Delivering cancer services involves multiple specialities and interventions, with patient pathways across and recross organisational boundaries. This requires close working relationships, integrated pathways of care and particular attention to maintaining person-centred care. It's important that we have a shared understanding of how to improve cancer services and outcomes. We know that we need to drive down the rates of smoking and obesity to detect cancer at an earlier and more treatable stage, to consistently provide the latest evidence-based interventions and therapies, and to support people properly throughout the treatment pathway. These are fundamental aspects of our approach. They're supported or enabled by changing service models, developing a sustainable workforce and, of course, the best use of digital systems and data.

There's been genuine and close work around this agenda from stakeholders for many years in Wales, and there is much consensus about the best way forward. The challenge now is to capitalise on that in the years ahead and to make the significant improvement in outcomes that we all want to see. There is, though—and again, to be fair, David Rees acknowledges—no escaping the impact of the pandemic. The chief medical officer has been clear that the pandemic causes harm in several ways. Access to normal healthcare, including in this instance cancer care, is one of those ways where indirect harm is caused. From the very beginning, our approach has been to try to protect as much cancer care as possible. NHS Wales worked incredibly hard to do so and provide as many people as possible with the urgent care that they need. However, we have seen capacity and productivity in cancer diagnostics and treatment significantly reduced. This has meant that the number of people waiting for treatment is rising and there is likely to be an impact in terms of outcomes in the years ahead.

Among the recommendations in the report is the development of a cancer recovery plan for the rest of the pandemic. I understand the desire for clarity on a national level, setting out how many procedures need to be done, how many will be done, and how long it will take to treat those who are waiting. The reality is, though, that as soon we put those figures to paper, the pandemic changes what is possible. The difference between a well-controlled and a poorly controlled pandemic in terms of how many people it's possible to treat is a significant one. It goes to highlight where effective control of the pandemic is just as important to cancer and other urgent life-threatening conditions.

I know some have called for ring-fenced capacity for cancer care, and I do understand that, but, as we all know, and I certainly recognise, I'm the Minister for Health and Social Services and not exclusively the Minister for cancer care. I do not wish to oversee or live in a health system where the Government says, 'If your life-threatening illness is cancer, then you will be treated, but if your life-threatening illness is heart disease or something else, then your life is of less value.' That's exactly the same ethical dilemma that meant that we rejected the previous attempts to have a specific cancer guarantee that would have trumped other conditions. I do not believe that this is what cancer clinicians themselves would want to see either. So, I do want to be clear, health boards have detailed plans for the winter on how they'll balance the competing needs that they have to manage. They'll prioritise patients according to their clinical need, whether that is COVID or non COVID, cancer or non cancer. We must and will remain fair and equitable in how we use the available capacity we have to care for people right across Wales.

This Government committed, in March of this year, to replace the cancer delivery plan, as well as the heart and stroke plans, with a successor approach by December. Now, clearly, the pandemic has made that impossible. Whilst it has not been possible to develop such a detailed approach as set out in our existing cancer plan, we have continued to work with stakeholders to set out our aspirations for the next phase of service development and improvements.

I'm keen that we learn the lessons of the delivery plan approach and the pace of implementation in particular. We need to continue to evolve and build on our previous approach, rather than necessarily stick to exactly the same model. The commitment made in 'A Healthier Wales' to a national clinical framework and to quality statements presents us with new opportunities that can push the cancer agenda further and faster, and an approach embedded in these commitments would allow cancer services to benefit from wider developments and improve relative performance of disease pathways in NHS planning.

This is not a step back in approach, but, in my view, a leap forward in ambition. This would include exciting new developments around the cancer workforce and the planning of cancer services, to be underpinned by the development of the new cancer information system and the continued embedding of the single cancer pathway.

We want to double down on our work with primary care, and, more broadly, on earlier detection. There is vital work to be done through our endoscopy and imaging programmes. I want to bring forward our approach to cancer research, and realise our ambitions around holistic support, and these are all, of course, consistent with the recommendations in the cross-party report.

But it did take nine months to refresh the previous cancer delivery plan last time, and we can't afford to wait a similar length of time now before we give direction and to continue the pace of improvement. It's vital that we set out these ambitions and move quickly into determining how they'll be delivered. The scale of the challenge facing us before the pandemic was significant enough, and the case for greater pace and focus on implementation is where we now need to focus our attention.

So, once again, I want to thank those who worked so hard on the report, and, as ever, my thanks to all those people who are working right across our health and care system, in our NHS, in social care and in our third sector partners too, for all that they continue to do to meet the needs of people affected by cancer. I will give careful consideration to the recommendations in the report, and I will be happy to write and provide a full response to the cross-party group regarding its recommendations. Thank you very much for the opportunity to respond tonight, and thank you for your time tonight, Deputy Llywydd.