Thank you, Deputy Presiding Officer, and thank you to the Member for her speech and choice of debate tonight.

Timely access to NHS services has been and continues to be a priority for this Government. From 2015, we made significant additional annual investment in planned care. This resulted in four years of sustained reduction in the number of patients waiting over 36 weeks to start treatment. By March 2019, compared to March 2015, over 36 weeks had improved by 53 per cent, eight-week diagnostic times had improved by 75 per cent, and 14-week therapy times had improved by 100 per cent. Total urgent suspected cancers treated in the year September 2019 to August 2020 was 16 per cent higher than five years ago.

Our NHS Wales plans for 2019-20 were to continue those annual improvements. However, the undeniable impact of the changes imposed by the UK Government on the tax and pensions of NHS staff resulted in NHS plans not being deliverable. The initial impact of COVID in March of this year, combined with the tax and pension debacle, resulted in over 28,000 people waiting over 36 weeks—that is three times higher than in March 2019.

In the early months of 2020, the COVID-19 pandemic was starting to have an impact across global public health systems. Learning from the lessons seen in Europe, our strategic priority was to support our NHS to help save lives here in Wales. On 13 March, I took the very difficult decision to suspend non-urgent planned care. This decision was supported by clinical advice and it aimed to protect our NHS so that it could better help to save lives. Shortly after our bold decision here in Wales, the rest of the UK followed suit. Delivery of emergency and urgent non-COVID care, including for cancers, where it was clinically safe to do so, continued throughout the summer. In recent months, where possible and appropriate, some routine activity has also started to be delivered.

In-patient elective activity from March of this year to July of this year was down 55 per cent in Wales, compared to March to July in 2019. Management information has shown that in-patient and day-case planned care activity has increased by 56 per cent from June 2020 to September 2020. Within the Government, I have recognised that we have to balance the risk of harm from four areas, and this underpins our broad approach across the Government: direct harm from COVID itself, harm from an overwhelmed NHS and social care system, harm from reductions in non-COVID activity, and harm from wider societal actions, including lockdowns. Our decision to suspend routine activity in March to reduce harm from COVID itself has resulted in raising the risk of harm from reductions in non-COVID activity. This has resulted in an unprecedented growth in the planned care waiting list.

The significant number waiting in August 2020 is also seen in NHS England, but also in Scotland and Northern Ireland too. At the end of August 2020, NHS England recorded their largest number ever of patients waiting over 18, 36 and 52 weeks. Without doubt, the condition of some of these patients will be worsening and they will be coming to harm in some cases. This reinforces the need to maintain control of the spread of coronavirus. If the virus takes off again, non-COVID services will be interrupted and more harm will be caused—both directly from COVID, but also in indirect harm from reducing non-COVID activity. I cannot overstate the importance of changing the way that we all live our lives. We must not throw away the hard-won gains from the firebreak and go back to the way things were before we began the last two-and-a-half-week period.

We have, however, prioritised cancer patients and other urgent care patients. I'm pleased to say that, in August 2020, we treated 623 patients on the urgent suspected cancer pathway. This is a 13 per cent reduction on the same period in 2019, but it's also a 13 per cent improvement from five years ago. From June of this year, as part of the quarter 2 plans, the NHS has started to deliver more planned care activity. This has been a challenge to implement alongside COVID care, as there has been a need to redesign services and redeploy staff to operate within protected zones.

The additional safety measures necessary to protect patients and staff remain a priority for me, as the number of patients presenting with COVID continues to rise once again in our communities. This affects both the type and volume of services that are available. Where operating lists, pre COVID, planned to undertake, for example, four operations, the health and safety requirements involving PPE and social distancing have reduced productivity to two. Delivery of face-to-face reviews in our out-patient departments, the hub of many hospitals, has reduced by 40 per cent to 50 per cent of the activity previously undertaken. I am pleased to note, however, that some of this lost activity has been replaced by virtual activity. Around 36 per cent of out-patient activity now is virtual. It is due to the continued dedication of our staff, who have been able to increase our routine activity in recent months, and I remain incredibly grateful to our NHS and social care staff. They have continued to demonstrate their professional commitment and compassion throughout these unprecedented times.

We have implemented new ways of working for supporting patients in different ways. They alone, however, will not be sufficient to stop the continued growth in our waiting times. We will recommence publishing our national NHS waiting times again, beginning on 19 November. This will provide a stark picture of the reality that we face. As I said before, this is not unique to Wales; it is a UK and, in fact, a worldwide problem.

It is important that we as a Government, and the public, realise the size of the challenge. We will need to work together, and each of us—Government, NHS and the public—all have a role to play. The NHS will support the public through education and tools on how to play a greater part in their own care and self-management. But there is no quick fix. It will take years for each UK country to get waiting times back to where they were, and, here in Wales, to continue back on our improvement trajectory. Now, this position is not where the NHS, the Government, myself or anyone in Wales would want to be. We are fully aware of the effect that this is having on individuals who are waiting even longer for their treatment. My officials are working with clinicians across our NHS to understand what more support could be provided to patients while they wait.

Our national rehabilitation framework recognises the key role that rehabilitation can play in supporting people to stay well while they wait. Health boards are starting to develop prehabilitation services to support patients, while they wait on waiting lists, to remain healthy. While in some cases this may actually reduce the requirement for surgery, in others, surgery will still be required. I am clear that this Government remains focused on addressing this important area. My officials will continue to work closely with clinicians to understand the options that we need to consider to address the impact that we see. The options will need to be significant to address the size of the problem. But, together with all nations across the world and here in the UK, we'll be living with the legacy of the effects of COVID for many years, even after we have the virus under control. We all face a significant task ahead. Thank you, Deputy Presiding Officer.