Questions Without Notice from the Party Leaders

1. Questions to the First Minister – in the Senedd at 1:43 pm on 22 March 2022.

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Photo of Elin Jones Elin Jones Plaid Cymru 1:43, 22 March 2022

(Translated)

Questions now from the party leaders. The leader of the Welsh Conservatives, Andrew R.T. Davies.

Photo of Andrew RT Davies Andrew RT Davies Conservative

Thank you, Presiding Officer. First Minister, we often talk about the consequences of shutting down parts of the NHS to deal with coronavirus, which has left 20 per cent of the Welsh population on an NHS waiting list, and, of those 20 per cent, one in four people are waiting over a year. But none of those lists contain the waiting times for dentistry. The waits have become so chronic that we are seeing people having to fork out hundreds of pounds, if not thousands of pounds, or taking more drastic measures into their own hands to extract teeth. 

I'd like to introduce you to Adam, who's from north Wales, who had a similar problem when he tried to access dental services in north Wales. He is a teacher in Bangor, and he tried time and time again to get registered with dental practices in Menai Bridge, Bangor, Llandudno, Penmaenmawr, Colwyn Bay, Caernarfon, and, on each and every occasion, he could not get registered, because the waiting times were in excess of two years at all those practices. Now, when we see dental treatments falling by 70 per cent over the last 12 months, do you agree with me that there is a genuine problem with capacity within the Welsh dental services and people's ability to register with NHS provision?   

Photo of Mark Drakeford Mark Drakeford Labour 1:44, 22 March 2022

Well, NHS dentistry is undoubtedly very challenged at the moment, Llywydd, but it's not so much a capacity issue; it is the circumstances under which dental treatment is carried out. We still have significant numbers of dentists in Wales carrying out NHS dental treatment, but they are simply not able to provide the volumes of treatment that they were in pre-COVID conditions, because, of all the things that the NHS does, the aerosol-generating procedures that dentistry relies upon are the most likely to spread COVID. Therefore, conditions continue to be that dentists have to reduce the number of patients they can see over a day, they have to have longer periods between appointments in order to carry out necessary cleaning, and that is resulting in the very difficult circumstances to which the Member referred.

There is recovery in dentistry. We're back up to about 70 per cent of the volumes that were possible prior to COVID. There are new ways of providing advice to people. I think there are over 2,000 people a week getting over-the-phone advice from their dental practitioner. And there are plans particularly to diversify the dental workforce, which will mean that the capacity we need in future can be brought on stream. In the meantime, the position will continue to be challenging. Despite there being more money in the system, the system isn't able to absorb the money that the health Minister made available to it in this calendar year. Because the money isn't the answer here. There just isn't the time in the day or the hands on deck to be able to do everything that we'd like to see done.

Photo of Andrew RT Davies Andrew RT Davies Conservative 1:46, 22 March 2022

Thank you for that answer, First Minister. You identified that there are challenges within the dental service across Wales, but there are in fact 83 fewer dentists working across Welsh health boards than there were in 2020. This is probably not helped by the Government's new NHS dental contract, which professionals—not myself—say reduces focus on regular check-ups, makes dentists choose between old and new patients, pays dentists based on out-of-date performance data and is funded by a falling amount, 15 per cent less than six years ago. That's according to the British Dental Association. In a letter from the chairman of the Dyfed Powys local dental committee sent to the health Minister, the committee has confirmed—again, it's not me saying this—that all practices in their area are unable to sign the proposed contract, which would result in a cut in capacity of 75 per cent on agreed existing levels. The chairman said—and again, this is the chairman saying it, not myself—that every member is unprepared to compromise on quality of care of their patients. That, as a group, is extremely concerning—that NHS dental services in west Wales are at risk of collapse as soon as next month. That's not me putting that there, that's the chair of the dental profession in the Dyfed Powys health board area. If you accept that there are challenges on this particular issue, why are you introducing a contract that would make the situation worse and potentially create dental deserts in certain parts of Wales?

