Questions now from the party leaders.

And it's very good to see the leader of the Welsh Conservatives back with us, Andrew R.T. Davies.

Thank you, Presiding Officer. Thank you very much for the very warm welcome and, with your indulgence, I will pass on my thanks to all Members from across this Chamber and beyond who've sent best wishes to me, in particular the personal note the First Minister wrote to me—it was greatly appreciated—along with other Ministers as well. We can give no quarter yield in this Chamber, but when we get outside this Chamber we are all human beings, and that support was greatly appreciated, to say the least. I went out of this Chamber in September 19.5 stone; I am now 17.5 stone. So, there's two stone less of Welsh beef in this Chamber today. [Laughter.]

But back to the business at hand, this is First Minister's questions. I'd like to ask you, First Minister, around primary health care and, in particular, last week's comments from the British Medical Association that said that something had to give with the booster roll-out in other services, and the health Minister agreed with the provision that most probably there would have to be a curtailment in those provisions, in doctors' surgeries in particular. Other Governments in the UK have made an announcement over the weekend. Are you in a position to announce what services might be temporarily withdrawn from community services, especially primary medical services, because obviously that ultimately could lead to greater demand on accident and emergency units across Wales?

Well, Llywydd, before I begin, could I say it is very good indeed to see the Member back in his place in the Chamber this afternoon? Thank you for that important question as well. We are concluding our discussions with primary care providers in Wales. We do want them to play a greater part in the short-term but urgent need to bolster our vaccination programme ahead of the arrival, as I'm afraid we now must expect, of a major wave of the omicron variant. In Wales, we have taken a wider view of primary care than in some parts of the United Kingdom in the vaccination field, so we also include high-street optometrists and dentists as well, who are able to clinically successfully carry out vaccination. The things that will have to be put to one side temporarily, we hope, will be the most routine aspects of primary care—important things, I know. We pay a lot of money through the contract to our general medical services colleagues to carry out those surveillance activities, monitoring of people's diabetic condition, their blood pressure, all of those things. It's not for a moment to say they're not important, but of all the things that GPs do, they probably can be set to one side for a brief period of time in order to have greater capacity in primary care to deliver more of the vaccination programme, because of the urgent need to get ahead as far as we can, and as fast as we can, of the likely impact of that new variant.

Thank you for that answer, First Minister. It is important that we understand what services might be withdrawn; you alluded to health checks, for example. When might we know the outcome of these negotiations, because people are genuinely concerned? There have been understandable pressures on GP surgeries and getting appointments and I think it's really important that people understand what they can expect in the winter months going forward, with all the pressures that there are on GP surgeries. But importantly, what safeguards are going to be put in place to make sure that people can access the services over the important Christmas period and into the new year? Traditionally, that's a pressure point for understandable reasons and I hope, in those negotiations with primary care, that those discussions are leading to the provision of extra services, so that A&E can get that respite that it desperately needs. We know what went on in an A&E unit in Cardiff over the weekend where a plea went out not to turn up unless it was a life-threatening situation. I would suggest that that is replicated in A&E units across Wales, and so, knowing when those negotiations with primary providers are going to be concluded and what services might be withdrawn, I think is of critical importance. So, if you could give that, we would be most grateful.

Thanks again to Andrew R.T. Davies. We will make those announcements as fast as we are able to. There are a couple of pieces of the jigsaw that we are still completing. We hope to get additional help in this coming vaccination campaign from the fire and rescue service, for example, who do a great deal as first responders and who we think, with some extra attention, would be able to provide vaccinators. We are looking to involve more help from the armed forces as we did earlier in the pandemic, and we're just waiting to get the final confirmation of the help that we can get from them. And, of course, pharmacies are another major contributor to vaccinations. So, there are just some bits of the jigsaw that we are waiting for final confirmation on. All of those would help us to reduce the need for GPs to pull back from some of their more routine activity, because we want to minimise that as well, and to do so for exactly the reasons that the leader of the opposition has said.

The system as a whole is under enormous pressure in every part of it, and if we reduce activity in one part of the system, the risk is that you just displace that activity into some other part of the system that is already hugely pressurised. So, I'm hoping that, very shortly, as fast as possible—we're talking days, not weeks—we will be able to make that announcement, but there are just those final bits that we need to make sure that we've got completely in place, so that we can use primary care and our GP teams, but do it in a way that allows them as much as possible to go on doing the other very important things that they provide.

Thank you for that, First Minister. I'll look forward to that announcement imminently, hopefully.

But you talked of a jigsaw, and the pattern of healthcare is about a jigsaw and it's important that Government has strategies with its partners. Now, last week, to the health committee, Cancer Research highlighted how Wales, shortly, will be the only part of the United Kingdom without an up-to-date cancer strategy. We know, over the weekend, that the Welsh Government—and I commend them for doing this—brought forward a staff training budget with an increase of £250 million and that will provide a 15 per cent uplift, as I understand it, in training provision. But what we do know is that there are many people who haven't come forward with cancer symptoms, and we do know that, by 2030 according to Macmillan, we'll need an extra 80 per cent of cancer specialist nurses here in Wales. So, to bring this jigsaw together, it is important that there is a strategy in place that pulls all the component parts together, so that cancer services can deal with the tidal wave—and I regretfully use that word—of undiagnosed cancer that does sit in communities, because people, for understandable reasons, haven't come forward. Will you commit today to bringing forward a cancer strategy so that all cancer services across Wales can work to that strategy, and wherever you live in Wales, you will be assured of a world-beating cancer service, wherever you live in Wales, rather than a postcode lottery, which I say doesn't exist at the moment, but we don't want that to open up in Wales?

