We're moving on this afternoon to the next item, which is a statement by the Minister for Health and Social Services on the approach to respiratory viruses. I call on the Minister to make her statement—Eluned Morgan.

Diolch yn fawr, Dirprwy Lywydd. I provided an update to Members regarding COVID-19 and winter pressures on 20 September. I highlighted the fact that we are preparing for a third winter of living with COVID, but that the situation regarding respiratory viruses is more uncertain than previous years because seasonal patterns have been significantly disrupted due to the pandemic. The latest rise in prevalence demonstrates that COVID-19 has not gone away, and we need to be vigilant and prepared. According to the latest Office for National Statistics coronavirus infection survey, the proportion of people in Wales testing positive for COVID-19 in the week ending 26 September was around 1 in 50 people.

To help prepare our communities and the health and social care systems for what could be a challenging winter, today, we are publishing our public health approach to respiratory viruses for autumn/winter 2022-23. Alongside this publication, we will also be providing further technical advice on scenarios and actions needed within the health and social care system. This will further supplement the existing planning commenced many months ago in the NHS, as set out in the NHS planning framework. So, planning for seasonal peaks in pressure is a year-round exercise, and there's been further development of interventions that will enable resilience within urgent and emergency care services this winter.

The technical advice on winter 2022-23 models, also published today, will further aid the ongoing NHS planning in Wales through the provision of four COVID-19 models. Over the previous two winter periods, we have seen low levels of flu and respiratory syncytial viruses circulating relative to a typical year, and that was mostly likely due to restrictions in place in relation to COVID-19. There is, therefore, much uncertainty for the winter of 2022-23, as those restrictions are no longer in place. Now, these winter models for COVID-19 and other respiratory viruses explore a 'what if' situation should these viruses come together, and that will help NHS planners and other partners prepare for a reasonable worst-case and COVID-urgent scenario, along with other pressures and challenges.

I'd like to take the opportunity today to highlight the key messages in our public health approach to respiratory viruses for autumn/winter 2022-23. Now, central to the approach that we've taken is our objective to protect the most vulnerable in our society from serious disease. This remains a key focus when we're operating in a COVID-stable environment, whereby we expect further waves of infection but we do not expect these to place continued, unsustainable pressure on the health and social care system. However, as we're aware, circumstances can change rapidly with a sustained increase in cases or the impact of future variants in terms of transmissibility, immune response and vaccine escape and severity. We'll need to act rapidly to respond to changing circumstances, and this could include introducing other measures and stronger advice on protective behaviours, including, for example, the use of face coverings and introducing additional testing to further protect the more vulnerable. 

We've set out plans to deliver, in partnership with Public Health Wales, an effective, combined surveillance system that provides timely information to aid effective risk assessment and risk management decisions to reduce harm from COVID-19 and other respiratory viruses. This will be more critical this winter, with the end of mass community testing for COVID-19 in April 2022 and the uncertainties on potential impact for both COVID-19 and other respiratory viruses. We've also outlined our tried-and-tested processes for managing outbreaks of communicable diseases, including respiratory viruses.

Our approach emphasises that vaccination continues to offer the best protection from COVID-19 and flu. For those who are eligible to be vaccinated, getting vaccinated is the most important action that they can take to protect themselves and others. Our winter respiratory vaccination programme was launched on 1 September and, to date, over 360,000 COVID-19 vaccines have been given.

Our advice and approach will continue to focus on enabling and promoting individual behaviours to protect themselves, to protect each other and, particularly, to protect the more vulnerable. This has to be done because this can have significant benefits in terms of reducing transmission of respiratory viruses. We should all now be familiar with these protective behaviours, which include staying at home if you're unwell and wearing a face covering in crowded indoor places and health and social care settings. We've also included targeted advice for those working in key settings, such as health, social care, prisons and education settings.

Another key element of our approach to respiratory viruses is how we can protect people who are at high risk of becoming severely ill as a result of COVID-19. We've set out advice for those who are eligible for treatment with antiviral or antibody therapies, including eligibility criteria and how treatment can be accessed. Our testing approach is also now targeted to protect the most vulnerable. This will help to inform the surveillance process, will support outbreaks, and will help to plan for a potential wave in cases of the virus and a COVID-urgent scenario. We continue to provide tests for symptomatic patients, health and care staff, prisoners, and care home residents. For the winter, we are also providing additional multiplex testing within several settings. These tests can diagnose other respiratory viruses apart from COVID-19, and can ensure that the appropriate treatment and protective measures are put in place.

Our planned communications campaigns will focus on daily protective behaviours that everyone can implement to prevent the spread of respiratory viruses, in order to protect those people who are most at risk. The messaging will be sensitive to the increased cost of living, and they will focus on behaviours that are easy and simple for everyone to maintain and will help us respond to the challenges during the winter months. Thank you very much.

I thank the Minister for her statement this afternoon, and I very much support that message, encouraging people to take up their flu vaccination and booster as well. I was very pleased to sponsor an event in the Senedd last week, encouraging people to take their flu jab; I know, myself and many other Members had their flu jab at that event last week.

Minister, you mentioned in your statement today, you finished by talking about a campaign to encourage people to take up their flu vaccine and booster. Are you expecting health boards to run that campaign in each of the local health board areas, or is there an element of Welsh Government being involved in a more Wales-wide campaign? Perhaps you could tell us a little bit more about that.

