The next item is the statement by the Minister for Health and Social Services, an update on COVID-19. I call on the Minister, Eluned Morgan.

Diolch yn fawr, Llywydd, for the opportunity to provide Members with the latest information about the public health situation and the outcome of last week’s review of the coronavirus regulations.

Since my last update three weeks ago, there has been a reduction in overall rates of infection in Wales. They have fallen back from very high levels that we saw at the end of October, thanks to the hard work of everyone across Wales. However, we aren’t out of the woods yet. Cases remain high across Wales at around 500 cases per 100,000 people, people are continuing to be admitted to hospital with COVID-19 and, very sadly, the latest data shows that over 250 deaths have been registered involving the virus in Wales in the past three weeks.

Our healthcare system is under intense pressure at the moment from the combination of pandemic and winter pressures; from a spike in emergency demands while also trying to catch up with the treatment and operations that were postponed earlier in the pandemic. Our NHS and care staff are doing a fantastic job under extraordinary circumstances. I want to thank them for everything that they do every day. They continue to play a crucial role in our response to the pandemic, whilst also caring for those who need help.

Wales will remain at alert level zero for the next three weeks. There'll be no further changes to the suite of protections that we have in place. We will not be extending the use of the COVID pass any further at this time. But, we will continue to keep it as an option to help keep hospitality businesses open and trading through the winter months and the busy Christmas period.

We will continue to work with the sector. Our aim is to keep Wales open and to keep Wales safe. Cases may have fallen back from the record high rates we saw just a few weeks ago, but the pandemic is far from over. A fourth wave is sweeping across Europe and many countries are introducing new restrictions to control the spread of coronavirus. Austria started a 20-day full lockdown yesterday, and will make COVID vaccinations compulsory from February. Germany is considering following suit after introducing new restrictions for unvaccinated people in many areas. Slovakia introduced a lockdown for the unvaccinated yesterday. The Czech Government is limiting access to a range of services, and the Netherlands has a partial lockdown in place.

Closer to home, the Republic of Ireland has introduced new protections following a surge of cases. These include a midnight curfew for hospitality, working from home and an extension of its COVID pass to theatres and cinemas. In Northern Ireland, a COVID pass will be introduced for hospitality, nightclubs, events, cinemas and theatres, and the Executive is considering further restrictions to reduce rising cases. In Scotland, the Government is deciding whether to extend its vaccine passport to indoor cinemas and theatres. I believe that they have decided that they won't be doing that at this stage.

Dirprwy Lywydd, vaccination is our best defence against this awful virus, especially when combined with all the other measures we can take to protect ourselves. We continue to encourage everyone who is eligible to take up the offer of vaccination and the booster. We are implementing the latest advice from the Joint Committee on Vaccination and Immunisation to offer a second dose of the vaccine to young people between the ages of 16 and 17 years. And we will also be extending the booster programme to people aged 40 to 49.

Our vaccination programme is now offering first doses to everyone aged 12 and over on the principle that no one is left behind, second doses for everyone eligible, including young people between the ages of 16 and 17, a third primary dose to people who are severely immunosuppressed, and booster doses for eligible groups, including people between the ages of 40 and 49. To date, 90 per cent of eligible adults have had a first dose of the vaccine and 82 per cent have had a second dose. More than 725,000 booster doses have been given so far, with 71 per cent of all front-line healthcare staff, three quarters of people over 80, and 78 per cent of eligible care home residents having received the booster.

Dirprwy Lywydd, the signs from the continent are not good. A new wave of coronavirus is once again sweeping across Europe, and countries all around us are tightening their restrictions. None of us wants to see restrictions back in place in Wales at Christmas, but neither do we want to see people falling ill with COVID at Christmas. This three-week cycle is vital. We need everyone’s help and support to keep the virus under control as we start looking ahead and planning for Christmas.

We will continue to do everything we can through our fantastic vaccination and booster programme; regular testing in schools and putting other protective measures in place to keep the virus out of schools; using the COVID pass in certain settings; self-isolating if someone we live with has COVID-19; and taking all the simple steps that keep us all safe, such as regular hand washing, wearing face masks, and keeping social distance wherever possible. 

The decline in rates since the last review is very positive, but there's still more we need to do. Let’s work together and let's keep Wales safe. Thank you very much, Dirprwy Lywydd.

Conservative spokesperson, Russell George.

