Questions now by party spokespeople. The spokesperson for the Conservative group—Janet Finch-Saunders.

Diolch, Llywydd. Minister, 1,097 patients or individuals were discharged to care homes without a COVID-19 test in March and April. On Sunday, you mentioned that there is no evidence to suggest this caused any increases in COVID cases or deaths. In relation to mortality rates and causes, there was a promise to issue an interim report before recess. Will this be looking very closely at the impact of discharges on care homes? What do you say to care home owners who have provided oral evidence such as, 'The people who were discharged from hospital were not tested because they only displayed the symptoms once they got to us'? I have established that 188 homes in north Wales had patients discharged to them in the nine weeks from 16 March. Will your interim report cross reference discharge data with that of care homes that have recorded cases of COVID-19?

Ordinarily, Llywydd, questions from Janet Finch-Saunders are for the deputy, but I think it's clear today this is for me. When it comes to the interim report that I still want to have published before we go into recess, it plainly won't be going into the level of individual detail that the Member questions.

What we will do, though, is we'll want to try to understand what has happened, both in the choices that we made at the point in time when the NHS was at real risk of being overrun if we didn't prepare—. That's why I took the decision in the middle of March to pause a range of activity and for hospitals to create space and time for staff to retrain to save lives. It's also why we've taken a range of measures throughout the pandemic to support not just the residential care sector but the broader health and social care environment. I think the interim report will have a range of lessons for the Government and more broadly. As I say, there's more learning to take from that.

When it comes to the discharge without coronavirus tests, as I've said on a number of occasions, that was because that was the state of the current advice. The decision that I took, based on that advice, was that at that point in time people without symptoms should not be tested. However, it is worth all of us remembering that a range of those people discharged were being discharged to return to their own home. I think it's important that we support people to return and be cared for in their own home as we look to support the wider care home sector. That's the approach we'll continue to take—to take learning from what's happened and to apply that to the future.

Thank you, Minister. Now, it's not just me who is concerned about care homes. The older people's commissioner's report, 'Care Home Voices', has requested step-down facilities to support safe discharges from hospital, and found that the limited availability of testing was a cause of significant worry. From 15 June, all care home staff were to be offered a weekly test for a four-week period. Will you extend this? In the latest week, 49.6 per cent of test results authorised in NHS Wales laboratories were returned within a day, and 74.1 per cent within two days. Why are the percentages getting smaller, and what specific measures will you take to reverse the trend?

I'll deal with the last point first. When it comes to improving testing turnaround, it's a real concern of myself and the Government and the health service. We have an improvement programme in place identifying areas to make a practical difference to the operational delivery to speed up testing turnaround times. There's already action in place in terms of courier services and more action taking place, together with colleagues in Public Health Wales, to improve the efficiency within our labs. 

When it comes to the broader approach, we will be publishing a revised testing strategy. I'm expecting some advice for me to consider and make a decision upon, and I expect to have that testing strategy published before the end of next week. So, we'll continue to learn from evidence and from experience as we look to revise our approach for the future, with the sole focus of saving lives and helping Wales to safely come out of lockdown.

Thank you again. Now, from many people I've spoken to in the social care sector and care home staff, they feel badly let down by the First Minister. Do you agree with me that he should apologise for failing to make the £500 payment announcement without contacting Her Majesty's Revenue and Customs or clarifying whether the bonus would affect any benefits before making the announcement, or is this down to you? Should he urgently provide a date for when the bonus will be paid, stop dithering, and use Welsh Government's powers and funding to gross up the payment so to ensure that social care workers benefit by at least this £500? I would also like to see him ensure that community hospice staff are eligible for the bonus. Do you agree with those sentiments, health Minister?

Well, as you'll recall from listening to the First Minister earlier, we continue to talk with the UK Government to try to make sure that social care workers in Wales receive the full £500. I do not think that it would be a good day for HMRC if they picked the pocket of poorly paid workers in the social care sector, and we will look to exhaust all of the avenues of discussion before making any further choice, but it is a matter within the hands of the UK Government. This payment should not be a windfall for the UK Treasury.

Plaid Cymru spokesperson, Rhun ap Iorwerth.

Thank you very much. First of all, may I welcome the First Minister's statement that he's considering stronger guidance on the use of face coverings? We are focused on making face coverings compulsory in certain indoor arenas. The evidence on the benefit of that, and on the likelihood that the virus is spreading through the air, is becoming more prevalent. So, I'm looking forward to a robust statement at an early stage on that.