Photo of Mark Drakeford Mark Drakeford Labour 1:48, 22 March 2022

I'm puzzled at the report of the letter, because, as from next month, dentists in Wales have a choice. They are able to take the new contract, but if they feel the new contract does not suit them they will be able to continue with the existing contract. Nobody is being forced to take the new contract. The new contract has been very carefully negotiated with the professional bodies. Many, many dentists believe it is far preferable to the existing contract because it allows them to carry out quality dentistry rather than the treadmill of UDAs—units of dental activity—that drive the existing contract and push dentists into doing routine check-ups, small procedures, rather than practising at the top end of their professional competence. The new contract rewards dentists for preventative work and for doing the things that you need a fully qualified dentist to do. But, if an individual practice believes that the existing contract is the one that works for them, then that will be available to them after 1 April.

Photo of Andrew RT Davies Andrew RT Davies Conservative 1:49, 22 March 2022

Clearly, the chair of the dental profession in the Dyfed Powys health board area really does feel that there is a potential for the collapse of services, hence why he has written on behalf of his members to the health Minister on this particular issue. We cannot forget how difficult it has been to access NHS dentistry before the pandemic. The British Dental Association said last year that access to services for new patients in Wales had more than halved since 2012, dropping to 15 per cent for practices accepting adult patients, and 27 per cent for children accessing dental services. We know that there's the new contract coming through. We know that there are concerns from the British Dental Association and representatives on the ground. We realise that there's a constraint on supply. What exactly can we look forward to over the next 12 months to make sure that those constraints are lifted and that people can access dental services? I've heard it from your backbenchers time and time again, when they've been questioning Ministers, that it's a problem from their own areas. This isn't just the Conservatives standing and saying this. This is across Wales, and action needs to be taken. 

Photo of Mark Drakeford Mark Drakeford Labour 1:50, 22 March 2022

There are a series of actions that the Welsh Government will be taking. I listened to the first question by the leader of the opposition. The teacher that he identified living in Bangor will be able to take advantage, I hope, of the new centre that will be opening in Bangor—a major new dental centre that will provide a new level of NHS dental provision to people in the north-west of Wales. We will continue to provide more money for dentistry next year—a further £2 million recurring provided by the health Minister to bolster dental provision. And we will, as I said to the Member, press ahead with the liberalisation of the profession. We need a different cadre of professionals in dentistry, able to do the routine work that you do not need a fully qualified dentist to undertake. We have seen in GP services a significant liberalisation of the profession. If you go to a GP surgery now, you are very likely to see the practice pharmacist, the practice physiotherapist, the practice nurse. There is a range of professionals who contribute to the team under the oversight of the general practitioner. We need the same approach in dentistry. We need the skills and abilities of our highly trained dentists to be devoted to doing the things that only a dentist can do, and then, alongside them, to have a wider spread of other allied professionals able to undertake aspects of dental care that don't need a fully qualified dentist, carried out under their supervision. In that way, we will be able to increase the capacity of NHS dentistry and make the best use of the most expensive and most highly qualified staff that we have in that field.

Photo of Elin Jones Elin Jones Plaid Cymru 1:52, 22 March 2022

(Translated)

Leader of Plaid Cymru—Adam Price.

Photo of Adam Price Adam Price Plaid Cymru

Diolch, Lywydd. First Minister, on Sunday, I and hundreds of others, including the Minister for Social Justice and the Counsel General, rallied and marched here in Cardiff as part of UN anti-racism day. We heard powerful testimony from family justice campaigners, from trade unionists and community activists, that spoke to the shared experience of structural racism faced every day by black people and other ethnic minorities here in Wales. In listening to those voices, I felt that all institutions in society, including political parties—my own party among them—had failed to properly acknowledge and address the systemic racism to be found in almost every sphere, from politics to health, to education and the economy. As a powerfully symbolic, but also practical, step to achieve that shared aspiration to become an anti-racist nation, will you commit to Wales joining Scotland in incorporating into law the UN's convention on the eradication of all forms of racial discrimination?

