On behalf of the Welsh Conservatives, Paul Davies, to ask leaders' questions. 

Diolch, Llywydd. First Minister, the latest NHS figures show that Wales's health services are struggling, with A&E waiting times and ambulance response times recently recorded at their worst ever levels. The vice-president of the Royal College of Emergency Medicine Wales, Dr Suresh Pillai, has said that 709 patients in Wales in 2020-21 alone have died as a direct result of crowding and long stays. He also said that,

'These deaths were preventable; the government, Boards and NHS leaders must understand and act now to ensure that the current crisis does not deepen and lead to more avoidable excess deaths.'

First Minister, do you agree with Dr Pillai's comments that these deaths were preventable? 

No, I don't in that simplistic way, Llywydd. The Member, of course, is right that the NHS in Wales is struggling under the demands that it is currently having to address, and that is about to get worse and more difficult because of the new variant that has already arrived in the United Kingdom. The health service is dealing with the impact of a global pandemic, with the delays in treatment that that has inevitably created. It is dealing with all the everyday things that we expect it to do—delivering the flu vaccination programme in primary care, for example—and, at the same time, it is responding to record levels of demand through the emergency system and through A&E departments. I think it is very important—and in this way, I have agreed in the past with advice from the college of emergency medicine—that that has to be seen as a problem, not just at the front door at the hospital, but for the hospital as a whole, and that the whole system has to find a way of responding to the very many pressures that the service is currently under. I think it is a very sobering truth, Llywydd, that these problems are about to get even more challenging over the coming weeks as we try and respond to the latest twist and turn in the very challenging story of coronavirus.

First Minister, the reality is that action needs to be taken, and taken very quickly. As we move into winter, there will be further pressures on our NHS services, and with the news that there is a new COVID variant in the UK, it's crucial now that the Welsh Government has a plan to ensure that waiting times are addressed and preventable deaths aren't taking place. 

The latest statistics show that the average time spent in emergency departments was three hours and seven minutes, which is a new record high, and they also show that ambulance performance against the eight-minute response target was the lowest on record at 50 per cent, which was down from 52.3 per cent in the previous month. Dr Pillai has warned that not only does bed capacity need to be addressed, there is also a shortfall of staff of around 100 emergency medicine consultants along with vital emergency medicine nurses, junior and other supporting staff. So, First Minister, will you now commit to restoring bed capacity back to pre-pandemic levels, and will you also commit to publishing a long-term workforce plan that recruits staff and also retains them as well?

Llywydd, more people work in the Welsh NHS today than at any other time in its history, and that includes more doctors, more nurses, more physiotherapists, more occupational therapists, and all the team that go into providing services for the Welsh public. That is the result of continued investment by successive Welsh Governments in our NHS and in its workforce. There are record numbers of people not simply employed, but in training as well—more nurses in training, more professionals allied to medicine in training—than in any time in our history.

We've published those plans every single year and they demonstrate the result of that investment. There have been more beds available during the COVID crisis as a result of the field hospital capacity and the other additional capacity that we have made available through considerable extra investment, and enormous efforts by people who work in the service to make that physical capacity available and then to find people to provide the services alongside it. When the pandemic is over and we are able to return to the levels of activity that we were able to see in the Welsh NHS prior to its onset, then of course we will need to make sure that we have the physical capacity to go alongside the additional members of staff that we will have recruited in the meantime. 

First Minister, it's quite clear that you need to prioritise tackling these backlogs, and if the Welsh Government wanted to prioritise this issue we'd have seen some commitment to addressing the problems in the NHS in your coalition agreement with Plaid Cymru. Instead, you chose to prioritise more constitutional reform, more politicians, and even the creation of a broadcasting authority, despite it not being within this Government's remit. Nothing of the people's priorities—the need for urgent intervention to support our health services—and there was certainly no mention of a Wales-wide COVID-specific inquiry.

Now, you will have seen the comments of the Older People's Commissioner for Wales, who has also argued for a specific Welsh public inquiry, as she believes it would provide the best opportunity for older people to be listened to, have their experiences and views valued, and their questions answered, and I hope you listen to her, because we need to see some answers and accountability.

