1. Questions to the First Minister – in the Senedd at 1:44 pm on 22 June 2021.
Questions now from the party leaders. The leader of the opposition, Andrew R.T. Davies.
Thank you, Presiding Officer. First Minister, yesterday I visited Tŷ Hafan in the Vale of Glamorgan—a wonderful facility that provides so much care and compassion for children with life-limiting conditions and their families as well. Tŷ Gobaith, obviously, does the same in north Wales. Do you recognise, as it's national Children's Hospice Week, the difference between a children's hospice and an adult hospice, and the level of funding that would be required for the hospice movement here in Wales?
Wel, Llywydd, I too have had the privilege—and it is a privilege—in the past to visit both Tŷ Hafan and Tŷ Gobaith, and to see for myself the astonishing work they do and the commitment of the people who work there. The formula that we use to provide the help that we do to the hospice sector in Wales is a formula that was put in place through the work of Baroness Ilora Finlay in her discussions with the sector. We keep that under review with the sector and talk to them all the time, but it is not a Welsh Government formula that we devise and we impose; it's a formula that we derive through the discussions with the sector and the many needs that it seeks to fulfil.
Do you recognise, First Minister, that regrettably in Wales that formula only delivers 5 per cent of funding to children's hospices, whereas in England it's 21 per cent of funding and in Scotland it's 50 per cent of funding? Now, I'm not for a moment saying that the Welsh Government should step in and jump straight to 50 per cent, but do you believe that there's a journey required to level up that funding stream, especially coming out of COVID and the devastating impact that that's had on fundraising activities for charities? Because it cannot be equitable that such a formula delivers such an imbalance in funding for children's hospices here in Wales at 5 per cent, 21 per cent in England and 50 per cent in Scotland. So, will you commit the Government to reviewing this formula, so that a more equitable formula can be put in place to support the compassionate work that hospices in the children's sector do here in Wales?
Well, I certainly agree with Andrew R.T. Davies, Llywydd, about the important work that the third sector has carried out in Wales during the pandemic. It's been strongly supported by a specific fund that the Welsh Government has made available and which has been put to very good use by the third sector in responding to a whole range of needs, the loneliness needs that we heard about earlier this afternoon, and in the work that it does in the hospice movement as well.
The comparison that the leader of the opposition draws is not a like-for-like one because it doesn't take into account the other forms of support that are available in Wales that are not necessarily available elsewhere. But we remain in a constant dialogue with the sector about both the quantum of money that we are able to provide to it and the way that it is dispersed. It's a fiercely and quite properly voluntary sector, isn't it? It absolutely wants to make sure that it goes on doing all the things that it does to raise its own funds, to draw on the generosity of people in Wales. Agreeing a way of making sure the money that we are able to provide arrives in the right place, arrives in a way that recognises the significant differences between the different sorts of services, the different types of hospice that charities provide in Wales, is quite a complex one. It's why we were reliant on the excellent work that Baroness Finlay carried out in her discussions with the sector, and we continue to try and move forward with the sector in partnership in that way.
Regrettably, I didn't hear a commitment to have a review of that funding formula, although I do accept that it's a complex area and I do accept the point that you make, First Minister, about the fierceness with which the sector protects its charitable status, and rightly so because of the money it raises.
But if I could raise a separate matter with you and that's around the football that's due to take place in the last 16 of the UEFA European Football Championship on Saturday. Yesterday, the health Minister, in my mind rightly, pointed out the restrictions that are being put on international travel for fans to go over to Amsterdam. However, this morning the Danish Government have come out and said that their fans will be able to travel to Holland, to Amsterdam, to watch their team play, provided it's within a 12-hour window. Now, very often fans in the stadium are classed as the twelfth man, helping their team on to victory hopefully, as we all wish next Saturday. Given the change in circumstances for Danish fans, and as I understand it the level of infection is the same in Denmark as it is here in Wales, will you be making any representations to the Dutch authorities to allow Welsh fans to travel, should they meet the travel requirements that are placed on travelling fans to watch in-tournament matches? Because I do believe that the ground has now moved, given that both teams were on the same field yesterday when it came to fans' restrictions, but today the Danish Government have moved to allow their fans to travel within a 12-hour window for Saturday's match.
Llywydd, well, first of all, of course, to congratulate the Welsh team on proceeding to the knock-out parts of the tournament and to wish them every success on Saturday when they face Denmark in Holland.
The advice of the Welsh Government has not changed, Llywydd. It's the same advice that the Football Association of Wales and, indeed, the Foreign, Commonwealth and Development Office have given to fans, that this is not the year to travel to watch Wales play abroad. I'm hugely grateful to those thousands of people who would dearly have loved to have been able to travel, and to have gone to support the Welsh team elsewhere, who have followed the advice that they have been given, which is that they are safer and the people that they care about are safer if they choose to stay in Wales and to support the team from here. We've seen, even in the last 24 hours, that there are players who have fallen ill as a result of coronavirus and won't be able to take part in the next stage of the tournament, and while we are in the position that we are in in Wales, with the delta variant rising and the vulnerabilities that that causes us, the advice of the Welsh Government has not changed. It remains aligned with the advice that comes from elsewhere; our advice is, 'Don't travel, enjoy the tournament, support your team from Wales.'
