Item 4 on the agenda this afternoon is a statement by the Minister for Health and Social Services on the COVID-19 vaccine strategy. I call on the Minister for Health and Social Services to speak to the statement. Vaughan Gething.

Thank you, Deputy Presiding Officer. Yesterday, I published our national COVID-19 vaccination plan for Wales. The plan was published on the same day as we commenced daily reporting on the number of vaccines administered in Wales. As of this morning, more than 91,000 people across Wales have now received their first dose of one of the two approved COVID vaccines. This marks significant progress given that we are still just over a month since NHS Wales mobilised the biggest vaccine programme that our country has ever seen.

The plan reflects months of detailed delivery planning, and sets out our national strategy and priorities for the coming months. The plan sets out three key milestones. By mid February, all care home residents and staff, front-line health and social care staff, everyone over 70 and everyone who is extremely clinically vulnerable or the shielded population will have been offered the vaccination. By the spring, vaccination will have been offered to all the other phase 1 priority groups. This is everyone over 50 and everyone who is at risk because they have an underlying health condition. Completing all groups identified as priorities in phase 1 will protect those groups in which we understand that 99 per cent of all avoidable deaths occur. By the autumn, vaccination will have been offered to all other eligible adults in Wales, in line with any guidance issued by the independent expert Joint Committee on Vaccination and Immunisation. 

By the autumn, the aim is that 2.5 million people in Wales will have been offered immunisation—all within a matter of months. This is a mammoth task for NHS Wales. It is worth noting that no decisions have yet been made on phase 2 and how to prioritise that phase of the roll-out. The JCVI will however provide advice on the next phase for the four Governments of the United Kingdom to consider.

The milestones in the plan are predicated on sufficient supply of vaccines being available. We have received assurances from the UK Government that supplies will be forthcoming. However, ultimately, this is a matter outside of the Welsh Government’s control.

The plan also includes three markers, which we are aiming to achieve as part of the journey towards achieving milestone 1. These are that, by 18 January, all front-line Welsh ambulance staff will have been offered their first dose of the vaccine. This is part of our aim to vaccinate all front-line health and care staff as soon as possible, given the pressure that our NHS is under and the critical role that our health and care staff are playing in this pandemic. By the end of January, all care home residents and staff will have been offered their first dose of the vaccine. Whilst many care home staff attended our vaccination centres for their first dose of the vaccine in the early weeks of the programme, outreach into care homes was difficult because of the well-advertised challenges associated with the Pfizer-BioNTech vaccine. They are a priority focus following the introduction of the Oxford-AstraZeneca vaccine last week. And also, by the end of January, our aim is for at least 250 general practices across Wales to be part of the delivery model. The role of primary care is a critical element in our programme: 250 practices coming on stream in a matter of weeks illustrates the opportunities for scale presented by primary care. Scale is one thing, but another key consideration is accessibility, and primary care solutions will ensure that vaccines are offered closer to home for those that need it most. 

The plan lays out our medium-term approach for vaccinating 2.5 million people in Wales. If the last year has taught us anything, it is that things will change. Our plan will be updated at points to reflect these changes. It will also be updated as we move through the milestones and greater clarity emerges on the next steps, particularly with respect to phase 2 of the programme.

However, I do need to remind Members and the watching public that the situation in Wales at the start of 2021 remains very serious. Cases of the virus are very high, and a new, more infectious strain of coronavirus—the Kent strain—has emerged right across the UK, and is circulating in all parts of Wales. This is a race against the virus, and the vaccine programme provides us with great hope. Reaching the finish will be a marathon effort over the coming months ahead. The vaccine is not a quick fix, but I am confident that team NHS Wales will deliver a vaccination programme that we can all be proud of, and it will help to save many lives.

Just as our NHS, local government, the military assistance being provided, and volunteers all have a part to play in delivering the largest vaccination programme in history, we all have a part to play to keep Wales safe: to keep washing our hands regularly, to maintain a good distance with other people not from our household, to wear a face mask where required, and, yes, to make sure that we're providing good ventilation wherever possible. We all have a part to play in helping to keep Wales safe. Thank you, Deputy Presiding Officer.