First Minister, last week the abuse of patients and the culture of bullying and intimidation that has occurred in the NHS in north Wales was raised with you, and there were no real answers or accountability from this Government. This week, I've asked you about what your Government is doing to tackle waiting times and stop preventable deaths from taking place. Again, no real answers or accountability, and now, the older people's commissioner has joined calls for a Wales-wide COVID inquiry. Will we now get some answers and accountability, First Minister, or will you continue to oppose a Welsh public inquiry and deny the people of Wales the answers that they deserve?  

Llywydd, the Member would do better not to read out his pre-prepared scripts for us, because then he would have had a chance to listen to the answers rather than reading out what he was going to say, whatever the answer happened to be. I'm afraid his questions today are tired and inaccurate. He hasn't read—or if he has read, he hasn't understood—the agreement that we have struck with Plaid Cymru. [Interruption.] I'm very happy to dare to explain to him that when he says things to me that are clearly inaccurate, it's part of my job here to help him to understand a bit better than he does the nature of that agreement. The agreement, as others who've taken more trouble will understand, is a limited and specific agreement on a range of very important matters that we have agreed with another party in the Chamber. There are many, many other things that Government does that are part of our programme for government that we will move ahead with, and any party in this Chamber will be entitled to take a contrary view on those matters should they choose to do so. That's the nature of this agreement—a specific Wales-only made and bespoke to Wales. 

On his final points, I've seen the older person commissioner's letter. I'm also pleased to say that I've received a letter from the Prime Minister in the last week in which he provides a series of commitments about the nature of the public inquiry that is intended; commitments to the involvement of devolved Governments in the appointment of the chair, and in the terms of reference for the inquiry; a commitment that the inquiry will respond positively to the points that I made to him in my letter when I set out what people in Wales would need to see in a UK inquiry. I received today as well a letter from the First Minister of Scotland, in which she outlines her support for the points made by me in my letter to the Prime Minister, and re-emphasises the need for the UK inquiry to commit to representing the issues that people in different parts of the United Kingdom will quite rightly want to see such an inquiry undertake.

So, I draw some confidence from the correspondence that I've received from the Prime Minister and from the First Minister of Scotland. There is still a great deal of work to do, Llywydd, to make sure that those commitments are delivered in practice, and that we do see an inquiry that has the best chance of providing the best possible answers that people in Wales quite rightly want to see raised and answered, but, for the time being, I think the assurances that the Prime Minister's letter sets out take us further down that path, and I continue to be committed to working alongside the UK Government on this matter so that people in Wales have an inquiry in which they can have proper confidence, and will give them answers that they quite rightly seek.  

Leader of Plaid Cymru, Adam Price. 

Thank you very much, Llywydd. As you know, First Minister, the winter fair is happening in Llanelwedd at the moment. I was there very early this morning, and it was a wonderful opportunity to speak face to face with farmers and representatives of that community. The clear message that I heard there from a sector facing so many different pressures from so many different directions was that they needed stability in the industry during this most challenging of times. First Minister, would you endorse that message, and do you agree with us in Plaid Cymru that in order to allow farmers to be environmentally sustainable, and to play their part in delivering Wales's contribution in dealing with the climate emergency, for example, that farmers also need to have economic sustainability? 

Well, Llywydd, may I begin by congratulating everybody that has been part of creating the winter fair in Builth Wells, in a way that is appropriate to the context? I had an opportunity to speak to the Minister, Lesley Griffiths, about her visit to Builth Wells yesterday, and I am very pleased to hear about everything that was in place to assist people to be able to go and attend the fair in a safe manner. And, of course, I know that the current context is a very challenging one for farmers in Wales following Brexit, and in the context of coronavirus and so on. Things are changing, Llywydd, in the world of agriculture. Things have to change. But of course we acknowledge the fact that stability is also important for farmers, too, and so we, through our agreement with Plaid Cymru, are going to proceed to work closely and collaborate closely with people in the sector to prepare for the future, a future where we'll be able to pay farmers for the important things that they will be doing to assist us in the context of climate change. So, through the collaboration and by listening to what people in the field are telling us and by planning carefully together, I am confident that we can create a future for the sector, but also to do it in a manner which does offer stability, but also creates new possibilities for the sector that will help us all with the challenge that we all face with climate change.