Thank you, Deputy Presiding Officer. Can I first of all thank the Minister for the advance copy of the statement, which was greatly appreciated? I share in your pleasure that we're seeing those rates of COVID lower in Wales. That is positive news, albeit from a very, very high case rate, and of course I share your concern as well about the level of those that are sadly dying from COVID.

I wonder if I can firstly ask, Minister, some questions around vaccine passports. The most alarming part, to me, of your statement today was that you are keeping it as an option to introduce COVID passes for the hospitality sector. This is particularly, I think, concerning. In your statement, Minister, you say that you'll continue to work with the sector, so what are they telling you? What are the hospitality sector telling you in regard to the introduction of COVID passes for their sector, and what are their asks, as well? Previously, when I have raised the issue about additional cost, the answer back, the reply, has been, 'Well, if you're going into a theatre or a cinema, then you have to show documentation so there shouldn't be any additional work in that regard.' This is different for the hospitality sector. If you're a cafe or a restaurant or some elements of the other parts of the hospitality sector, you will require additional staff, potentially, to be on the door, and of course there is an issue at the moment in terms of attracting staff to come and work in the hospitality sector, let alone the cost that is attached to it. As this option is remaining on the table, can you outline what discussions you're having with the economy Minister and the finance Minister in regard to additional financial support for the hospitality sector, should you extend COVID passes in this regard? I certainly hope you won't, for all the reasons that I've previously outlined.

In regard to evidence, you referred in your statement today to the case rates in parts of Europe, in some of the continental countries of Europe. Case rates are increasing at an alarming rate. Some of those countries, of course, have had COVID passes for some time, so the data should be there if the evidence is there. I appreciate that in Wales there's time for the vaccine passport to bed in, and that data may not yet be available, but I think it is particularly crucial to have that evidence as soon as possible in regard to the effectiveness of COVID passes, particularly since a number of studies have shown that people who are double vaccinated are just as likely to pass on COVID as unvaccinated people. So, it's all the more crucial that we have the evidence that demonstrates the support for COVID passes, if you believe that is the appropriate way forward, which I, of course, don't.

Minister, if I can ask about mandatory vaccinations, in your statement you correctly, of course, point out that there was, in Austria, a full lockdown yesterday, and they will make vaccinations compulsory from February, and other countries are considering the same as well. I am entirely opposed to vaccinations being compulsory. I think that is the Welsh Government's position and that is your position as well. I'd be grateful if you could confirm that is the position or not. I certainly agree with you that vaccination is our best defence against the awful virus, and I think that we should all be encouraging everyone to take up the vaccination in that regard, but your thoughts on mandatory vaccination would be appreciated. 

Walk-in vaccination centres for booster jabs—I think this is the appropriate way forward, particularly as we go to those lower age groups. You yourself say you want to encourage people to be vaccinated. I agree with that. To do that, I think we need walk-in centres, particularly as we go to those lower age groups, because those lower age groups are going to be in a working environment, and we need to make it as easy as possible for people to have those booster jabs. Now, previously, you have said that you don't support this approach, that it's a free-for-all. Do you still hold that position? I'd be grateful if you could outline which health boards across Wales are considering or have introduced walk-in centres because I think there is a disparity about what is happening across Wales. So, in the context of your view that you have got concern that they are a free-for-all, and also, that some health boards are operating walk-in centres and others aren't, your views in that regard would be appreciated.

And, finally, I'm sure as you have, I have deep concerns, of course, about the state of the current NHS in Wales. Last month, we saw the worst ever A&E waiting times, the worst ever ambulance response times, the longest treatment waiting lists on record—nearly 9,500 people waiting more than 12 hours for emergency treatment. That's 2,000 more people in Wales than the whole of England, and considering England is 16 times bigger, that's a concerning position. We've got one in four patients that are waiting over a year for treatment compared to one in 19 in England. So, the staff, as you say, are doing a fantastic job, health Minister, and what they need, of course, is support to do their job. So, I'm highly concerned, as you are—

You need to ask the question now because your time is up. 

I'm getting to my last question, Deputy Presiding Officer. In regard to the A&E waiting times and many waiting up to 36 hours, can you please give us details about your plan to support our fantastic NHS staff in terms of bringing down those waiting times, and the additional beds that are needed to stop the backlog that we've seen to the extent we have in terms of ambulances waiting outside A&E in hospitals?

