I am proud to be a trustee of Brynawel, a drug and alcohol rehabilitation service in south Wales working to support people who have become dependent. What we know is that there are many people throughout Wales who can live normal, functional lives, whilst at the same time maintaining a lifestyle that increasingly relies on alcohol as a key part of their social and family life. Many sustain this lifestyle before becoming physically unwell and requiring the support of acute NHS services. Many drift into dependency all too easily, and, from there, the shift ever downwards into consistent alcohol abuse becomes sadly normalised.

I would like to focus on the Welsh Government's delivery plan, as this is crucial to how this country responds to a growing challenge; at a time when we have seen a reduction in treatment numbers over the past five years, the number of alcohol-related deaths is the highest it has been for 20 years. I would like to set out a number of concerns that I have, which I hope the Government will address. 

Whilst we need to tackle the causes of the problem, and this is incredibly challenging, I want to pay tribute to all those professionals across the health and third sectors who play such an important role in supporting those with addiction. Lifestyle choices, how we live our lives, add hugely to the pressure on the NHS, whether it's drug and alcohol use, smoking or obesity. The NHS is therefore largely reactive to this increasing challenge, and I don't want to underestimate the impact on them and the services they provide. There are, of course, a range of options for us to pursue, and the NHS is not the only provider of services. 

Ensuring appropriate and efficient service provision is key, and, whilst I am encouraged to see a focus on partnerships and pathways for service users, this is not always played out in their experience of services. Partnerships between health, social care, mental health and third sector services are critical, as with other areas of our health and care system. It does not always work effectively. Pathways between specialist substance misuse and mental health services can be unclear, with many health boards unable to articulate how they provide seamless pathways for individuals with co-occurring mental health and substance misuse issues. Surely, there is a case to be made for mental health and addiction services adopting a 'no wrong door approach' to service provision.

It is also important that Wales establish a Wales-wide recovery plan for those who are now sat on lengthy waiting lists for community prescribing and in-patient detoxification. I appreciate that, as we emerge from the effects of the pandemic on the wider population, we know that services are struggling to step back up to get to where they were before March 2020. This has an impact on many people, but it is worrying that, unless we act quickly enough, the impact of our failure will fall disproportionately on those who are socioeconomically disadvantaged.

Many people who succumb to alcohol dependency will, if their condition worsens, need the help of family members, who often take on a caring responsibility. I would like to know how the provision of support for carers and family members will be evidenced by services, given the relatively low number of carer assessments offered by tier 2 and tier 3 substance misuse services. It might also be useful to conduct an awareness-raising campaign for this group of people. Many family members of people with substance misuse problems do not see themselves as carers in the same way, for example, as those caring for those with dementia. They are not aware of the benefits, practical help such as carer assessments, or their rights at work in terms of flexible leave and protection from discrimination.

I would like the Minister to set out how we will both tackle the causes of the problem, including the lack of appropriate mental health support, which could reduce the chance of alcohol dependency, and examine what capacity is needed to redouble our efforts to support those who have hit rock bottom. I'll take a minute. Time is of the essence, Minister, if we are to avert a major public health and service delivery crisis.

Lastly, although the Government has published the treatment framework for those with alcohol-related brain damage, there is limited progress among the health boards. Thank you very much.