Thank you, Minister, for your statement this afternoon. If I could place on record my sincere thanks to all involved with the vaccination campaign, because the intensity of the effort must have been huge, and will continue to be huge and demanding as we go forward.

Could I ask a series of questions, please, Minister, in relation to the plan that you put forward yesterday and given the statement on today? It is well documented that, regrettably, here in Wales we are behind other parts of the United Kingdom. How will the plan enable us to catch up and overtake the other parts of the United Kingdom in the roll-out of the vaccine, and what lessons have we learnt from the start of the campaign that need to be ironed out? We heard yesterday that two fifths of 80-year-olds in England have been vaccinated. Can you update us today how many over-80s have been vaccinated here in Wales? Because, certainly in my mailbox, I'm getting lots of constituents of that particular age bracket addressing their concerns about not being contacted.

Yesterday, only 5,121 people were vaccinated here in Wales. How will this plan enable the roll-out of the vaccine to speed up the numbers beyond that 5,121 that's being done on a daily basis? And can you confirm if the Welsh immunisation service is now up and running? Training for vaccinators is also critically important and, as we go forward, it is going to be vital that we can bring vaccinators on stream to help in the national effort. Can you confirm what measures you have taken to facilitate the speeding up of training for vaccinators and, indeed, the ability for retired medical professionals to come back into service to help in the national effort?

You refer to the 'second phase' in your statement. I'm assuming that means the second round of vaccines, but I'd be grateful to understand exactly what you mean by the 'second phase'. But I'm taking it to mean the second round of vaccines, and when people will be called up for those vaccines. So, I'm assuming we have to wait for more information to come forward.

This morning, myself and the constituency Member for the Vale of Glamorgan were approached by a Barry care home, where the vaccination team had turned up with little or no PPE to perform the vaccinations within that care home, other than masks. Can you confirm that, under the plan, PPE will be an integral part of the delivery mechanism of the vaccination programme in Wales and that there's a plentiful supply of PPE, so there's no reason why teams should be out in the community delivering the vaccination without PPE?

It's important, also, to understand how many no-shows are actually happening when people are booking themselves in. Have you any numbers that you could provide Members with this afternoon to show the no-show rate at vaccination centres here in Wales? And when will all counties have a vaccination centre? The First Minister was asked on this specifically in First Minister's questions, and I note today that Barry, the largest town in Wales, in the council area of the Vale of Glamorgan, does not have a centre, as does Pembrokeshire not have a centre designated. Are you in a position to tell us when that map might be filled in so that all counties in Wales will have that vaccination centre?

And finally, it has been alluded to, the fact that to speed up the vaccination programme, there is the opportunity for 24/7 vaccination. Is this something that's under active consideration under the plan, Minister, and if it is, are you able to tell us how this might accelerate the speed of vaccination across Wales? Thank you very much.

I thank the Member for his series of questions. Sorry, there's been a problem with my computer. I'll just get rid of this.

So, in terms of the series of questions that he's asked, I think he asked a couple of questions that were essentially the same question in a different way. The plan that I announced yesterday will help us, and it sets out how we're going to speed up the roll-out of the vaccine, and that is, in particular, in relation to the use of both the Pfizer-BioNTech vaccine, but also the Oxford-AstraZeneca vaccine. The significant increase in primary care—and I should say that I had a very constructive meeting with the Royal College of General Practitioners earlier today—will allow us to have a significant reach in terms of access and speed. And that will come alongside not just the first two weeks of the Oxford-AstraZeneca vaccine that we've got—and you'll have heard the First Minister say that we've had a bit over 20,000 for each of the first two weeks—but we're expecting a much bigger increase in vaccine supply for the third week. Getting primary care up and running and ready is really important for that third week where we'll have much greater supply. I've seen some of the concerns that some primary care deliverers have had that they could do more if they had more supply, but we're actually running, with that Oxford-AstraZeneca supply, with the supplies that we've been given. I do think people in all parts of Wales should take some assurance from the fact that we expect a much more significant supply to come into Wales, which will then be delivered in Wales from next week in particular. 

