1. When will the Welsh NHS be operating as it was before the Covid-19 pandemic? OQ55426

It is impossible to say when NHS Wales could operate as it did before the COVID-19 pandemic. None of us can say with certainty when the pandemic will end. We will, though, as I have stated previously, adapt NHS practice to take account of innovation and improvement during the pandemic.

Thank you for that answer, Minister. Hundreds of doctors in Wales say that important wider patient care has been neglected during the COVID-19 pandemic. As of yesterday, the number of people who have died in Wales from COVID-19 was 1,531. Each one of those is a very sad story of loss for the family concerned, but the drop in the number of people starting vital cancer treatment is far higher. For example, in April alone, it was more than 5,000, and referrals to a single cancer pathway have halved since lockdown. Dr David Bailey, chair of the British Medical Association's Welsh council has said, and I quote,

'many ill patients are not getting the care they need now—they are risking their conditions getting worse and some may even die as a result.'

Research from the Royal College of Paediatrics and Child Health shows that in the UK, more children have died from having treatment delayed during lockdown than have died from COVID-19, including nine from cancer sepsis and metabolic disease. You seem happy to boast that you're preventing more deaths from COVID-19, but when will you be publishing figures of the number of people who have died from other diseases because of the restrictions you've put on our NHS? 

Well, I think there are a couple of important points from the variety of comments. Obviously, I don't agree with every single comment the Member's made, but when it comes to cancer services, we've already made clear that urgent cancer services were always available during the pandemic, even when other parts of the NHS were closed down, following my decision on 13 March. So, we are looking to progressively restart services. We're going to restart screening services; the Member and others will be aware they're being progressively restarted through the summer.

It's part of the difficulty, though, that because of the pandemic, a range of patients made choices to defer their treatment. That was in consultation with their treating clinicians. There were alternative treatment options provided, and I am concerned, of course, not just in cancer, but in a wide range of other areas, that we haven't seen the level of activity maintained, and what we need to do is both to rethink, as we are doing progressively, how the NHS services restart, but also to build confidence within the public that they could and should access the NHS services that are available, as, indeed, cancer services are. We're starting to see a recovery in those referrals.

The second point I think, Llywydd, is the broader point made on excess deaths. I've always been interested in the excess death figures, and what it means in terms of, not just Wales but every other part of the United Kingdom, as we try to learn from the first phase of this pandemic. I'm hopeful that before the end of next week we'll have an interim report on excess deaths, with learning for us to not just take here in Wales, but to share with other parts of the UK, as I want to learn from practice in Wales, Scotland and Northern Ireland, as well as England.

I heard your response, Minister, to the earlier question, and I also heard your response to the First Minister—sorry, Paul Davies's question to the First Minister earlier today on this subject. Can I ask what assurances you can provide that Welsh residents will receive equal treatment from English hospitals in the resumption of NHS services, and particularly in the resumption of outreach services by English hospital consultants to Welsh hospitals to provide appointments and procedures closer to home for Powys patients?

Thank you for the question. It's an important matter about cross-border care, both for those who come into Wales, in particular in primary care, but also some hospital treatment that takes place as a regular, normal part of NHS treatment for Welsh residents in English hospitals. It's particularly the case for Powys and for Betsi Cadwaladr where elements of care are regularly commissioned, and they have had regular conversations with the trusts, because England have organised their hospital trusts into regional groups, and they're managed through silver and gold commands. And I can assure the Member, and people watching, that both Powys and Betsi Cadwaladr are active partners within that conversation as commissioning organisations who provide care for Welsh residents.

There are individual challenges as some of the missions have changed in individual hospitals. I know that in Gobowen there's been a slight change in the way that that provider delivers, just as there are some challenges around the Shrewsbury and Telford Hospital NHS Trust that are well advertised. But I'm happy to give the Member the assurance that the Welsh system is properly engaging with our regular partners across the border in England to try to make sure that Welsh residents don't have their care compromised.

Minister, NHS staff can only engage in much-needed catch-up work if they are able to work over the summer, and support bubbles will only be of help to those NHS staff who have family members. Now, there was a very welcome announcement of extra funding for summer childcare earlier in the week, but no guidance has been issued to local authorities on providing childcare for NHS and social care key workers. I'm delighted to say that Torfaen council will be providing childcare for NHS and social care staff, but I've heard of one local authority that is thinking of charging £20 a day to key workers, which is a real kick in the teeth to NHS staff who have sacrificed so much in this pandemic. Will you discuss this with the Deputy Minister as a matter of urgency, and issue clear guidance to local authorities on what your expectation is of them over the summer, so that NHS staff can get back to doing that vital catch-up work that we know is desperately needed? Diolch.

I thank the Member for the question. Of course, we want to see health and social care workers able to continue to work during the summer, and I recognise that childcare arrangements are part of it. It would be helpful for me if the Member would provide the example she's provided today in some more detail to me. I'd be delighted to receive some correspondence between yourself to myself and the Deputy Minister, so not only can we discuss matters with our officials here, but also we can have a constructive conversation with the Welsh Local Government Association, because throughout the pandemic, they've been a very constructive partner with us, and I think they'll recognise the issues that exist in every community, because, of course, they're just as concerned as we are that the NHS can carry on doing its job, together with partners in social care.