Questions now from the party spokespeople. The Conservatives' spokesperson, Russell George.    

Diolch, Llywydd. Minister, are you confident that everything is being done, in your power, to ensure the speedy roll-out of the booster vaccination in Wales?    

Well, thanks very much, Russell. I am confident that all the stops are being pulled out, as we speak; that the NHS health boards are developing, and, today, are supposed to come back to us with what their proposals are to massively increase the booster roll-out in Wales. We're not just asking that of health boards; we know that we're getting offers of support from local government, from the fire brigade, and we may be looking to the army for more support as well. So, all of those things are being put in place. We know that there's no problem with supply, but we will be calling for a volunteer army as well, in particular those people who stepped up the first time and who won't need to be retrained. It is a short period of time that we're asking people to step up here. If we can get this done very quickly, before any possible omicron wave hits us, that would be very helpful. 

Thank you for your answer, Minister, and it's a positive reply, I think. I think that it's correct to use every tool in the toolbox and to call upon the army and the volunteer army that you talked about as well. I think it's welcome, and, of course, it's good news that we've got that supply as well.

But there's one area I would like to pick up, and this is, again, about walk-in centres for booster vaccinations. I raised this with you yesterday, and you cited the JCVI advice that each and every age group should be worked through in order, and you again claimed that it would be a free-for-all. Now, I think perhaps there's been a misunderstanding about what a walk-in centre is and how it operates. NHS England's advice is that letters, text messages and e-mails are automatically sent to those who need a booster, which can then be taken to the walk-in centre. And if you don't get one, then you can ask your GP. So, no letter, no jab. So, this is in order of the correct approach and taken in terms of need, but it also means those who are to receive the booster being able to do so as quickly as possible and as easy as possible for them. 

We're now at the point where the new variant has been, of course, identified in the UK, and I would say we must boost the booster programme. And the BMA this morning said that, 'If they want us to be involved'—talking about you—'If they want us to be involved in the COVID booster campaign, then, of course, something has to give.' So, to ensure that we have significant uptake of the booster, it's clear that we need to use every tool at our disposal. So, with GPs overstretched beyond their limits, can I ask you now to reconsider your rejection of walk-in centres as a means to support the booster jab roll-out?

I'm sorry if there's been some misunderstanding in terms of the situation with the BMA. My understanding is that, of course, they are aware that their members are under huge pressure already, but I don't think they were closing the door on the option of GPs being able to help out if they were called on to do so. What they were saying is, if we do that, then, obviously, something else will have to give. Now, there is an understanding of that. We believe that this is a priority now in order to make sure that we're not overwhelmed at a later date, and I know that there will be GP practices all over Wales that would be more than willing to step into this position.

When it comes to walk-in centres, well, maybe we're just getting terminology mixed up here. We obviously have mass vaccination centres, where people come in with their appointments. So, that sounds quite like a walk-in centre to me, if that's what you're talking about, and we do have those, of course, all over Wales. Obviously, we're looking at how we can increase massively the number of people who are admitted to those centres. 

Thank you, Minister. I appreciate, if this is a misunderstanding, that's positive—perhaps a step forward in terms of making sure that we do have those booster walk-in vaccination centres across Wales, because some health boards are already operating those. So, I think perhaps it would be helpful to provide health boards with clarification in terms of your views in regard to booster walk-in centres.

You and I both know, Minister, that we're facing, of course, an unprecedented level of demand on the NHS. We've got the worst accident and emergency waiting times, sadly, on record, alongside the slowest ambulance response times on record. On top of that, one in five of the Welsh population are stuck on a waiting list. Specifically, it's deeply concerning that 59 per cent of cancer patients were treated within 62 days of being suspected of having cancer. We also know from your own figures that 20,000 fewer people were urgently referred for a cancer diagnosis between March and November of last year, compared to the previous year, before the pandemic, and 1,700 fewer people began treatment in the first few years of the pandemic. So, the cancer workforce is also overstretched beyond capacity. Now, your predecessor published the quality statement for cancer in March, but this has been severely criticised by the Cancer Alliance for lacking detail and accountability, meaning we're soon going to be the only UK nation without a cancer strategy. So, I'm sure you'll be responding in more detail to the Member debate this afternoon. But, can I ask you how far you are with your plans to roll out rapid diagnosis centres across each health board, what progress you are making on regional surgical hubs, and when will you be publishing the cancer workforce strategy?