In turning to the health committee's report, the report was published today and it raised some fundamental questions on the Welsh Government's response to the pandemic. And one of those questions is on the pace of protecting the care sector. Now, I've seen some figures that seem to suggest how many antibody tests have been carried out in various sectors in Wales: 13,000 health workers have been tested; 9,000 workers in educational hubs have been tested; but only 75 people working in the care sector. Now, does the Minister understand that that reinforces this perception that this sector wasn't prioritised properly at an early stage during this pandemic and it's still not being prioritised now? 

I don't think it is a factually accurate conclusion to reach that the Government and our partners did not prioritise the social care sector in terms of the amount of support we've provided, both in extra cash support on an emergency basis, and the further amount of support that we're looking to find at a hard-pushed time as well. We've also provided significant amounts of personal protective equipment free to the social care sector at a time when their normal supply lines had collapsed. So, there's been a significant amount of support, including staffing as well.

When it comes to the antibody tests, I don't think that the figures are accurate. I'll happily look at the figures again and come back, not just to the Member, but more generally, because social care workers, health workers and education workers are three of the priority groups for the antibody test. And the antibody test is actually to help us understand the prevalence of coronavirus around the country at this point. The evidence on how long term an antibody response is, or indeed, the usefulness in terms of people's transmissability to other people, or indeed to help people recover or be immune from a further incidence of coronavirus is not clear, but it does certainly help us to understand how far coronavirus has spread. We'll continue to use the tests available to us to do so, and you can expect to see more of that in the testing strategy that I have already referred to.

I want to turn to data, now, if I may. We all welcomed the figures earlier this week, when there was another day when not a single COVID-19 death was recorded in Wales; we want more days like that day, of course. The figures also show that only seven new cases of COVID-19 were recorded on the Public Health Wales dashboard—again, that's good news. But we have to be careful with these figures, I think, because the figures could be inaccurate, because I do understand that as many as 35 to 40 per cent of new positive cases may not be being announced in these ways if they are tested in laboratories that aren't part of the NHS.

Will the Minister provide an assurance that everything will be done to ensure that every positive result is recorded and demonstrated on up-to-date dashboards and also that we can see in what areas these positive cases are emerging? Also, please can we ensure that GPs are informed when their patients prove positive, because, from speaking to GPs in Anglesey, they receive no information at all?

I think there are three points that I'd make in response to those. The final one is to do with the point about GPs being informed. It should be available as part of the patient record; it should be available to general practice. And if the Member has individual instances that he's aware of within his constituency, then I'd be very pleased to see those to make sure the system is working as it should.

The Member will recall that's part of the reason we weren't able to—. Well, I chose not to participate in the UK testing programme, because, at an early stage, we weren't able to have the results of those tests fed back reliably and on a regular basis within our system. The Member will recall there are issues ongoing in Leicester about how regularly that information is provided within the English system.

That leads me on to my second point, which is that, of our positive cases, we do already provide information on the number of positive cases that come from the UK testing programme that we've opted into, in particular in drive-through centres, as well as that the Public Health Wales labs provide. So, yesterday, there were three positive results from the UK programme, and, together with the seven from Public Health Wales labs, that means 10, in total, positive cases across Wales.

And that goes into my third point, that, on all of the data we're currently seeing, we're seeing a positive downward trend in terms of the incidences of coronavirus, despite the fact there are two outbreaks in north Wales and the incident around Merthyr. So, that's on things like hospital admissions, positive cases, and, indeed, the use of critical care. We're all seeing things move in the right direction, and that's why we're able to make cautious but progressive steps to ease Wales out of lockdown. But the outbreaks are a reminder that none of us should become complacent, because coronavirus, sadly, has not gone away.

Yes, quite right. I think you confirmed what I was saying in your response there on the dashboard data. You say seven positive tests in Wales, three in non-NHS labs; the dashboard I saw only had those seven. So, that shows that all the data has to be presented in an up-to-date way, wherever the tests are processed.