Well, diolch yn fawr Russell. I must say, in terms of the vaccine passport, we will, like everything else, keep all the options on the table. I think it would be irresponsible for us, particularly when we see the rates on the continent go through the roof, not to keep everything on the table. So, that option will continue to be on the table. We continue our discussions with the sector. It is true that we're having mixed messages, if I'm honest, from the sector. Some clearly are less enthusiastic about the prospect of vaccine passports, but many, many others are saying, 'Look, if this is what it will take to keep us open over Christmas, then we'll welcome it.' So, they prefer the security of knowing what the situation is likely to be, and keeping it open is really what they are really focused on. 

I think, in terms of the continent, it's clear that the delta variant is hitting them much later than it hit us. So, we know that there's a 70 per cent advantage of the delta variant over the alpha variant, which is why it is really becoming far more transmissible now on the continent. And there's plenty of evidence to demonstrate that indoor places, where lots of people congregate, we are more likely to see the spread of the virus. So, there's plenty of evidence to support that case. And, so, that's what we're keeping our eye on.

We don't have any plans for compulsory vaccinations. We're very proud of the fact that the Welsh public have responded really positively to the vaccination programme. We've got 91 per cent of people over the age of 16 who've had the first vaccination; 86 per cent of people over 16 have had the second dose. And I think we've got to bear this in mind constantly. When we keep on worrying about the situation in relation to a COVID pass—86 per cent of the public have had their vaccination, both vaccinations. It's the minority that's making a lot of noise here, and I do think that we need to be very careful that we're listening not just to the voices of the minority, but we are protecting the majority who've come with us on this journey, who see it and understand their responsibility to their fellow human beings. And I think it's really important that we don't lose sight of that. 

The vaccination plan in Wales, in terms of the booster, it's not a free for all, no; we are doing a very comprehensive programme where we're calling people in an order, where we're following the same order as we did with the first vaccination. Obviously, with Pfizer it's more complicated because people have to wait for 15 minutes after they've had their vaccination. So, it is a more sophisticated and more difficult programme. And, obviously, we have lots of different vaccination programmes that we're undertaking at the same time here. It's a very, very complex mix that we're trying to service at the moment. 

And, of course, we're more than aware of the pressure on the NHS at the moment, and that's why we do have, in particular, when it comes to emergency services—we've put an extra £25 million into emergency care. We are developing these urgent primary care centres; we're completing the 111 call centres; we are developing more same-day emergency care centres to avoid admission into hospitals; and we're implementing far more discharge to assess. So, all of those things are being undertaken with our six goals programme, and, of course, on top of that, we've brought the army in to help us out with the ambulance service, and we are really focused on the fragility of our care service. 

Plaid Cymru spokesperson, Rhun ap Iorwerth. 

Thank you very much, Deputy Presiding Officer, and thank you for the statement. The situation is still very serious obviously, although I am pleased to see figures reducing somewhat, in terms of numbers, and in terms of the positivity rate too. But this afternoon, I'm thinking particularly about Ffion Parry, a 10-year-old girl from Amlwch, in my constituency, who's been gravely ill in Alder Hey hospital, after her body responded very badly to this virus. And I want to wish her and her family well. And that is why we are taking this virus seriously, and that's why each and every one of us, in all parties in this place, need to be considered in our response to it. 

Yes, I understand the frustrations of people that we are still facing some restrictions that are having an impact on our daily lives. But I'm sure I'm speaking on behalf of every politician and everyone who makes laws and regulations, that we look forward to scrapping those laws and regulations as soon as possible, but we aren't at that point as of yet.

A few issues I wanted to raise—. First of all, a lack of consistency in terms of the provision of the booster. I'm grateful to the Minister for saying earlier that an official will look at the situation in my constituency—in Holyhead and Amlwch—where far lower numbers have had the booster in those areas. But I would like an assurance about the steps being taken to ensure consistency in the provision of the booster across Wales. 

Secondly, vaccination, of course, is our greatest protection, we know that. But I am still concerned that there is a lack of action on some of the other fundamentals that could keep us safe. And, when I see pictures or hear reports about trains that are full to overflowing and people not wearing masks as they travel to rugby matches, then, clearly there is still a lack of enforcement. And I would like to know what steps the Government is taking to seek to tackle those problems, and in schools too. It's an issue I've raised time and time again: what's going to be done, as we go deeper into the winter months, to strengthen ventilation policies and open windows in schools to keep pupils and staff safe?

