Cancer is, of course, more than 200 diseases rather than one thing. It's primarily a disease of the ageing process, but a significant proportion of cases are preventable, particularly through tackling rates of smoking and obesity. Prior to the pandemic we had a number of iterations of national strategies and delivery plans, and we saw many successive years of gradual improvement in cancer survival and mortality, as well as very high levels of positive patient experience. We had invested heavily in radiotherapy equipment, had introduced the UK's first complete overhaul of cancer waiting times, and had established excellent national leadership around cancer service development. And I'm pleased to note that part 3 of the motion recognises one notable success of this approach, which has been the establishment of the rapid diagnostic centre concept. This shows how a national approach can really help identify opportunities for new service models, fund high-quality pilots, develop an evidence base and then support the upscaling of this and spread it across Wales.

The pandemic has inevitably had a significant impact on cancer care. Early on in the pandemic, significantly fewer people came forward for investigation. The screening programmes were temporarily suspended, some people did not want to attend their appointments, and some people's therapy was altered to reduce their risk. We issued essential services guidance immediately, which included cancer investigations and treatment, and our cancer services rapidly came together to change how they delivered services.

Towards the end of 2020, thankfully referral activity recovered as people started to come forward in normal numbers, but figures indicated fewer people than would normally be expected were seen last year. From early 2021 we have seen referrals for most cancers increase significantly above normal levels, and this is combining with restricted capacity resulting from staff absence and infection prevention controls. This above-normal demand and below-normal capacity is what is driving the cancer waiting time performance described in the motion.

Our NHS staff continue to work incredibly hard to investigate and treat people with cancer, and they're treating more people than in previous years. As a Government, we're providing additional resources to the NHS to undertake as much cancer diagnostic and treatment activity as possible, and I've made cancer recovery a planning priority for the NHS, as reflected in our approach to recovery, 'COVID-19: Looking forward', supported by nearly £250 million of additional resources.

Although we don't currently have any clear evidence of poorer cancer outcomes, we think that the disruption of the pandemic is likely to have an impact in the years ahead. Pandemics, unfortunately, do much indirect harm in terms of access to normal healthcare, as the chief medical officer has set out at length.

As well as our wider approach to recovery, we published in March this year the quality statement for cancer, as many people have referred to. And can I just be clear that I understand the concerns that have been raised with regard to this new approach? But I think it's really important that we consider how we got to that point, and this goes back to the Organisation for Economic Co-operation and Development and parliamentary reviews, which led to commitments made in 'A Healthier Wales', and 'A Healthier Wales' committed us to introducing a series of quality statements for the NHS in Wales. We can't deliver this commitment and stay true to its rationale whilst clinging to the old way of doing things.

What we're trying to achieve is a better integrated, more effective, quality-based approach for a number of clinical services; an approach that is more attuned to the planning framework for local NHS bodies and better informs the accountability arrangements that we use with all local NHS bodies. And this approach is described in significant detail in the national clinical framework. This is the approach that we have determined will work best for Wales and for our health system. It's a completely new way of doing things, but it does build on what has been achieved in recent years.

The approach for cancer is grounded in enabling quality improvement. It has a heavy focus on enabling earlier detection and access to treatment. There’s also an important focus on introducing a new cancer informatics system, enabling better cancer workforce planning and supporting better service design.