, even if it's rapid and concentrated, to make sure that people's skills are at a level that they will be confident to practise again.
All of those matters are being very actively discussed between the Governments and between the professional associations, and I'll repeat the undertaking I gave to Adam Price that should these discussions mature into a piece of legislation—and the Welsh Government's view will be that one piece of legislation for the whole of the United Kingdom is preferable, as far as possible, to separate pieces of legislation in parts of the United Kingdom—we will nevertheless make sure that the outcome of those discussions is properly reported to the Senedd, and Members here will have an opportunity to scrutinise them.
The Leader of the Brexit Party, Mark Reckless.
When you became First Minister, 60 per cent of people asked by YouGov said that they didn't know who you were. When YouGov asked again after you had been First Minister for a year, half of people in Wales still didn't know who you were or had any opinion about you. When they polled in Wales a month ago on who would make the best First Minister, 8 per cent of people answered 'Mark Drakeford', 71 per cent answered 'Don't know'. First Minister, to invigorate Welsh democracy, isn't it time we directly elected the First Minister?
Llywydd, it's not a course of action that I think has merit.
Thank you for your short answer, First Minister. In the referendum less than 10 years ago, the people of Wales were asked if they agreed to law-making powers being devolved in 20 specified areas. So, how do you justify now all powers being devolved except those that are reserved to Westminster? This afternoon, we vote on Welsh rates of income tax; yet, in that referendum, the people of Wales were promised—it was actually written on the ballot paper—the Assembly cannot make laws on tax, whatever the result of the vote. The legislation was passed in 2006, I believe, for that vote. Why was that promise broken? Why did your 2016 manifesto, before the Wales Act 2017 was passed, refer to 'when' income tax powers are devolved, given the Wales Act 2014 required a referendum? And why, given that your predecessor and, it seems, your backbenchers refer to this as a Conservative broken promise, did you agree to it?
Llywydd, the promise was broken by the Conservative Party, the party of which he was a temporary member at the time and no doubt supported it when that party changed its mind. This Government agreed with the original proposition that, if income tax were to be devolved to Wales, it ought to be subject to a referendum. It was the Conservative Party that changed its mind about that. The Conservative Party in power in Westminster, with his support, changed its mind about it. Now, I am not saying that there wasn't a case for doing that; the Conservative Government at the time made that case. But the Member asks me about an action for which he was responsible.