2. Will the Minister make a statement on accident and emergency waiting times in Carmarthen East and Dinefwr? OQ57827

Thank you. Hywel Dda health board is working at speed to ensure that people in Carmarthen East and Dinefwr have timely access to urgent and emergency care. We are supporting the health board through additional targeted funding to enable improvement in quality and timeliness of care at the A&E department at Glangwili.

We're all aware, of course, of the huge pressures on our health service at the moment, but it strikes me that a situation that was already bad before the pandemic is now critical. I've had cases recently of one constituent having to wait in an ambulance for 10 hours outside Glangwili, another family, from Brynaman, having to wait seven hours for their child to see a doctor, and waiting for five hours is commonplace now. And we must bear in mind that, because of the geography of the area, people very often will have waited a very long time for an ambulance to arrive and then will have had to travel long distances to Glangwili in the first instance. 

And, of course, we are aware that this is a problem across Wales at the moment. I'm looking at A&E live, and you have to wait up to nine hours in Wrexham Maelor and up to eight hours in Prince Charles Hospital. The first step in solving such a crisis, Minister, is to recognise that there is a crisis. Are you willing to accept that there is a crisis in terms of the ambulance service in Wales at the moment?

I don't accept that there's a crisis, but I do accept that there is huge pressure on the service at present. I've had another meeting with the chief executive of the ambulance service this morning, as I have regularly, because we are determined to improve the situation. Of course, the thing to remember is the fact that this is part of a whole system, and the fact is that, at present, there are 129 people in Hywel Dda who are ready to be discharged from hospital, but that's difficult because the situation in the care service is so challenging. And it's good that we're working together on solving that particular problem. But it isn't one that we can solve overnight. We have to remember that there are 118 people currently in hospitals in the Hywel Dda area who are suffering from COVID, and that brings additional pressure.

I'm pleased to say that the Welsh Government has been providing additional funding to assist the situation—£25 million. Hywel Dda will receive at least £1 million of this funding to develop centres for primary care. Also, I visited Glangwili recently, and I went to see that same-day emergency care unit. It's worth seeing that service, because what they're trying to do is ensure that people have another means of being seen the same day, rather than their having to go to A&E.

Minister, the major hospital service in both Adam Price's constituency and my own, on the eastern border, is Glangwili hospital. And I'm sure you will agree with me that the A&E waiting times at this hospital are simply unacceptable. The latest figures available show that 46.5 per cent of patients are spending more than four hours in A&E before admission, transfer or discharge, and 16.5 per cent—a sixth of all patients—are spending more than 12 hours waiting, the worst in the whole of the Hywel Dda health board region. One of the contributing factors to these rates is the difficulties that hospitals are facing in discharging patients, with backlogs being seen all through the hospital journey—something that I know that the Health and Social Care Committee are currently looking into. With today marking the second anniversary of the nation being locked down due to COVID-19, it is important we recognise the enormous pressure that our healthcare professionals have been working under for the last 24 months and to thank the NHS staff for their service. But what actions are you as the Minister, and this Welsh Government, taking to address these worrying figures and improve the hospital experience for patients throughout Carmarthenshire?

Diolch yn fawr, Sam—thanks very much for that. And I'd like to join with you in thanking all of our NHS and, indeed, our care workers for the incredible work they've done over the past two years. And I think it is worth reflecting on the pressure that they've been under for that prolonged period.

Part of the issue that we have, of course, in Glangwili is actually the fact that we have trouble recruiting, and there is an over-reliance on agency and bank and overtime in terms of what happens in Glangwili. And that, of course, means that they have to pay more money, which pushes the health board into even more debt. So, all of those things are issues, and, of course, I guess that's one of the reasons why the health board is suggesting consolidating A&E into a new hospital, so that you can recruit easier. That is certainly something that they're suggesting and, obviously, that is something that my officials are working through at the moment.

I do think that there is a whole-system issue here. The fact that we have now introduced the real living wage, from April, and have established a bridge for those who are in the service already to get to that real living wage, with additional support, we hope will encourage people to stay in the service, so that we can get those people that you set out, who are in hospital, who shouldn't be there, who need to be discharged but there's nowhere for them to be discharged to because of the fragility of that system—. So, we do have to address that issue. We've started doing that through the real living wage. We have a care commission that I know Julie Morgan is working very closely with, but this is a whole-system issue and certainly something that I'll be bringing up with the chairs when I meet them tomorrow. 

Morriston Hospital A&E is the main A&E centre for eastern Carmarthenshire, especially the Amman valley, as well as Neath Port Talbot and Swansea. A&E in Morriston is very busy and there are regularly several ambulances waiting outside. Does the Minister agree that we need to get those who are not accidents or emergencies seen by either their GP or a pharmacist, and can the Minister indicate what percentage of A&E patients are returned home either immediately after being seen or within 24 hours of being admitted?

Thanks very much, Mike, and I absolutely agree that we do need to provide alternatives to A&E, which is one of the reasons why we've invested an additional £25 million and set out six priority actions that we expect health boards and the ambulance service to deliver on. 

We're hoping that urgent primary care centres—there's £7 million earmarked for those—will provide a new model for service delivery. I know that Swansea is likely to get at least £0.5 million of this funding. And we're anxious to see more same-day emergency care services, and shortly we'll be publishing national guidance on that in order to improve patient flow.

But, on top of that, I am absolutely delighted to say, at last, we have a national 111 service where people can phone up for an alternative view before they go to A&E so that they can be sent to the appropriate service for them. Cardiff introduced their new 111 service on 16 March, and because of that now we will be able to promote that service as a national service that is available to everybody in Wales.