On not just the points about access, I think it's probably worth dealing with your points about vaccination centres. We expect every local authority will eventually have a mass vaccination centre, but I think that perhaps there's confusion between a symbol and the reality of access. Delivering the vaccine through primary care with the Oxford-AstraZeneca vaccine will mean much greater ease of access to people. When you've got several hundred general practices working, whether from their own premises, or others that they'll liaise with in conjunction, especially, with local authorities and health boards, that will practically mean that access will be made much easier. I don't think the public will be much bothered about whether there is a triangle on a map in their local authority or whether they can have easy access to a vaccination venue when it's time for them to receive their vaccine. That will be about people going to those venues, whether in a local health centre, whether a hotel or a converted restaurant, a bowls pavilion, or indeed a mass vaccination centre. I think the public want to know, 'When I will get easy and good access?' That includes our delivery, of course, in care homes. 

On your question about the Welsh immunisation service, yes, it's up and running. No, I can't give you the figures on the number of no-shows today, and I don't have a figure to give you about the over-80s, but when we're publishing our weekly dashboard, we will be providing more information on some of the detail that you've asked for. And in terms of the lack of contact, everyone will start to be getting a letter from today onwards, from health boards and local government partners, to set out the approach locally and to give people some of that reassurance that the health service hasn't forgotten them. 

When it comes to training vaccinators, we've worked with people in Health Education and Improvement Wales and across the service to make sure we make it as easy as possible. I've seen some of the concerns in every nation of the UK, including, of course, in England, where people are concerned the process is too bureaucratic, including for retired staff to return to practice to help with the programme. So, we are looking again at what is possible to do. Now, it's entirely possible that I don't need to make a single decision on that. I've been very clear about the policy directive to make this as quick as possible and as easy as possible for trusted staff, whether volunteers or not, to deliver the vaccines. If there is a need for me to make ministerial choices, then I'm more than prepared to do so to speed up the programme. 

When it comes to phase 2, I was actually referring to phase 2 in terms of the priorities list. I think in your question you were really asking me about the second dose, and that's partly about supply. So, expect to see the second dose starting in earnest once we get through to March, when more and more people will be starting to get their second doses come through, and then into April as well, and that is part of what we'll be doing. You will have noticed we're already reporting on how many people have had their first dose and their second dose in the totals that we provide. So, we'll be transparent about the progress we're making. 

I'm not aware of the individual issue about the Barry care home you refer to, but PPE supply is available, it's in plentiful supply. I think Members right across the political spectrum can be very proud of the way that we have procured and supplied PPE here in Wales throughout this pandemic, at good value for money, for all of us, for all taxpayers, and without a single whiff of corruption in the way that that PPE has been supplied and procured. 

When it comes to the 24/7 suggestion, that is something that health boards are looking at. I'm not setting an objective that everyone must have a 24/7 delivery model; I want the best and the quickest delivery model available. If we set an objective that everyone must deliver 24/7, that may not achieve that. I think some health boards will trial it to see if it really does not just expand access but speed of delivery, and I look forward to learning from that. We won't know until that's essentially been tried, but like I said, my directive to the system is to go as fast as possible, as safely as possible, but to do so in a way where we look after our staff and our volunteers who are delivering the vaccines, and make it as easy as possible for the public to get those vaccines as well. Thank you, Deputy Presiding Officer. 

Thank you for the statement. It's good to have the chance to make a few comments and ask four or five questions as well. I'm glad we now have a rough guide to the timetable that the Welsh Government is hoping to follow. I wrote to the Minister on Saturday evening and I asked for targets so we could measure performance against them. But can I just have a little bit more detail, please? You talk of hitting priority groups by spring. When is spring, for example? Are we talking start of spring or end of spring? I think we just need a bit more detail on that.

