The next group of amendments is the third group, which relates to the duty to secure quality in health services and the power to issue guidance. Amendment 16 is the lead amendment in this group. So, I call on Angela Burns to move the amendment, and to speak to the other amendments—Angela Burns.

Amendment 16 (Angela Burns, supported by Caroline Jones) moved.

Diolch. I formally move the amendments tabled in my name. The point of these amendments is to give the Welsh Ministers the duty to secure quality in health services through the guidance principle. They seek to support recommendation 2 of the committee, which requests that the Minister issues statutory guidance. In Stage 1 evidence, stakeholders highlighted that the Bill was simply not strong enough in setting out what that duty of quality is and how it would be measured. 

These amendments have been drafted with the support of the Welsh Government and the Minister, and we're grateful to the Minister for this. They essentially say that Welsh Ministers must issue guidance to NHS bodies. Although we have tabled this, I would also be grateful if the Minister would confirm that the proposed guidance will include how the duties of local health boards, NHS trusts and special health authorities are assessed, as well as a demonstration of improved outcomes and how innovations and improvements can be implemented across Wales. It's about growing those small shoots, isn't it?

At Stage 2, I also mentioned that assessments are key planks to the duty of quality. They enable the relevant health authorities to provide us with uniform information about their quality indicators, and this is also how they move from what was criticised as an aspirational duty by the chair of the Welsh NHS Confederation management board to a very real and enforceable duty.

At Stage 2, the Minister noted that he agreed about the importance of setting out how NHS bodies can demonstrate an improved outcome as a result of taking steps to comply with the duty, and he shared the desire to see how innovations and improvements designed in one area could be spread and scaled across Wales. As I said at that Stage, we believe that getting the guidance right before the duty of quality comes into effect is essential. We're still not quite clear yet how that guidance will help health authorities to achieve the set levels of expected improvement, so again I would be grateful if the Minister would outline a little bit more detail on that guidance, especially given that he expects the guidance on the duty of quality to include the need to consider how a body works in partnership delivering services in an integrated way to secure improvements. And as we all know, partnership, co-production and collaboration are a very important part of raising the level of quality and the level of candour within our health boards. Thank you.

I'm also supporting the amendments in this group. If we are to have any chance of achieving the duty of quality, we must have statutory guidance in place that instructs health and social care providers on how they can go about implementing the duty of quality. Without statutory guidance, we leave it open to interpretation by the local health boards and local authorities. A duty of quality doesn't differ from region to region; it requires consistency and, therefore, we need national guidance. These amendments will ensure a single national approach.

The Minister—Vaughan Gething.

Thank you, Llywydd. Following considerations at Stage 2, I have had constructive discussions with opposition Members and I am pleased that we've been able to reach a shared position with Angela Burns on this. By specifying in statutory guidance the evidence to be used and the way such evidence has been assessed, that will require NHS bodies to report openly and transparently on the actions that they are taking to secure improvements in quality outcomes. Importantly, in undertaking that assessment, NHS bodies will also be required to evidence how they are taking the health and care standards we discussed in the first two groups into account in discharging their duty of quality. That means that NHS bodies will have to consider all the matters set out in health and care standards, which includes matters relating to workforce, improving population health and equity. That will be explained in the statutory guidance. There is a point here about the statutory guidance that we're committing to produce on each area of the Bill: we want to see that co-produced in the way that we deliver it, rather than simply delivered by the Government. I am therefore happy to support all the amendments in this group in the name of Angela Burns.

Angela Burns to respond.

Thank you very much indeed. It's sufficient to say that there are two words that bring joy to my heart. Caroline, you mentioned 'consistency', that's what we need; Minister, 'evidence', that's what we need. Thank you very much for supporting the amendments.

The question is that amendment 16 be agreed to. Does any Member object? Therefore, amendment 16 is agreed.

Amendment agreed in accordance with Standing Order 12.36.

The next amendment is amendment 27. Angela Burns.

Thank you very much—

Do you want to move amendment 27?

Amendment 27 (Angela Burns, supported by Caroline Jones) moved.

Sorry, I beg your pardon. I move. My listening Welsh isn't as good as I think it is. [Laughter.]

Moved, then.

Amendment 27. The question is that amendment 27 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 27. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. So, amendment 27 is not agreed.

Amendment 27: For: 22, Against: 28, Abstain: 0

Amendment has been rejected

Amendment 28, Angela Burns. 

Amendment 28 (Angela Burns, supported by Caroline Jones) moved.

Formally.

The question is that amendment 28 be agreed to. Does any Member object? [Objection.] Therefore, we proceed to a vote on amendment 28. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, amendment 28 is not agreed.