I'm going to turn, finally, to another area where we need faster test results, and that's cancer diagnosis. The COVID crisis has led to a number of very worrying predictions about excess deaths from cancer that are likely to occur this year as a result of screening programmes being cancelled, people being too afraid to visit the NHS, and, of course, treatment being postponed. So, it's more vital than ever that we get fast test results where cancer is suspected. So, will you therefore adopt a cancer rescue plan that has more ambitious targets for testing and treatment than have previously been the case, because of the probability that the NHS will be identifying cancers at a later stage?

[Inaudible.]—cancer information, and I can give the Member the assurance that the decision I made to both introduce and trial the single cancer pathway is going to be the path forward when we restart new performance measures in the future, as we progressively restart more forms of NHS activity. I have already decided that we will not be reporting the old measures. I think it would be unhelpful and confusing to report the old measures under the urgent and non-urgent pathway, and we will only be reporting as the single cancer pathway, which, as the Member knows, has been supported by both clinicians and the third sector cancer charities. And that, I think, will give us a much more accurate indication of what is really happening in terms of cancer treatment and waits. So, I expect that to provide the level of clarity and transparency in how quickly we're getting through the number being referred in to our cancer services, as we deal with needing to restart services. Because, as the Member will know, endoscopy services were suspended during the pandemic; they're now restarting. But that does give us significant challenges in a range of our work, not just in cancer, but we'll continue to be open and transparent about what we're doing and what that means for people here in Wales.

Brexit Party spokesperson, Caroline Jones.

Diolch, Llywydd. Minister, thanks to the hard work and dedication of our health and care staff, as well as the enormous sacrifices by the Welsh public, we are over the worst of the coronavirus outbreak for now. As the chief medical officer rightly points out, we could be facing a renewed threat from COVID-19 come the autumn. What plans does the Welsh Government have in place to ensure that the NHS in Wales can deliver routine services at the same time as dealing with COVID-19? Or do your plans foresee a further suspension of everyday NHS services? Thank you.

There are two points to make there: the first is that, yes, we look at international surveillance, what happens in other countries as they reach their winter. It's part of the challenges around Melbourne, but it's also part, for example, of a concern we have about South America as they're approaching their winter and, in particular, the challenges of overcrowded housing and people who are already vulnerable. That is a real factor of concern for us, and that does inform our plans here about both restarting the NHS, as I said before, the plans we already have—the need to have COVID-positive or suspected pathways and non-COVID pathways, the green and the red demarcation, which will require extra work to be done over the summer, physically in the environment in a range of our NHS treatment facilities—and we'll then need to think not just about restarting that activity, but how much and how far we can maintain that through the winter, when we know that there's normal, regular pressure on the health service. But if there is a further spike in coronavirus through the autumn or the winter, then it is of course possible that I may need to make another decision to suspend parts of our health service, because of a much greater harm that could be caused by having a spike in coronavirus and not changing the way that our health service delivers its service.

So, all of those things are possible, but my plan is to get as much as possible of normal treatment to resume in the national health service through the summer and to take all necessary steps to help people to continue taking measures to reduce the prospect of a further upswing in coronavirus here in Wales.

Thank you, Minister. Of course, the biggest threat this winter comes from dealing with a bad cold and flu season alongside a COVID outbreak. Minister, will you commit to expanding the availability of the flu vaccine and making it available earlier? Pandemic restrictions will make delivering the flu vaccine much harder than in previous years, so we need to begin roll-out preparation now. Minister, last year, many people did not receive their vaccinations until December, and there were widespread shortages. Can you guarantee that these shortages will not happen this year? Thank you.

Well, I can say we're already looking at this year's flu programme and, in particular, at procuring extra stocks of the flu vaccine. There is work going on across Wales on extending eligibility for the NHS flu programme. I want to have a much higher uptake of both staff who work with vulnerable people as well as those people who qualify for an NHS flu jab to actually take up that entitlement.

There were particular issues with the form of the vaccine supply last year. We're in early conversations. That is work not just within Wales, but also it's a conversation that I've had amongst the four Cabinet health Ministers across the UK, because we do actually share resources in the way we procure the flu vaccine. So, we're looking at an earlier and more significant procurement to make sure we're able to help people protect themselves and their families, of course.

We do know that vulnerability to flu is a potential issue if we do see a further increase in coronavirus itself. I'm not so much concerned that there might be a difficult flu season, but an average flu season with a further increase in coronavirus could have really significant consequences and real harm across Wales, so it's one of my more significant concerns now in planning for the autumn and the winter.