The Minister has told us that daily vaccination number updates will now be given, but I think we need more than a universal figure regularly. As I asked in that letter, we need a daily update on how many of each type of the vaccine we've received, how many of each type of the vaccine has been distributed to each health board, how many have been administered, and to which priority groups, on health board and local authority areas. I'm pleased to hear others calling for detailed data as well, including the Royal College of Physicians. This is really important in giving focus to your work and in letting the public, as well as us, whose role it is to scrutinise Government—we need to know how we're doing and we need to have confidence that we are on track.

Can I also ask for a tightening of the prioritising within the health and care workforce, after reports that some non-patient-facing staff have been vaccinated? I know that one health board says that's because vaccines have been given to some non-patient-facing staff at the end of the day, to stop any prepared doses having to be thrown away. I've suggested that perhaps we could follow the Israel model, where unused doses could actually be offered to the public on a first-come, first-served basis, at the end of the day. I also pointed out other innovations in Israel that have made them world leaders in vaccination, including seven-day working and drive-through vaccination centres, for example. You say maybe you don't want 24/7; we certainly need the seven.

I'd also like to know what you're doing on the ground to ensure that your own priority list is being followed. I know, for example, that GPs in my own constituency wanted to follow your guidelines, get all care home residents done in one day—all in one go, 500 of them; they are the number one priority—but instead, doses were given out to do some community vaccination of 80-year-olds and over. Don't get me wrong, we need our most senior citizens in the community vaccinated with real speed, but that doesn't actually follow the priority list you have given to us. Perhaps you could comment on that. If we have a priority list, we need a strategy to stick to it, surely.

I'm hearing from other GPs, in other parts of Wales, frustrations at what appears to them to be poor strategy—sending vaccines to each surgery in turn, rather than build up area-wide capability. I quote one who's made public comments in the Hywel Dda area here:

'If you are unlucky enough to be a patient in one of the later allocated surgeries then you have to wait for the vaccine—even if you are in the top priority group....This should be about priority groups not postcodes.'

And finally, there are other priorities—I hope you'd agree with me on that—beyond the top nine. I'm not suggesting deprioritising any of the top nine priority groups, but be it the police or teachers or others in public-facing roles, can you explain how you intend to expand that priority list to those who need protection most, outside the priority groups we now have?

I'll end with a sporting analogy. People have compared how things are going with the roll-out in Wales with other UK nations. It's natural that people do—we've been falling behind. The First Minister has said it's not a race, that it's a marathon not a sprint. Those who take their marathons very seriously pretty much get out of the blocks at sprint pace, and the winners pretty much sprint the whole 26 miles. I'm not talking about a race to beat other nations—that's neither here nor there—but we do need to know that we are racing forward as quickly as we can, for the benefit of the citizens of Wales, and speed is of the essence.

Thank you for your comments and questions. Just to make clear, I've said repeatedly that this is a race against the virus; it's a marathon effort, over many months, and we all want to move as quickly as possible. I don't think I can be any clearer about the approach of the Welsh Government and the direction that our national health service is taking. I really do think we should all be very proud of what our staff are doing—staff who are under pressure. As ever, there are times when criticism of the programme can be taken personally by staff. I appreciate that most Members will say they're not criticising staff, they're criticising me as the Minister, but there is a need to think about the entirely legitimate question that Members will have for me and for health board leadership and the impact that has on our staff who are working under incredible pressures. 

Turning to your first point about spring, spring is the season and it's not a never-ending season. So, you won't have this sort of idea, as David Jones, when he was in the Welsh Office, suggested, that spring and summer actually then went on, at some point, into the autumn and the winter. The reason why we've given spring as an outline timescale is that that really is part of where we are with vaccine supply. If I had absolute certainty of vaccine supply through to the end of April, I could probably give you a much clearer timescale. But some of those are uncertainties. To be fair, I don't think the UK Government are going to be able to give me a cast-iron guarantee on all deliveries up to the end of April right now. We'll give more detail, as we review the plan, about when in the spring we think we'll be able to complete all of the phase 1 priorities. But, just to give some reassurance, by the end of spring is when we expect to do that.