Amendment 28: For: 22, Against: 28, Abstain: 0

Amendment has been rejected

Amendment 66, Rhun ap Iorwerth.

Amendment 66 (Rhun ap Iorwerth) moved.

Formally.

The question is that amendment 66 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 66. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, amendment 66 is not agreed.

Amendment 66: For: 21, Against: 29, Abstain: 0

Amendment has been rejected

Amendment 67 is the next amendment—Rhun ap Iorwerth.

Amendment 67 (Rhun ap Iorwerth) moved.

Formally.

The question is that amendment 67 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 67. Open the Vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, amendment 67 is not agreed.

Amendment 67: For: 21, Against: 29, Abstain: 0

Amendment has been rejected

Amendment 68 is the next amendment, in the name of Rhun ap Iorwerth.

Amendment 68 (Rhun ap Iorwerth) moved.

Formally.

The question is that amendment 68 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 68. Open the Vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed.

Amendment 68: For: 21, Against: 29, Abstain: 0

Amendment has been rejected

The next amendment is amendment 29, in the name of Angela Burns.

Is the amendment being moved?

Amendment 29 (Angela Burns, supported by Caroline Jones) moved.

Formally.

Therefore, the next vote is on amendment 29, in the name of Angela Burns. The question is that amendment 29 be agreed to. Does any Member object? [Objection.] Therefore, we proceed to a vote on amendment 29. Open the Vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 29: For: 22, Against: 28, Abstain: 0

Amendment has been rejected

Amendment 17—Angela Burns.

Amendment 17 (Angela Burns, supported by Caroline Jones) moved.

Formally.

The question is that amendment 17 be agreed to. Does any Member object? Amendment 17 is agreed.

Amendment agreed in accordance with Standing Order 12.36.

Amendment 30, Angela Burns.

Amendment 30 (Angela Burns, supported by Caroline Jones) moved.

Formally.

The question is that amendment 30 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 30. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 30: For: 22, Against: 28, Abstain: 0

Amendment has been rejected

Amendment 31, Angela Burns.

Amendment 31 (Angela Burns, supported by Caroline Jones) moved.

Formally.

The question is that amendment 31 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 31. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 31: For: 22, Against: 28, Abstain: 0

Amendment has been rejected

The next amendment is amendment 69—Rhun ap Iorwerth.

Amendment 69 (Rhun ap Iorwerth) moved.

Formally.

The question is that amendment 69 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 69. Open the vote. Close the vote. In favour 20, no abstentions, 29 against. Therefore, amendment 69 is not agreed.

Amendment 69: For: 20, Against: 29, Abstain: 0

Amendment has been rejected

Amendment 70, Rhun ap Iorwerth.

Amendment 70 (Rhun ap Iorwerth) moved.

Formally.

The question is that amendment 70 be agreed. [Objection.] We therefore proceed to a vote on amendment 70. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed.

Amendment 70: For: 21, Against: 29, Abstain: 0

Amendment has been rejected

Amendment 71, Rhun ap Iorwerth.

Amendment 71 (Rhun ap Iorwerth) moved.

Formally.

The question is that amendment 71 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 71. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed.

Amendment 71: For: 21, Against: 29, Abstain: 0

Amendment has been rejected

The next amendments is in the name of Angela Burns—amendment 32.

Amendment 32 (Angela Burns, supported by Caroline Jones) moved.

Formally, Llywydd.

The question is that amendment 32 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 32. Open the vote. Close the vote. In favour 21, one abstention, 28 against. Therefore, the amendment is not agreed.

Amendment 32: For: 21, Against: 28, Abstain: 1

Amendment has been rejected

The next amendment is amendment 18—Angela Burns.

Amendment 18 (Angela Burns, supported by Caroline Jones) moved.

Formally, Llywydd.

The question is that amendment 18 be agreed. Does any Member object? Therefore, amendment 18 is agreed. 

Amendment agreed in accordance with Standing Order 12.36.

Amendment 33, Angela Burns.

Amendment 33 (Angela Burns, supported by Caroline Jones) moved.

Formally.

The question is that amendment 33 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 33. Open the vote. Close the vote. In favour 21, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 33: For: 21, Against: 28, Abstain: 0

Amendment has been rejected

The next amendment is amendment 34—Angela Burns.

Amendment 34 (Angela Burns, supported by Caroline Jones) moved.

Formally.

The question is that amendment 34 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 34. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore that amendment is not agreed. 

Amendment 34: For: 22, Against: 28, Abstain: 0

Amendment has been rejected