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

Thank you, Presiding Officer. Dare I stray into local government issues, First Minister, especially as there's something happening next Thursday? But I will ask you the question about the agricultural Bill. This is a Bill that has not seen the light of day yet. We were promised it in the spring of this year; we even got promised it in initial form before the last Senedd elections. The Minister sitting next to you informed the committee that scrutinises these matters just before the Easter recess that it's now going to be delayed until Christmas at the earliest. Could you tell me why the Bill has been delayed again?

The Bill will be introduced in the autumn, Llywydd, and as early in the autumn as we can make that happen. Part of the reason why the Bill is delayed is because of some of the reasons that the Member has himself alluded to on the floor of the Senedd, and quite properly. I remember him asking me a question not that many weeks ago about the way in which we have to rethink some of our ambitions for agriculture in Wales in the context of the war in Ukraine and what that means about food security in places like the United Kingdom. So, we are taking the opportunity to make sure that the Bill we bring forward is a Bill that brings together those two key strands—sustainable food production by the agriculture sector here in Wales and then those other public goods that we know farmers and land managers are capable of producing—and that we bring those two things together in a balanced way in the Bill that we will put in front of the Senedd.

Thank you for that explanation, First Minister, because when I questioned the Minister around the food crisis that I see evolving now the Ukraine situation is escalating and the damage it is doing to the supply of food on to the market, the Minister said that there was no crisis and that there was no need to bring the processors, the food producers and the retailers together in the very questioning that you alluded to that I arranged with you some weeks ago in First Minister's questions. So, it is surprising to find now—and I welcome this—that there's a change of heart in the Government to look at using the agricultural Bill to actually enhance the food security element of that Bill, and that is something to be welcomed. But could I also ask on the legislative front as well, because you alluded to manifesto commitments not being kept—? You said about the 2017 Conservative manifesto. Well, your leadership manifesto talked about the clean air Act in 2018 and it being a critical part of your mandate should you become the leader and then the First Minister of Wales. We're now in 2022. We know that 1,400 premature deaths happen a year in Wales because of dirty air. We have not seen even a draft of a clean air Bill come from the Government and we cannot see anything on the horizon emanating out of Cathays Park when it comes to the clean air Act. So, what is the timeline for you hitting this manifesto commitment, because your own time in office, First Minister, is ticking by, by your self-imposed retirement?

Llywydd, can I first of all be clear with the leader of the opposition—there is no crisis in food supply in Wales? There are pressures in global food markets because of the war in Ukraine, and we see some temporary measures that supermarkets are having to take in order to protect certain—and it's a small number—goods, so that there can be a fair distribution of them. But there is no crisis in the food sector and my colleague Lesley Griffiths meets a whole range of relevant interests on a very regular basis. Llywydd, we will publish the clean air White Paper this year. We are on track to make sure that we legislate during this Senedd term and I look forward, as I've said to him before, to the positive support from the Conservative Party here in making sure that that legislation is as good as we can make it. 

First Minister, there is a crisis. Fertiliser, which you need to grow crops, is now £900 to £1,000 a tonne; it is normally about £300 to £350 a tonne. Wheat, the key component of making bread, is north of £300 a tonne; it normally trades at £140 to £150 a tonne. Beef is at £440 a kilo; it normally trades at £340 to £360. I could go on; I like to think I've got my hand on the pulse on this one. And there is a growing storm happening, and if the Government doesn't respond, we will reap a very meagre harvest indeed, and that will play out on the shelves of this country. We need to see Government action when it comes to this particular agenda item. We're not seeing it at the moment; we're seeing delay in bringing this Bill forward. As I said, I welcome the delay if it is about making the Bill more food security-conscious, but from what the Minister has said in her previous statements, that doesn't seem to be the case. So, can you confirm today that food production will be an important element of the Bill and that food production will be a public good that can be supported from the public purse?

Llywydd, sustainable food production has always been a fundamental pillar of the future that we see for agriculture here in Wales, and there are many, many advantages that Welsh farmers have in that sustainable food production area. There are many headwinds that the agriculture sector faces in Wales. We've rehearsed the impact of the war in Ukraine, but it also faces the headwinds created by trade deals struck by the UK Government in Australia, for example, which we know will not create a level playing field for upland farmers here in Wales.

There isn't a crisis in food in our shops. There are some very significant issues that have to be addressed—in fertiliser, I entirely agree with what the Member said on that—and those things can only be properly addressed on a four-nation basis. It's why my colleague Lesley Griffiths has such regular meetings with the Secretary of State, George Eustice and counterparts in Scotland and when there is an administration in Northern Ireland as well. I believe that there is a meeting of that sort scheduled for tomorrow and many of the issues that the leader of the opposition has highlighted will be discussed there on that four-nation basis.