If there is a challenge in vaccine supply, if there is a challenge in delivery, then we're completely upfront about that. You'll recall that we had a COVID outbreak in the Cardiff mass vaccination centre. We lost more than two days of delivery, because the outbreak had to be dealt with, the place had to be cleaned and staff who weren't contacts had to be brought in to continue running the centre. So, it is always possible that events will intervene, it is always possible that supply will intervene, but if there are any of those challenges, we'll be absolutely upfront about what the position is and, crucially, what we are still able to do to make sure the programme carries on. 

In terms of the significant detail that you're asking for in terms of daily figures, I just don't think that is the priority issue for us at this point in time on a daily basis. We'll have weekly detail that will give much greater colour about the delivery of the programme, and I am sure that, once people are used to that weekly set of data, people will be ready to ask questions and to look at what that data provides in detail. If I were to try to make a choice to say that I wanted that level of detail on a daily basis, we'd need to put more time, energy and effort into data entry and to analysis to get it right, and I think we'd end up having to give significant caveats about the information. There's a choice about whether that investment in data entry to meet with the Member's demands for individual daily accounting is the right choice, as opposed to wanting to have a greater focus and priority on the delivery end. But there will be regular information each week that we'll provide to Members and the wider public. 

On your point about prioritisation—I've been asked this question a couple of times—there appears to be a handful of examples that I think health boards have looked at to understand what's going on. I don't have any problem at all with end-of-day doses, to make sure they're not wasted, being offered to health or care staff who are nearby, or, indeed, to the public. I don't think that's the greatest policy question that I need to address as the Minister with the responsibility for vaccine delivery. My concern is that we adhere to the prioritisation list we've got, that we make sure that we don't have leaking of people coming into that group who are, somehow, gaming the system, which is a concern that I've had. Some people have expressed to me that, somehow, they've been able to jump the queue in a way that isn't simply about a handful of doses left at the end of the day that I don't think anyone has any particular concern about. I've checked again with health boards, and my understanding is that they are running through the prioritisation list properly. But it's up to all of us to do the right thing, and if you're offered a link to jump the queue over other people who are undertaking patient-facing work, there's a responsibility on you not to queue jump and put yourself ahead of other people who are putting themselves in harm's way each and every day on our behalf. 

When it comes to seven-day working, we are already seeing lots of working over the weekend, and I do expect that every health board will be undertaking some seven-day working in the vaccine delivery programme. I hope that's helpful, just to be straight about that. General practitioners are working with health boards on priority delivery. They're also working with local government. Every health board and set of local government partners are meeting over the coming days, if they haven't met already, to run through the detail of their programme. They'll be able to go through what they're able to do with primary care to make sure they have appropriate premises, because, as I said, many primary care premises will be fit-for-purpose premises to run a vaccination centre from—a local one. Some of them, though—and we'll all be aware of those general practitioners who are working from, essentially, converted terraced houses—may not be  appropriate in terms of a venue for vaccination. But this is about how we have appropriate venues within local communities that are in much easier reach for people to allow access and an increase in volume and pace. 

When it comes to the question about occupational groups and the priority list, I think I've been very clear about this and I'm happy to reiterate the position. We have from the JCVI an endorsed list of priority groups that will help us to avoid 99 per cent of avoidable mortality—that's phase 1. If we add into that groups who are outside that, then what we will do is we will deprioritise people who are in the most vulnerable group. Whether it's teachers, police officers or any other group, if they come into phase 1, then someone else will be deprioritised who is of greater need. Think about it this way: if you're thirteenth in a queue, and you move up to tenth place, then you can't say, 'I'm not asking for anyone to be deprioritised, I just want to go to tenth.' The people who are ahead of you are now behind you. And the very clear advice we have had is that if we were to do that, for whichever the group of front-line workers it is, then that would mean that we would knowingly be making a choice that would put other people at risk, and that would cause avoidable hospitalisation and mortality.