One of the specific challenges facing the agricultural community at the moment is that multinational financial companies are coming into rural communities and purchasing agricultural land for the planting of trees in order to buy carbon credits. I was given to understand this morning from one of the agricultural unions that those selling land are now cold calling farmers in an attempt to encourage them to sell their land to investment firms. First Minister, can you provide an assurance that the Government believes that this effort, which speaks more to profit than sustainability, if truth be told, is contrary to our concept here in Wales of sustainability, is contrary to the Well-being of Future Generations (Wales) Act 2015, and that our aim as a nation taking a lead in this area is to encourage local ownership of measures to assist the climate, as we intend to do, of course, in terms of generating sustainable energy to the same extent?

Well, Llywydd, the Minister, Julie James and the Minister, Lesley Griffiths, have met with unions to discuss what we hear is actually happening at present. The important thing for us is to collect this information to be clear about the situation and what is actually happening in this field. To be honest, we're not quite sure as yet what exactly is going on, but we want to collaborate with the unions and other people to collect this information. We have brought a group of people together to assist us in this, and they represent people working in the field, so that we can think and consider how we can attract investment into the field. We will have to do that, but to do so in a way that goes hand in hand with the policies rather than militates against them, and we're aware we have to do it like that. We want to do it in a collaborative fashion with the local communities, so that we can be clear about the ownership of this land in Wales, but also, where we can—. And it's important for us to do this; we cannot attain our ambition in this field without bringing other people and other funding into the sector. That is what we wish to discuss with these other people, to plan with them, and draw together the real authentic information about what's happening at present.

We've even recently heard some Conservatives in this Senedd raising their voices against multinational corporations buying up Welsh agricultural land. It's great to see the Tories as late converts against the unbridled operation of the free market, and I think Welsh agriculture, beset by all these pressures at the moment, needs a bit of a united front. But the wider attempt to present the Tory party as defending Welsh farming sticks in the throat of many farmers. When they were promised in the 2019 manifesto that the Conservatives would guarantee the annual budget of farmers in every year of the next Parliament, what have we had but the opposite: the promise of a cut every year in this comprehensive spending review? So much so that, actually, as the FUW point out, by 2025, it's going to be—[Interruption.]—Welsh agriculture allocation is going to be £248 million worse off. I'm all in favour of finding common ground, but let's be clear who the common enemy is: a Westminster Government that has betrayed farmers and farming in Wales time and time again.

Well, Llywydd, the leader of Plaid Cymru had an opportunity to go to Llanelwedd today. I spent Friday evening in the company of Clwb Cinio Caerfyrddin, and a very fine evening it was too. I was surrounded by people who work in the farming industry, and what Adam Price said was absolutely what was reflected to me. These are people who feel very, very badly let down by the promises that were made to them—[Interruption.] I can assure the Member that nitrate vulnerable zones were not mentioned to me once, but what was mentioned to me repeatedly were the promises that they felt were made to them in the run-up to the referendum in 2016. Plenty of people on those benches were very willing to make those promises in those days. You remember them: 'Not a penny less', 'An absolute guarantee'—£137 million taken away from the Welsh rural economy by your party this year alone, and more cuts to come in every year, every single year, of the comprehensive spending review. Where was the 'absolute guarantee' of 'not a penny less' that those people heard from you then? No wonder—. No wonder, no wonder—[Interruption.] I think the—[Interruption.] I can't hear the Member, Llywydd, but he appears to be impersonating a traffic policeman. This may be another ambition on those benches.

What I am pointing to, Llywydd, is what the leader of Plaid Cymru said, the anger that is felt—[Interruption.]—the anger that is felt in rural communities at the promises that were made to them and the way in which they have been let down ever since—money taken away from them; trade deals struck in other parts of the world with no regard whatsoever about the impact that they will have on the rural economy here in Wales. No wonder—[Interruption.]—no wonder that, when you meet people from those communities, they go out of their way to tell you their anger and their disappointment at the Conservative Party here in Wales.