Leader of Plaid Cymru, Adam Price.

Diolch yn fawr. Wales has consistently had poor cancer survival rates compared to other similarly developed countries. Why is that?

Well, one-year survival rates and five-year survival rates from cancer in Wales have improved consistently in recent years. They may still not be where other countries are able to achieve things through their health system, but the system in Wales has been gaining ground in survival rates over a number of years. There are many reasons why survival rates are not where we would wish them to be in Wales. That includes our industrial heritage and its impact on the health of people, it includes, particularly, late presentation. It is very difficult to obtain the survival rates that we would like to see when so many cancers in Wales only become apparent when they have already developed to a point where the techniques of intervention that would be available at early stages have already been passed by. There are other reasons as well that could be adduced by people who make this their lifetime study.

Which is the reason, of course, why we in Wales, more even than any other country, needs a focus in our cancer strategy on early diagnosis. This month a groundbreaking study in The Lancet found that over 30 per cent of cancers in Wales were diagnosed as a result of admission to A&E. Wales had the third highest figure among the 14 nations and regions studied. For liver cancer, we are one of only two health systems where the majority of liver cancers are identified through emergency admission, whereas in Alberta in Canada, for example, the corresponding figure is less than a third. This means that many more cases of cancer in Wales are only diagnosed once a person's health has deteriorated to a point where they might need to be rushed into hospital. Do you accept that higher levels of emergency presentation are one of the reasons for the lower relative cancer survival in Wales?

Well, I think that is absolutely the case, Llywydd. It was the point I was trying to make when I said that one of the reasons why we have survival rates of the sort we do is because people present with their cancer late. And people who end up having their cancer diagnosed because they come into an emergency department—and as The Lancet article demonstrates, they're not presenting at the emergency department because of their cancer condition—they've arrived there for some other reason and then the investigations that are carried out reveal the fact that they are suffering from cancer.

We have some very stoical parts of the Welsh population who don't want to bother the doctor and who live with things that they think are just chronic conditions that are part, for example, of the process of getting older. The thrust of the system in Wales is to try to persuade people to present early and then to make sure that we equip our GP population to be able to identify those very early signs—not easy to do. We know that for many cancers, the signs that would lead you to identify a cancer are signs that would also make you think that another more common condition is what you're seeing in front of you. So, it's not an easy thing for our GPs to be able to do, but it's why we invest so much in making sure that they are as well equipped as they can be and that the system rewards them for the work that they undertake in trying to get diagnosis as early in someone's suffering from that condition as possible.

All the cancer charities in Wales would agree with you that we need a new urgent focus on early diagnosis and detection, but they say that needs to be put at the heart of a new comprehensive cancer strategy for Wales, in line with the recommendations of the World Health Organization. Now, I heard you say previously that the various existing documents that exist, and you could argue that you can add to that the programme for planned care, which you're publishing today, which raises the 62-day target from 75 per cent to 80 per cent—all of this, you would say, maybe amounts to a strategy. But surely the fact that that target, even before the pandemic, most health boards weren't achieving, the fact that the cancer mortality gap within Wales between deprived and affluent areas is worse now than it was 20 years ago, the fact that people with cancer in Wales are being forced to go private, as the recent Health and Social Care Committee report on waiting times testified, taken together suggests, does it not, even if you maintain, against everything that every cancer charity in Wales is saying, that we do have a cancer strategy, that the strategy is failing and it needs urgently to be replaced if we are to avoid, in the future, thousands of preventable and premature deaths amongst cancer patients in Wales.

Well, Llywydd, my view of the way in which we make those deaths preventable is not by taking up more time in further strategising. We have all of that in place. Where I want the energy of the system to be focused is on delivering the treatments that the existing strategy already tells us need to be there. I don't think it's sensible to suggest that people in Wales are in large numbers having to take private treatment: 11,300 people in Wales last month alone received the good news that they were not suffering from cancer, having been referred by their GP because cancer was suspected. We know that around one out of every 100 people who are referred actually turn out to suffer from cancer, and, therefore, last month, as I say, 11,300 people received the good news that, having been referred, and hopefully early referred, they weren't suffering from cancer at all. Now, what I want the system to do is to focus on the things it's already dedicated to doing: early identification, rapid referral, quick diagnosis and then, for that small number of people who turn out to be suffering from the condition, that they move into the treatment phase as early as possible in the condition. That is the way, I think, that we will be able to avoid deaths that otherwise would take place, and I think that is where the energy of the system should be directed, not in further getting people away from doing the job of treating patients and writing more plans and strategies.