Thanks very much. Well, there's no question about it, our NHS services are under pressure like they've never seen before. We've seen a huge increase in terms of demand, but I can assure you that when it comes to cancer, this has always been an essential service; it has never been something we've switched off. We have invested significantly in new equipment, and I'll have a lot more to say about that in the debate later. The cancer pathway is a unique approach in the United Kingdom, making sure that we count people right from the beginning of the suspicion of cancer. It's a very different method, and that perhaps goes some way to explaining why we see significantly more on the waiting lists in Wales, because, actually, the way we count patients in Wales is very different. They're counted very differently, particularly in relation to cancer, in England. So, rapid diagnosis is, of course, really important, and developing an adequate workforce is key, as well, which is why we're investing in those as well.

The Plaid Cymru spokesperson, Rhun ap Iorwerth.

Thank you very much, Llywydd. The Minister has enthusiastically described how she's going to create a vaccination army to accelerate the booster programme. We don't have many details yet; it's at an early stage. I look forward to seeing more of those details. And although I am aware of the statement published today on amending contracts for general practice, we have heard concerns from the British Medical Association today that there is a serious capacity problem among GPs in contributing to this work. So, how does the Minister intend to implement these vaccination plans, including in primary care, whilst simultaneously ensuring that primary care is sustainable?

Thank you very much. Of course, there will be a problem with capacity if we're going to throw everything at this in the next few weeks. Evidently, other things will have to take a back seat to that. In terms of primary care, we're very aware that there is great pressure on them, but it is interesting to see that some GPs have been willing to come to the fore and to take the reins. As you've seen in the Pen Llŷn area, they've already been helping with the booster delivery. I think that they do understand the situation, and I am very hopeful that GPs will step up, as well as people across Wales, those who are volunteers and, of course, people from local government and so forth.  

Thank you for that response. The Minister talks about some things taking a back seat, and that's what I'm concerned about. And there are serious implications—the most serious—when some things take a back seat, and I'm thinking particularly about cancer and the need for early cancer diagnosis, for example. There are many people who are still staying away from primary care. They may have a cough and they should be accessing treatment because it could be lung cancer, but for some reason they choose to stay away. I had a meeting with Tenovus yesterday, and they described what they saw as a devastating number, to quote them, of people who weren't discovering lung cancer until stage 4. A strategy to ensure that cancer is diagnosed early would be a crucial part of the new cancer plan for Wales that we truly need to see. But, what's the Minister going to do now to ensure that (1) people feel safe in going to their GP, (2) that they can see their GP, and, (3) when it comes to cancer, that the referral can still happen, even when we are facing this new variant that is such a cause for concern?  

Thank you very much. It is very important to underline the fact that cancer has always been prioritised and that it has always been an essential service, even at the outset of the pandemic. So, we've always prioritised that and have never taken that away from the plan. It's important for us to have clinical advice about what we will have to put in the back seat as we develop the vaccination programme over the coming weeks. That will have to be a clinical decision, and I will look forward to receiving advice on that. 

In terms of seeing a GP, you will have seen today that we have made a statement that more funding will be going in to ensure that people can have better access to see their GPs. Some £12 million will be going towards that, including new systems, and so that they can recruit more people in order to make those decisions and ensure that people are led to the right service and the right person. The GP isn't always the right person on every occasion. So, that's something we're very eager to see, and we're very pleased that we've had agreement from the GMC.

I want to change tack for my third question. There was a general welcome recently when the UK Government announced that a menopause taskforce would be created as part of the women's health strategy. It's not entirely clear where the boundaries lie in terms of devolution in this regard, but certainly there are greater expectations among women in Wales now, and that's a good thing, as a result of that announcement in Westminster.

At a meeting of the cross-party group on women's health in October, it became apparent that there was something of a postcode lottery when it comes to the services provided to women going through the menopause here in Wales. So, can the Minister tell us what steps she wants to see taken to improve menopause care in Wales? When will we see the impact of those steps? And how can we be confident that the resources will be available to provide this care that women need as they go through the menopause?

Thank you very much, and thank you for the question. As a woman who is of the age where we have to be concerned about such things, I'm pleased to see that the UK Government has followed what we've done in Wales. We've been offering free HRT for many years, so the revolution that's happening in England has been in place for many years here in Wales. You're quite right in terms of the postcode lottery, and one of the things that we need to do is ensure that women don't have to wait quite so long before people understand that that's the reason why they feel the way they do. That's why I've asked the women's implementation group, which is responsible for looking at health—. At present, they're looking at a few things in quite a narrow way, in terms of mesh and so forth. I've asked them to think about how they can broaden that out. One of the things that I'm determined to do is to look at a women's health programme, and you'll be hearing more about that in the weeks to come.