Questions now from party spokespeople. The Conservative spokesperson first of all, and these questions are to be answered by the Deputy Minister for Mental Health and Well-being. James Evans.

Diolch, Llywydd. Deputy Minister, this week is Mental Health Awareness Week, and I'm sure that you'd like to join me and others in this Chamber in recognising the importance of this week of raising the profiles of those struggling with their mental health, and to help those to access the support that they need from organisations whom they need to hear so we don't have people across Wales suffering in silence. Minister, can you confirm what support has the Government given to third sector organisations to help them to promote and raise awareness of this week, and what action is your Government taking to tackle this year's theme of loneliness?

Thank you, James, for that question. And I'm very pleased as well to place on record my recognition of the fact that this is Mental Health Awareness Week, and I'm aware that there are lots and lots of activities going on, and efforts, to raise awareness. You'll be aware that we provide funding to quite a number of third sector organisations—some directly, others through the funding that we give to health boards. You're probably also aware that we announced further funding for Time to Change Wales a few months ago. We are now the only part of the UK funding Time to Change. So, we are investing significant sums of money—it was £1.4 million that we announced—to enable them to continue their really important anti-stigma work. And of course, we've all got a role to play in raising mental health awareness and encouraging people to talk about their mental health and to come forward for help. And our whole approach in Wales has been based on ensuring that people can get that help really quickly, without need for referral through things like CALL helpline, through SilverCloud, and to ensure that that help is available at the earliest possible opportunity.

Diolch, Deputy Minister. Body dysmorphia is a huge problem facing many people across the country. Many young people cite the problem of the consistent bombardment on social media of highly edited images and filtering, giving many young people a warped perception of what is reality. The online safety and harms Bill proposed by the UK Government will hopefully go some way to addressing these issues. I know that digital is not a devolved competency, but all the support services for those young people are. So, can you confirm what support the Welsh Government is giving to young people who are struggling with body dysmorphia, and whether the Welsh Government is supporting the online safety and harms Bill that is progressing through the UK Parliament?

Thank you, James. Clearly, the online safety and harms Bill is an important vehicle to try and tackle some of the problems that you've alluded to, which I know you've raised before in this Chamber. You are right in that digital is not devolved to us, but there are discussions that take place between officials in Welsh Government and officials in Westminster, and I'm in particular looking at the opportunities that we can build on that Bill to enhance our work around things like suicide prevention. I think it's also important to recognise that the Welsh Government has invested considerable resources in ensuring that young people can access support in a way that's suitable for them—for instance, our young person's mental health toolkit, which has recently been revised, which is enabling young people to access support in the way that suits them, doing it online. We're also looking at bystander interventions with things like bullying, and all our responses are geared towards making sure that we are supporting young people where they need to be supported, and, of course, our new curriculum has a really important role to play in that. We've got a health and well-being area of learning in the curriculum that is going to be embedded across the whole curriculum, alongside the work that we're doing to have relationships and sexuality education for children and young people, and I think it's really important that those issues are tackled as a part of that across the whole curriculum, and hopefully from a younger age as well. But, as you say, it's not devolved, what's going on in social media, but we all have a role to play in supporting young people and making sure that they can access the support, so that they know that the things that they see on social media are not real things.

Definitely, and thank you for your answer, Deputy Minister. It's very important that you work very closely with the Minister for education around that to make sure that our young people are educated in schools around that. And you talked about accessing support, and many of those young people who are struggling need the appropriate support through their troubles, but a lot of that, Minister, is lacking across Wales. Many young people cannot access initial child and adolescent mental health services assessments: 60 per cent of children wanting specialist CAMHS pathways are waiting over four weeks for an initial assessment; it's nearly doubled since March 2020. And I know you and I both agree that that's just not good enough. As someone recently told me, Deputy Minister, 'You need to be on the verge of doing something extremely silly to get the support you need.' I know that's something you don't want to hear, and that's something certainly I don't want to hear. So, can you, please, outline how you're going to work to speed up CAMHS referrals, and how you are going to ensure that, when a young person is struggling and they do present in those early stages of their mental health problems, they get the support they need and they're not left until they hit the crisis point? Diolch, Llywydd. 

Thank you, James. And what you've said is really important, because obviously we don't want young people's problems to escalate. That's why our whole emphasis in Welsh Government is on early intervention and making sure that children and young people have the support at an early opportunity, preferably in the environments where they live their lives, such as school. So, we've got a whole-school approach, which we're continuing to invest very substantial sums of money in, and which myself and the education Minister are driving forward. We're taking forward our NEST framework, which is our early help and enhanced support mechanism, across Wales. But we also recognise that, for children who need specialist support, they need to have quick access to specialist CAMHS.