I'm grateful to the Member for raising the point, and I would reiterate that that's why we have this approach. It's not a finger in the wind list, it really is about protecting the public and about saving lives. I know that the Member understands that and will support that approach; other voices, of course, have taken a different view and have demanded that we take an entirely different approach. I hope Members across the political spectrum understand that's the choice we're making. That's the decision that I have made here in Wales, and I'm not going to make an alternative choice that may keep an individual group of stakeholders happy for a few minutes, but what I'm sure will cause much greater concern and consternation and, frankly, to avoidable mortality.

Thank you. We've had two questions and we're two thirds of the way through the allocated time for the statement, so if I could just gently remind people about the need to get everybody in. I've got quite a few speakers. Alun Davies.

I'm grateful, Deputy Presiding Officer. I have two questions. The first relates to the speed at which those over 70 and with a condition that makes them clinically vulnerable will be offered a vaccine because they will be, clearly, at elevated risk, and it's important that we're able to address those. But also people who share households with people who would not fit into one of those vulnerable groups, but, clearly, the household is a single family unit, and if we are vaccinating one part of that unit, it seems to make sense intuitively to vaccinate the whole of that family unit to provide that protection around a vulnerable individual. 

The second question is about unpaid carers. We all know that unpaid carers are the great army of people who take care of some of the most vulnerable people in this country. What is the place of unpaid carers? I think, if there's a gap in this strategy, it is those people who are taking care of vulnerable adults and children everyday. 

And finally, Minister, members of staff at special schools. I noticed that you were saying that those staff who do provide care—intimate care—and support for children and children who are particularly vulnerable in special schools will be a part of the priority list. And I was wondering where they would be within that, and when they could expect to receive a vaccine. Thank you.

Thank you for the questions.

So, on the speed of the over-70s and the clinically extremely vulnerable, otherwise known as the shielded group of people, we're expecting to have offered all of those their vaccination by the middle of February. That is for them as opposed to the whole household. We have asked, and there have been a number of questions that have gone back to the JCVI around the space, including the question on unpaid carers. They'll continue to look at the evidence of how we can provide the greatest benefit in terms of avoiding harm and mortality. But I understand entirely the case that is made around unpaid carers. It is entirely possible we'll see some revised advice, because that's exactly what happened with special school staff who provide intimate care: we looked again. And they're analogous, essentially, to social care staff who provide intimate care as well. So, they will be prioritised within this first phase group, and so we will be looking to make sure that they receive offers of vaccination. It's a relatively discrete group of staff, and that is because their care is directly analogous with the care that you would expect some front-line health and care workers to provide.

I'll ask again with our chief medical officer about the questions we've gone back to the JCVI about, both questions, but my understanding is that, on unpaid carers, they'll come in in priority groups; they may be in a different priority and will get into the second phase. A number of those carers, if they fit into other categories in the first phase, will be vaccinated according to that category. We know that a number of unpaid carers are actually within the age profiles we're currently dealing with in phase 1, but not all of them will be. So, we're looking at whether there's a way to describe them in a way that people will understand, that the NHS will be able to meet and match, and provide the reassurance that I know that the Member is seeking, and quite rightly is asking on behalf of his constituents.

Thank you for your statement, Minister, and I'd like to take a moment to thank all the scientists and volunteers who've made it possible for us to be discussing this vaccination programme. Yesterday marked one year since the first ever recorded death from COVID-19, and in just 12 months we have approved three vaccines. This is truly remarkable. Minister, how will you be monitoring the effectiveness of the vaccine over time, especially as the period between doses is vastly different from that undertaken during phase 3 trials?

I, too, am concerned about vaccines being wasted due to people not attending, so I am concerned about what plans you have to minimise the wastage. Have you considered just having a list of people, especially teachers or police officers, who could be called in at the end of the day to be vaccinated, ensuring not a single dose of this precious resource goes to waste?

Finally, Minister, how will you ensure that people receiving their second dose will be given the same vaccine as their first dose? We have to ensure that we receive sufficient supplies of each vaccine to guarantee that there will be no mixing of different vaccines. And finally, how will you be monitoring this and what arrangements have you made with the UK Government to secure additional doses of a particular vaccine if required? Diolch yn fawr. Thank you.