On behalf of Plaid Cymru, Rhun ap Iorwerth.
Thank you very much, Llywydd. First Minister, around a year ago, you were announcing that schools were to reopen again after a long lockdown, but, of course, we know how much feeling isolated, being separated from friends has had a heavy impact on the well-being and mental health of young people. Now, throughout the pandemic, the proportion of young people waiting over four weeks for an appointment after a referral to specialist child and adolescent mental health services hasn't fallen below a quarter. Is that good enough?
Well, first of all, I do recognise the impact that coronavirus has had on the health and well-being of young people. Every time I meet young people, through the Youth Parliament, for example, that is an issue that they raise with me. Generally speaking, they aren't talking about specialist services such as CAMHS, they are talking about things that they want to see in schools and in communities, things that they can access quickly and access when they are trying to deal with those day-to-day problems of growing up in such an uncertain time.
Now, with reference to CAMHS, of course, they, like every other department within the health service, are trying to deal with the impact of coronavirus on them. They can't see people in the way they did prior to coronavirus, and they are working hard to try and be flexible and creative to find ways of providing that specialist support to those young people who become so unwell that they need that specialist service.
There is, of course, pressure on specialist CAMHS services during the pandemic, but this isn't a new problem. Figures that have just been published demonstrate that in August 2019 almost half of those that received a referral for specialist CAMHS services were waiting over four weeks. I think in Cardiff and Vale it was 85 per cent. But where is the response to that? We see an increase and progress in the vaccination process, as a result of the delta variant. We see catch-up programmes being introduced in terms of education, but when it comes to mental health problems, serious problems, I don't see the same seriousness in the response. Now, as the health Minister in 2015, you said that it was important that the right people received treatment at the right time, but why, when it comes to mental health amongst young people, isn't that happening, even now, six years later?
I do think, Llywydd, that the Member doesn't give proper credit to the advances that were made in the CAMHS service in the two years prior to the onset of the coronavirus pandemic, because the figures did improve, and they improved significantly across Wales. The service was on a path of real improvement. I've answered many questions on the floor of this Senedd, from the time I was health Minister, and it's always been my view that what you need for young people is a range of services so that not everybody ends up being referred to the CAMHS service as the first step in getting help with a mental health issue. Part of the problem with the CAMHS service has been that a very large number of people who are referred to it turn out not to be suitable candidates for that service. All of those young people have got to be assessed, all of those young people then get into the queue in front of other people for whom that service genuinely is the response that is necessary.
What we have to do is to draw the people who are referred to CAMHS when they should and could be very properly provided for by a school counselling service, or sometimes even by people who are equipped with first aid mental health knowledge and understanding in universal services like the youth service, to be able to help those young people who need help of that sort—the help, as I said, Llywydd, that when you talk to young people themselves, that is the help that they most often raise with you: things that are easily available, close to hand, part of the normal run of things with which they are engaged. And then the people who need a CAMHS service will be able to get to that service more quickly. The service was well on that journey. It is inevitably disrupted by coronavirus. And, as I said, the service is working very hard to try and find creative ways in which it can go on providing a timely service for those young people who need it, despite the limitations on the extent to which they are able to do that in more conventional face-to-face ways.
And of course we need to refer people to the right kind of support, but we can't play down the importance of specialist CAMHS services either. And there was an increase in referrals in the first four months of this year compared to last year. But the Senedd's Children, Young People and Education Committee did a lot of work on the impact of the pandemic, and in particular highlighted this problem of the missing middle—the significant number of children and young people who need mental health advice and support but who may not need acute or specialist services. So, I agree with the First Minister on that.
You'll know that Plaid Cymru has put forward proposals for a network of walk-in centres across Wales, offering free and confidential mental health advice and support for young people. Now, First Minister, do you agree that such a network really could—now, in particular, after the pandemic, perhaps—offer a lifeline to the thousands of young people currently caught in that missing middle? And if so, would you and your officials meet with me to discuss pursuing that proposal further?
Well, Llywydd, I'm glad to hear that referrals have recovered. That's good news, and it's part of the general recovery of referrals to health services in Wales in the first months of this year, compared to the immediate post-crisis period in March and April of last year. Of course I am very happy to arrange a meeting to talk about whether that idea would be a contribution to the range of services that we currently provide. There are walk-in services for young people already in a number of different ways, some through the third sector, some through the counselling service that we have in schools. So, we would need to be confident that we were not duplicating something that was already there or undermining a service that was already succeeding in providing help to young people. But to explore the idea and to see what might be made of it, then of course I'm very happy to make sure that such a meeting is arranged.