Clearly, the pandemic has had an impact on CAMHS waiting times, and we are aware of that and working really closely with health boards to improve waiting times. I should say that, as I highlighted in my last questions, four fifths of the children and young people who are waiting for CAMHS appointments in Wales are in Cardiff and the Vale. So, that is distorting the situation slightly. But, just to reassure you, we've announced, out of the £50 million extra that we secured for mental health services in the budget, there is £10 million of service improvement funding going out to the health boards. All of them have been told that improving CAMHS waiting times is a priority and they'll all be expected to set out their proposals for driving down those waiting times. 

In addition to that, we've asked the delivery unit to do a review of specialist CAMHS in Wales, which will look at the whole piece of specialist CAMHS and, in particular, look at the data as well, because what we're finding is that we're not measuring the same things. Different health boards have different structures, and it's really important that we know exactly what is happening so that we can have a consistent approach in Wales. But just to assure you that making sure that things don't have to reach crisis point is a top priority for me. 

Questions now from the Plaid Cymru spokesperson, Rhun ap Iorwerth. 

Thank you, Llywydd. It's Nurses Day tomorrow, and I'd like to thank nurses in all parts of Wales for their care and dedication. But I want to draw the Minister's attention to concerns that have been raised with me by a nurse, who tells me that they represent a significant number of nursing staff in Ysbyty Gwynedd. I was saddened to hear the nurse describing the working environment, describing bullying, pressure and unreasonably long working hours, a poor relationship with matrons and senior managers; they say that morale is low, high numbers are leaving—out of 20 fully trained nurses in one department, I was told that five had left in the past three months. One specific concern is that nurses are moved often from their specialist areas to other departments, and that places a strain on nurses, who are afraid of making mistakes, and they're concerned that this is contrary to the guidance of the Nursing and Midwifery Council. Why are they moving? Because agency nurses are refusing to move. There's clearly too much dependence on agency nurses. Minister, I'll write to you on this, and to the health board. Why am I raising this here in the first instance? Well, to try to give confidence to the nurses that their concerns will be taken seriously. They don't have any confidence in the whistleblowing process. Can I have an assurance, therefore, that the Minister will be following up in detail the way that the health board will be responding to these concerns?

Thank you very much, and I'm very sorry to hear that. Clearly, that's a cause for concern. I did meet with union members in north Wales recently—members of the RCN and Unison—and this wasn't an issue that they raised with me. So, clearly, we must ensure that there are other routes by which they can raise such concerns. I do think it's important that everyone can be open. If we can't be open, we can't improve the situation. Certainly, I would be willing to speak to the chair of the health board to see if there is anything that we can do so that they feel that they can be more confident in raising those kinds of issues. We are doing a great deal, as you know, to try and recruit nurses, and have seen an increase of 76 per cent in the number of nurses that we train. But there's no point doing that if we're losing people from the other side of the system. So, certainly, I will raise these concerns with the chair.

I appreciate that. This nurse certainly was concerned about the staffing levels in general, and clearly the over-dependency on agency staff. I was told that the majority of nurses that came from Spain a few years ago, after a recruitment campaign, have returned to Spain. There are major gaps in the workforce. The Minister, I know, will have received a copy of the latest report by the Royal College of Nursing on staffing levels. Two of the recommendations in this: (1) that there is a need for an international recruitment strategy, which echoes what this nurse said; and also that we need to develop a retention strategy for staff, and that has to be a priority. But, to the first recommendation I turn with a simple question: the royal college says that the Welsh Government, during this current parliamentary term, needs to extend section 25B of the Nurse Staffing Levels (Wales) Act 2016 to community nursing and mental health in-patient wards. The Minister knows that this is a call that has been heard time and time again; we know that staffing levels that are too low endanger the well-being of patients. Can we have that promise, please?

Thank you very much. Certainly, Brexit hasn't assisted the situation in terms of the number of nurses working in our communities and in our hospitals. Of course, we would prefer to see people working full time for the NHS and not working for agencies, so we do have to continually strive to improve that situation, and the way to do that is to ensure that there are more people within the NHS. But the trouble is, of course, when people fall ill—and many nurses are becoming ill because of COVID—then you do have to call on agency nurses too. I'm sure you'll be pleased to hear that there will be an announcement tomorrow on international nurse recruitment. Certainly, I am highly aware of the RCN's demands, and we have regular discussions with them, and this is an issue that is raised on all occasions I meet with them. Clearly, we've made it clear to them what we think needs to be done in this area before we move to the next phase.