Thank you for the questions. On the second dose being the same as the first in terms of the type of vaccine, that is certainly what our plan is. I saw a rather unhelpful New York Times suggestion we might mix them, and that's never been the approach we've planned to take here in Wales, and at this point in time, we don't have an issue with supply. If there was a need to do that, then, I am more than happy, prepared and capable of going to the UK vaccines Minister to make sure that we get the right amount of supply to make sure the second dose can be delivered. We'll be able to have that information, to not just rapidly, but safely deliver doses of the vaccine through the Welsh immunisation service, again, built from scratch here in Wales by our staff.

On wastage, there is already a call-in approach, so health boards already have a backstop approach to the end of the day if there is unnecessary wastage. Actually, our wastage figures are very good, and I expect that'll be part of the weekly information that we provide. We think we can provide a useful figure on wastage that should show very low levels of wastage, and, again, that's credit to the staff delivering the programme.

In terms of having more to learn and the effectiveness over time of the impact of the vaccines, well, of course, we'll learn much of that as we deploy them. We think, from the evidence that we've been provided, delivering the vaccine to the first phase group of people and once we get through all of them will deal with 99 per cent of avoidable hospitalisations and mortality. That, in itself, will make a significant difference to where we are. We'll then learn more about the longevity of the vaccine and issues about transmission, if you've had the vaccine or not, as we move through time. But, as ever, our knowledge base is not complete. We can be confident that we have vaccines that are effective, are providing a high protection in the first dose, but much more to learn for all of us in the months ahead.

Minister, I'm going to take you back to the phase 2 prioritisation if I may, as you didn't quite answer Andrew R.T.'s question on this. I don't think any of us are suggesting that that the phase 1 roll-out be re-prioritised in any way, but I want to know whether you're personally sympathetic to the argument that school staff should be within the phase 2 prioritisation alongside those for which we've already had some indication. I appreciate what you say about JCVI, but towards the end of that prioritisation list, it seems to be mainly about age. All Governments are saying that schools should be the last to close and first to open, so I'd be grateful to hear from you on that.

And then secondly, quickly, with the question that Alun Davies raised about staff providing intimate care for pupils in special schools, can you tell us whether there was a reason why this wasn't rolled out to mainstream schools where staff also have to administer intimate care to those children who need it? Thank you.

Thank you for the questions. To be fair, I think the question about the phase 2 roll-out was confused at the start, and in terms of the phase 2 roll-out and the question about school staff, of course I'm sympathetic to a range of occupational groups who are working as key workers to keep all of us safe. In particular whilst we're staying at home, we're relying on groups of people to maintain some sense of normality in these extraordinary times. I also have sympathy for people who work in the police and other services, but the priority list is all about how we save lives.

When it comes to phase 2, as I made clear in my statement, we don't yet have advice from the JCVI or our chief medical officers on prioritisation within that second phase. And I will be interested in the evidence on how we can avoid the greatest harm, how we can go as quickly as possible to protect the adult population. But to give you an idea of the sort of differential rate that we are dealing with, the deputy chief medical officer, Jonathan Van-Tam, indicated to Ministers across the four nations in a call not that long ago that 43 vaccinations of care home residents would probably save one life, about 100 vaccinations of the over-80s will save one life; to save one life of a teacher who is under 30 without additional vulnerabilities, you need to vaccinate 62,000 people. So, it really does reiterate why we've got prioritisation of the groups we currently have. And when we get into the second phase, we can be confident that we are vaccinating people where there is still a risk, but the risk is much lower. And so that's why we have our priority list approach and that's why we're taking the approach of prioritisation for staff within that. 

May I thank the Minister for his statement and also congratulate and pay tribute to all of those NHS staff who are providing these crucially important services being provided? The situation is grave, as the Minister has said, and I think we need to push the vaccine out to thousands of people as a matter of urgency. The level of the virus remains very high in our communities and we need urgent action to ensure that Wales gets its fair share of the vaccinations, too, because there is a perception out there that Wales is falling behind on vaccination, and people are concerned that the high levels of the virus will bring about new variants again as time progresses and we experience high levels of the virus. It's important that we take urgent action, therefore. Would the Minister agree with me on that?