If I can turn to COVID passes, we've discussed the difficulties that some people have had in getting through to that central helpline to ask for a paper pass. And I appreciate the written statement made in the letter by the Minister, this morning, stating that there will be greater capacity in the system. I'm looking forward to hearing that that is working, because if a COVID pass is a sensible step in principle, it does have to work on a practical level too.

But one very specific point: there are concerns from people who support the principle as to how it's operating on a practical level. I've mentioned to the Minister already one cinema, where there was great frustration about having to turn people away—grandparents there with their grandchildren, who couldn't get in, because they had failed to get their paper pass. They had their proof of vaccination, and they wanted to use that to come in. But it wasn't possible to allow that, because they didn't have the official pass. Now, the cinema was asking whether there was another way of using that proof of vaccination along with an ID, for example. Now, I know that one could have a lateral flow test, and that would avoid the need for waiting for the COVID pass. But, it is clear that there is a lack of understanding still; it's clear that people and many institutions need more help in order to ensure that they can keep things tight, as they want to do. So, can I ask what additional support the Government and the Minister can offer to that cinema and to other institutions across Wales, who do want to support this and to work with the policy, but are having some difficulty on occasion?

Thank you very much. I am very sorry to hear about Ffion's situation, and we all think about her and wish her all the best. And I think that's a very important point to make: none of us know how we will respond when we catch coronavirus, and that's why it's so important that we do have the vaccine if we're offered it. So, I am very pleased to see that so many people have taken up the opportunity to have the vaccine. Other than those who are already physically weak and those who have previous medical conditions, a vast percentage of the 58 people in critical care in our hospitals are those who haven't been vaccinated. I do think we need to think about our responsibility as individuals to think about the pressure on our hospitals at the moment. And when 10 per cent of the beds in our hospitals are tied up with COVID, I do think we have to ask questions of everyone who doesn't take up the opportunity to be vaccinated to ask, 'Where does your responsibility lie to us who, perhaps, need to use the NHS for other things as well?'

In terms of enforcement, it is important that we do ensure that if we do introduce these new rules, enforcement is undertaken. And that is why we have constant discussions with the police, with, for example, those people who are responsible for trains and buses and with local government as well, and that happens very regularly. You will have seen that someone in Swansea didn't want to use passes for a cinema; it is worth saying that I have had a response from Ben in Snowcat Cinema, and what he told me was that, since we introduced the COVID pass—

—since we've introduced the COVID pass, in his cinema, he has seen the sales go through the roof; that, actually, people are far more comfortable about going to the cinema now, they feel safer and they're asking, 'Can we keep those measures once you take them away—? If you're going to dismantle them, we would like to continue to enforce them'. And I think it's really important that people hear that message; that, actually, the public are responding really positively and they're saying, 'I feel safer. Your establishment is one that I am going to go to.'

I'm very aware of the capacity in the system in terms of the telephone service if people are unable to download the pass. That's why we're putting far more resources into that and making sure that the number of phone lines, for example, are increased. So, all of that work is happening. And, of course, as you say, it is possible for people to use the lateral flow test if that is unavailable to them. So, I hope that that's been helpful. Diolch yn fawr iawn.

I thank you for your statement, Minister. I speak to an awful lot of people and get an awful lot of e-mails, like everybody else here, and it is the case that people do support those restrictions that we currently have and those ones that we are operating. And I've also had messages where people now feel able to go out and enjoy their lives a little bit more because of those COVID passes, where they were extremely nervous to do so before. But on the other hand, of course, I do understand that people don't support them; that they want all restrictions to come to an end. However, the figures tell us the reality of the spread of this infection and this virus, and we only have to look around in Europe to see exactly what is happening.

So, in terms of asking you a question, you do hint—and you've done it again today—that it may be possible that we have to expand the COVID passes into other areas where they are currently not used. When would you make that decision? What would be the trigger point at which you'd have to decide?

Thanks very much, Joyce. I think, actually, that one of the things that it might be worth us all considering is using different language around this. We keep on talking about restrictions. Well, I think that it's important that we start to talk about protections, because that's what we are putting in place—protections. We're trying to protect the public here from coronavirus. So, that's certainly something that I'm going to try and use in my discussions in future.