I thank the leader of the opposition for that and I thank him for drawing attention to the eighth year in a row in which there will be new and record investment in creating the workforce of the future for our NHS. And what Mr Davies said is right: we have cancer services of very high quality in all parts of Wales at the moment and that is a very precious resource to make sure that we sustain.

On the issue of a cancer strategy, I think in some ways this is a debate about semantics rather than substance. England has a cancer plan, Scotland has a cancer strategy and we have a cancer quality statement. Now, those quality statements are derived from the parliamentary review of the health service here in Wales, which described ways in which we could make sure that, in all of the major conditions—heart disease, stroke and, of course, cancer—we had statements of national priorities, a focus on treatment and the early detection of disease. We published our cancer quality statement in March of this year and I think that it does the things that people who ask for a strategy or a plan are looking for. Now, of course, we are very happy to discuss that with those third sector organisations that the leader of the opposition mentioned, but it is not the case that there is no plan for Wales. There is a plan and there is a strategy; it's captured in that quality statement. The aim of the statement is to do exactly the sorts of things that the leader of the opposition suggested.

Plaid Cymru leader, Adam Price.

Diolch, Llywydd. Can I start by saying how glad I am to see the leader of the Welsh Conservatives back in his place here? We've disagreed many times in this Siambr, Andrew, and I'm sure we'll disagree many times again, and sometimes passionately, but can I say that we've always had the best of personal relationships? Can I also pay tribute to the way in which you spoke openly about issues of well-being? You are a real inspiration for us all in that.

First Minister, the chief executive of the Development Bank of Wales has been making personal investments in companies based in Wales without seeking prior approval of the board. Is that something you, as First Minister, are comfortable with?

I expect any chief executive or employee of an enterprise or agents of the Welsh Government to observe all of the proprieties and the rules that are required of them. I'm not sure if the leader of Plaid Cymru is suggesting that there has been impropriety here, but if he is, he should say so, and if he says so, then we will investigate that.

Well, Mr Thorley did seek board approval and also wrote to the then-Minister for the economy before taking up his paid role as the chair of Zip World. Perhaps the First Minister could confirm whether Mr Thorley's personal investment in Zip World was also subject to prior board approval, as has been reported in the press.

Now, if it was, and the reason that I raise this—. Well, the question is clear, isn't it? Why was the same principle not applied to his investment in the Cardiff-based start-up Love to Visit? Can I ask you a fairly basic point of principle, First Minister, if it is stipulated that Mr Thorley, who is already among the highest paid employees of any publicly funded body in Wales, should not invest in companies using knowledge or networks he has acquired through his work at the development bank? Wouldn't you agree with me that it's not an assessment that Mr Thorley should be able to make, effectively as judge and jury in his own case?

Well, I certainly agree with the final point, Llywydd, that where any person is carrying out work on behalf of the public interest in Wales and is in a publicly appointed position to do so, then they are bound by rulebooks that are not of their own making, nor should they be the sole arbiter of whether they are complying with those rulebooks.

I'm not familiar with the detail of the decisions that are made by the chief executive of the Development Bank of Wales in the way that the leader of Plaid Cymru is. If there are specific concerns that ought to be investigated, then they need to be brought to the attention of the Government and then they will receive that attention.

As you know, First Minister, your predecessor Rhodri Morgan was highly critical of senior leadership figures within the Welsh Development Agency having outside business interests that gave rise to negative perceptions. He said, and I quote:

'Business does not just have to be done, it has to be seen to be done. That is well-nigh impossible when you have inter-locking relationships.'

It's not enough to say that these matters are just for the board, for example, when this is a publicly owned company with the Welsh Government as its sole shareholder. You amended the framework document that sets out, as I understand, the Government's expectations of the bank in relation to governance—some of the questions that I've raised with you today—in February of this year. Can I ask that you publish that document, along with the remit letter you signed with the bank as a Government last month? Will you insist on a review of governance arrangements to ensure they meet people's reasonable expectation that the public interest is neither overlapped nor overridden by the private interest of individuals, to avoid some of the problems in perception that I've raised with you today?

I entirely agree with the final proposition that Mr Price made; people should not put themselves in that position. I very well remember the views of the former First Minister on the WDA and its history and a number of its employees. It is the regular position of the Welsh Government to publish remit letters to organisations that we sponsor, but the Development Bank of Wales does deal in commercially sensitive areas where it isn't always possible to put into the public domain the same level of information that is possible for bodies that don't deal in those same areas. I'm reluctant, Llywydd, to give general commitments on the back of suggestions that I'm not completely certain of the basis of them, or indeed what is being alleged. I will read very carefully the Record of what's been said this afternoon and, of course, if I think that any action does need to be taken by the Welsh Government, then that action will follow.FootnoteLink

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