Yes, thank you, and thank you in particular for, again, mentioning our staff, who are working under incredible pressure to both deliver the vaccination and to protect the public, but also with the ongoing care and treatment for people who are ill from both COVID and non-COVID illness as well. And there is certainly no lack of urgency within our national health service and partner organisations for the task in hand. I understand why there is some concern about 'Is Wales falling behind or not?' I think that, when you look at the progress made over the last week, we went faster than Scotland on a per-head basis within the last week, not as fast as England and Northern Ireland. When we come back to look at this in the middle of February and again by Easter, I think people will be genuinely proud of what Wales will have achieved. I am confident that team Wales really will deliver for all of us in protecting the wider public. 

On your point about the challenges over new variants arising, we have the South African variant and the Kent variant that we know spread much more rapidly, and that's caused a real problem in every part of the UK. So, you'll be aware, as indeed will all other Members who attended the briefing for health and social care committee members today, that there are thousands of variants that have appeared from coronavirus, and they're monitored between the different public health agencies within the United Kingdom. And things only become a variant of concern if they look as if there are difficult or troubling aspects. It's why we are so concerned about the South African variant and the Kent variant. We talk about those and we talk about the Danish mink variant, but we don't talk about the several thousand other variants that have arisen because they've fallen away. So, yes, the greater prevalence, I understand why there may be a concern about will this mean there could be more troubling matters, but actually we have a relatively good surveillance system, and in all the variants of concern the same control measures work: keeping your distance, washing your hands, wearing a face covering where possible, having good ventilation, but crucially avoiding mixing with other households. That is the biggest control measure we can all take, and that will help us to have a very different future with as many of us as possible at the end of this journey together once vaccination provides coverage and protection for the whole population.

Rhianon Passmore. 

Sorry, I don't have a question, Ann Jones. 

Oh, right. Thank you. Mark Isherwood. 

Diolch. Thank you very much for calling me. Further to my question to the Trefnydd earlier, when she suggested I raise these with you now, firstly, given your particular reference to the police, how would you respond to the call by the North Wales Police Federation for policing to be considered for some priority on the COVID-19 vaccination programme. As their secretary said to me in writing yesterday, 'Day in, day out, police officers put their own safety, health and well-being at risk whilst protecting us all. Sadly, in north Wales we've seen many colleagues who have been unwell with COVID-19, some requiring hospital treatment, and many more having to self-isolate.'

And finally, how do you respond to the constituent who wrote to me, calling for autistic adults to be given some priority for the COVID vaccine also, whose brother lives in north Wales, has a learning disability and autism? She referred to the recent research by Public Health England, which found the death rate from COVID is six times higher for people with a learning disability than the general population.

The Llywydd took the Chair.

I think, on your final point, that is something that I know the chief medical officer and our chief nurse are particularly concerned about, because the figures are there about a more significant mortality rate for people with a learning disability. Our challenge is whether it's actually the learning disability or whether actually there are other underlying conditions, and, actually, when you think about it, most of our learning-disability adults have a higher number of people who are entitled to an NHS flu jab, and so, actually, they will be covered within the first phase. If you're like me, and you're entitled to an NHS flu jab because of an underlying health condition, not because of your age—although that time, I hope, will come in due course—then that means that you are in a different place in the list to if I were just being dealt with within my age profile. So, there are a range of other categories that I think will catch up and make sure that people under the highest vulnerability do get seen in order with their priority.

And when it comes to protections for the police, we are already trialling lateral flow testing as an additional protection for the police to help people to self-isolate if they're asymptomatic and to protect our workforce within the police. That's a trial that all forces in the whole of Wales are supporting. In terms of the police federation call to be moved up priority lists, I think I've dealt with that extensively both yesterday in the press conference and earlier today. There is a real impact to moving occupational staff groups around, and an impact on preventing the maximum number of deaths.

I thank the Minister.