Certainly, in relation to the COVID pass and any possible expansion, of course that will be done in the context of the 21-day review that we undertake every three weeks. The trigger for that will be, as always, the potential and the possibility of the NHS being overwhelmed as we go into the winter period. So, that's always the trigger for us: can the NHS cope?

Frankly, we still haven't really seen the flu really come at us with the kind of force that we were expecting. We're still waiting for that, and it's possible that it will come. But we will keep an eye on things. About 10 per cent of our hospital beds at the moment are filled with COVID patients. Now, that's quite a lot of people. Obviously, we need to keep an eye on that situation, but it's also about keeping an eye on the broader NHS. That's an important situation. Diolch.

Thank you for your statement, Minister, and for providing a briefing to Members of the health committee at lunchtime today. As in previous updates, I want to focus my questions on the care sector, as those living in care homes and their families have been deeply affected by the pandemic. Thankfully, a successful UK vaccination programme has meant that care home visits can once again take place.

Minister, how will your Government ensure that care home residents will remain able to be visited by, and able to visit, their loved ones? What steps are you taking to accelerate the booster vaccine programme for care home staff and residents? Some care homes across the UK are now asking for proof of vaccination for care home visitors. Is this something that the Welsh Government is considering introducing?

Finally, Minister, alongside COVID—and you've touched on it briefly in your answer to Joyce Watson—is the flu. Flu will be a big threat to those in care this winter. Will you publish flu vaccination rates for care home staff and residents, as well as outline the steps that you are taking to boost vaccination rates? Thank you very much.

Thanks, Gareth. Like you, I'm keeping a very close eye on the care sector, as is my colleague Julie Morgan—very concerned about the relationship between care homes and hospitals and the flow through that is crucial to keep the whole system moving. We do have very clear guidelines when it comes to visiting care homes. So, all of those are set out, and you will find that information on our website. That includes the fact that visitors do need to take a lateral flow test before they visit a care home. So, that facility is already in place.

About 77 per cent of care home residents have already received their booster vaccination. I was very pleased that we hit our proposed timetable, which was to offer all those care home residents the booster by 1 November. We did hit that milestone, so I was very pleased to see that. I can find you the flu vaccination rates for care home residents, but obviously that is one of the first places that we go in terms of getting the flu vaccine rolled out. But I will say this, and that is that we are not seeing the same uptake by the public in general across Wales when it comes to flu vaccination as we did last year. I would encourage people to take up that opportunity, because we genuinely don't know what's ahead of us, and we all need to take all of our protections seriously.

And finally, Mark Isherwood.

Diolch. Thank you very much indeed. What hope can you give to the constituents who have contacted me saying that they have had one vaccination in England and one in Wales, and, despite being passed from pillar to post for weeks, they still can't get their COVID pass because they can't show that they've had both vaccinations? And what hope can you give to the growing number of constituents who have contacted me telling me that they've been told that the booster vaccination in Wales will not be included on their COVID pass for overseas travel, despite France and other EU states saying that people from the UK will have to demonstrate that they’ve had the booster vaccination either to enter the country or to access restaurants and hospitality venues?

Thank you very much. Well, in terms of the vaccination in England and Wales, that surprises me that it’s such a problem because, actually, we’re sharing the data together. So, if you can write to me about that specific case, I’ll be more than happy to take that up. The COVID pass is a shared system, so we’re doing that together with England.

When it comes to overseas travel and the booster, we were only told, I think it was, last week that England would be updating it. They didn’t give us the opportunity to request that we did it at the same time prior to that. Once they told us, we said, ‘For goodness sake, let us have that opportunity.’ So, they will be giving us that opportunity. I’m hoping that, by the end of next week, that will be in place, so they should be able to show on their COVID pass that they’ve had the booster as well.

I thank Minister. I call on Joel James.

Thank you, Dirprwy Lywydd, and thank you for giving me an opportunity to correct the record. It was just with regard to the business statement earlier. As you know, I’m a councillor, and I forgot to mention that when I spoke. Thank you.

Well, it's on the record now. Thank you very much.

We will now suspend proceedings to allow changeovers in the Siambr. I'd like remind Members, if they are leaving the Siambr, to please do so promptly. The bell will be rung two minutes before proceedings restart. And finally, any Members who arrive after a changeover should wait until the bell rings before entering the Siambr.

Plenary was suspended at 15:52.

The Senedd reconvened at 16:02, with the Llywydd in the Chair.