Photo of Mark Drakeford Mark Drakeford Labour 1:53, 22 March 2022

I thank the Member for that. It was very good to read the accounts of the march on Sunday—a march that Members here will know commemorates the Sharpeville massacre, which took place in 1960. It is fantastic, I think, to see that continuing to be commemorated here in Wales. I was able to talk to my colleague Jane Hutt, who opened the speeches at the rally, and I know that the Counsel General spoke when the marchers made their way down to the Senedd. I read accounts of what the leader of Plaid Cymru said at the march as well.

In our race equality action plan, the advice, I think, that we have drawn on from people with lived experience of racism is that we have to move beyond a commitment not to be racist to a commitment to be positively anti-racist in the way that we organise ourselves as political parties, as public services. That is there to be seen on all the pages, I think, of the redrawn plan—redrawn as a result of the consultation exercise that we've carried out. I am absolutely happy, of course, to discuss the specific point that the Member has raised and to do so with that group of people who we've been able to draw on so powerfully in shaping the plan, because it's their lived experience that speaks throughout it. It also responds, I hope, to their determination that the action plan should, as well as having some important declaratory and symbolic actions, be really a practical plan, that it focuses on those things that we can do, tangible and practical actions, grounded in fundamental change. That's what they tell us they really want to see happening here in Wales.

Photo of Adam Price Adam Price Plaid Cymru 1:55, 22 March 2022

On the same weekend as our anti-racism rally, South Wales Police, supported by the police and crime commissioner, decided it was an appropriate time to restart in the city centre the use of facial recognition technology that it had been forced to halt by the Court of Appeal because of concerns over its inbuilt racial bias. According to the UK Government's own biometrics and forensics ethics group, the lack of representation of ethnic minority faces in the training data on which the technology used by the police is based means it is more likely to identify innocent black people as criminals. This will exacerbate the racial disproportionality in rates of detention that you, yourself, have acknowledged. In Scotland, the use of this technology is banned for this reason. We lack the power to do so currently in Wales, but will you at least support the prohibition of its use on publicly owned land like the Senedd steps, where the rally was held on Sunday?

Photo of Mark Drakeford Mark Drakeford Labour 1:57, 22 March 2022

I'm very well aware of the concerns that surround face recognition technology, and I think those concerns deserve to be taken very seriously. I know that my colleague Jane Hutt has had an opportunity to discuss this and allied matters with the lead PCC for Wales, Dafydd Llywelyn, and we will continue to make sure those concerns are properly represented to PCCs, and indeed to chief constables where it's an operational matter.

Photo of Adam Price Adam Price Plaid Cymru

While the spectre of fascism is stalking Europe again, the comedian Jimmy Carr is still refusing to apologise for implying that the deaths of hundreds of thousands of Gypsies at the hands of the Nazis was somehow something to be celebrated. Next Monday, he is performing in our capital city at St David's Hall. Welsh Gypsies are asking the venue to cancel the performance in solidarity with them. St David's Hall is owned and managed by Cardiff Council and subsidised by the Arts Council of Wales, which the Welsh Government funds. As First Minister, and indeed as leader of the Labour Party in Wales, will you ask the Labour leadership of Cardiff Council to agree to the Gypsy, Roma and Traveller communities' entirely reasonable demand, in the circumstances, that no publicly funded venue should be a platform for an unrepentant purveyor of racist tropes? If they refuse to do so, will you ask the arts council to urgently review the terms of its funding?

Photo of Mark Drakeford Mark Drakeford Labour 1:58, 22 March 2022

The views attributed to the individual are absolutely unacceptable and would be condemned by anybody, I think, in this Chamber. We spoke only last week about our concerns for Gypsy/Traveller communities, and we discussed those at some length in the policing board for Wales, which my colleague Jane Hutt and I attended. If it were as simple as issuing an edict and putting things right, then of course we would be able to do that, but I know from what I have heard from Cardiff Council that it simply isn't as easy as that. The views expressed are abhorrent to my colleagues in Cardiff Council, as they are to all of us here, and I'm sure that those sentiments will be powerfully conveyed.