3. Will the First Minister make a statement on access to primary health services in North Wales? OQ56982

Well, this is the first question. Under circumstances of sustained pressure, staff in primary care across north Wales work extremely hard to plan and to improve access to their services.

Yes, they are working exceptionally hard and have done so not only over the past 18 months, but in light of warnings about a lack of capacity in previous years. Now, six years ago, the Royal College of General Practitioners carried out a survey of GPs in Wrexham and a third of them said that they intended to leave the profession within five years. Six years later, that has come to pass, so do you regret that you failed to take sufficient action at that point, given the warnings on the loss of doctors in the Wrexham area, and what are you doing do now to put that right?

Well, at the current time, Llywydd, 770 GPs are working in north Wales and eight posts are vacant. So, I just don't accept what the Member says. Over the entire year, 29 posts have been advertised in the north. The number of people training in this field in north Wales has increased over the years, and next year 42 people will come into the profession in north Wales, more than in any year in the past, to be trained as GPs north Wales. Of course there is more to do; we want to expand the primary care teams, physiotherapists, pharmacists, paramedics and so on, to do more in terms of helping people in north Wales to receive the care and the services that they want to see. But there are people working exceptionally hard now; they're working with us to prepare for those things that are going to assist people to do all of that in future in north Wales.

First Minister, according to the community health council, people in parts of Wales are facing a crisis of access to GPs. The Betsi health board estimates that in the local practices it manages demand for appointments has increased by up to 20 per cent, so of course this is exerting real pressure now on our front-line GPs, with them consulting more than ever whilst also using the phone to treat and serve our most vulnerable people.

In Wales, however, this problem has its roots elsewhere. Under the capitation allowance in England, practices cannot have more than 2,000 patients per doctor. With an ageing population of 65-plus, this number is then reduced further to 1,750 patients. However, in Wales, the Welsh Government allows an unrestricted number of patients per doctor. Your regulations also pay no attention to the number of patients over the age of 65. According to the July 2021 GP practice analysis produced by the shared services partnership, at one of my surgeries locally, with two registered doctors, there are 6,072 registered patients. To address waiting times, and then acknowledging the realities of modern life in England after the 2015 election of the UK Conservative Government, they amended the working hours of general practice to include two evenings to 8 p.m. plus a Saturday morning. So, you haven't taken those changes on board.

Can you come to your question now, please, Janet? You're 50 per cent over time.

Will you confirm what steps you will take with your health Minister to review the number of patients that any single practice can have on the books, and also—

No, no 'and also'. Can you get to your question?

—review the working hours of our practices? Thank you.

Llywydd, we work with the General Practitioners Committee Wales, we're in negotiation with them at the moment, as we do every year, about how we best organise and deliver general practice services in Wales. We talk to Welsh GPs for Welsh solutions to the problems that we face. We don't spend our whole time, as the Members opposite do, looking over the border as though it were some land of milk and honey. What we do is we talk to the people who work in the system here in Wales and with them we devise the solutions that best meet our needs and circumstances.

First Minister, during and before the pandemic you were a regular visitor to GP surgeries in Clwyd South, including in Chirk and Llangollen. Would you join me in congratulating all staff at GP surgeries for the incredible work they've done during the pandemic, including, of course, reception staff? Would you also join me in condemning all abusive behaviour towards primary care health staff?

I absolutely do that, Llywydd. I thank Ken Skates; it was at his invitation that I went both to Chirk, a little while ago now, but far more recently to the fantastic surgery in Llangollen, a twenty-first century surgery with all the facilities that you need to run a modern primary care service. It was hugely impressive, Llywydd, hearing directly from the staff there of the way in which they had organised their services during the coronavirus pandemic, the enormous number of vaccinations they were able to do in a single day because of the way that they'd organised the services for that local population, and to hear not just from GPs but, as Ken Skates has said, from the practice manager and others who provide that service. It is a brilliant example and hugely appreciated by that local population. I completely agree, as I'm sure Members right across the Chamber do, with what Ken Skates said: none of those people should be subject to abuse for doing the fantastic job that they have done on behalf of their local populations.