You talked about the importance, of course, quite rightly, of healthcare staff and others taking up their vaccination as well. As I understand it, currently, just 29 per cent of healthcare staff have had their 2022-23 COVID vaccination, and one in three adults aged over 65 have taken their booster. Now, so far, that, of course, is well behind the Welsh Government's target of 75 per cent take-up of the vaccination. So, I'm interested, as well, in your assessment over the past 12 months in terms of take-up. There is that concern, of course, that, as time goes on, people put that priority lower down their priority agenda. How successful have those last 12 months been in terms of people taking up their boosters? Are you concerned about the figures that I've just outlined now? Are you going to meet your target of 75 per cent, and why 75 per cent? How was that target brought forward, and what does it mean if your target is not met? Also, there is concern that infection control amongst a number of health boards has become a bit lax, despite lessons learned during COVID-19. So, last year, just 57 per cent of healthcare staff with direct patient contact took their flu vaccination. So, perhaps I can ask you: is that a concern to you and how do you intend to combat that?

I was quite interested that you said in your statement, Minister, that your

'advice and approach will continue to focus on enabling and promoting individual behaviours to protect themselves'.

So, I'm just reading that and trying to digest that into my own words. Can you confirm that self responsibility is now the Welsh Government's approach to the future management of COVID?

Last week, of course, the technical advisory cell report was published. It was some interesting reading, as I read through that. The big headline there is that hospital rates are much higher in Wales than in England, considerably, and, of course, we know that death rates in Wales were higher than in any part of the UK on a per-population basis. I'm interested in what lessons you've learned in that regard to inform future approaches to respiratory outbreaks.

Thank you very much. Well, I can assure you that there will be a national campaign alongside the campaigns that are happening, I'm sure, at local authority level. If I'm honest, we are a bit disappointed with the number of people who have come forward so far in relation to health and care staff, which is why I've instructed my officials to write to the health boards to make sure that we drum up support and we drive up those levels of vaccination for both flu and COVID amongst health and care staff. So, I'm very keen to see that happening. We're working with trade unions also to try to see if they can help us out with some of that messaging. 

You asked if our programme has been successful; I think it's been incredibly successful. If you compare it to other parts of the world, we've had really high levels of take-up. The question is: how do we keep up that momentum, how do we keep up the enthusiasm when there's a danger of complacency because we're all getting back to normal—for the first time, let's face it, in about three years? So, what we have set is that 75 per cent target. We think that this is a realistic target. We recognise that, every time, fewer people are likely to turn up for their vaccinations. It's not ideal, it's not where we want to be, but I think we've got to understand that you can't force people into these things, you've got to bring the people with you. The best way to bring people with us is to convince them and to get them to understand that, not only are they supporting themselves, they're protecting their loved ones and they're protecting the broader community if they take up this opportunity. 

I think that, with infection control within NHS facilities and care settings, what we've done is we've allowed people to make choices at a local level. So, obviously, in some parts, you'll have higher COVID rates than in others. So, it's right that we give them that flexibility. If we saw the numbers soaring, then actually, we'd have to think about whether we needed to introduce more strict versions from the centre. But, you ask if self-responsibility is part of the response; it has always been a part of the response. It's a part of the response, it's not the only response. Vaccination is our key weapon in our armoury against COVID. But, self-responsibility—you know that if you go into a crowded room that is indoors in the middle of winter, and rates are at one in 50, the chances are that your risk is higher. So, of course it's up to people to take that responsibility themselves and to understand the risks that they're taking. 

You asked, finally, about COVID infections. You will have seen last week that, if you look at the number of COVID infections compared to England, 57 per cent of the Welsh public were affected compared to 71 per cent of the English public affected. So, excess deaths were 20 per cent lower in Wales than in England, although you're right to say that there were more hospitalisations, but you expect that in a population that's older, that's sicker, that's poorer and that's frailer. 

Thank you to the Minister for the statement this afternoon. I agree, generally speaking, with the plan as outlined by the Minister today. The Minister is right in saying, of course, that COVID has not left us; it is still casting a shadow, and that shadow is getting darker. And there's a concern too that flu could take hold this winter in a way that it hasn't done for a number of years. I am grateful to Dr Harri Pritchard and the team at the Amlwch Health Centre for giving me my flu jab, and I, like everyone else here, would encourage those who quality for that vaccination—those over 50 and those who were carers in one way or another during the pandemic—to go and get that vaccination and to contact a GP or pharmacist. 

I just wanted to ask one simple question on the impact that an increase in respiratory conditions through COVID, flu and other viruses, and the impact that that could have on the health service. I am truly concerned that the Minister is still telling us that she is confident of reaching Government targets in terms of waiting lists, that she's confident that, by the end of this year we will have reached the point where nobody will wait longer than 12 months for a first out-patient appointment. We are nowhere near being on track to reach that target, and if we see additional pressures because of respiratory conditions, then the pressures will be even greater, making it even more difficult to reach that target. So, when will the Minister carry out an assessment to see what impact respiratory conditions will have on the Government's ability to reach those targets? Because what I need to know is that the Government is willing to reassess at an early stage, to change direction at an early stage, or the whole backbone of the Government's plans in bringing down waiting lists and waiting times will suffer.

Thank you. Well, as you know, we have modelled and we have looked at what could happen during this coming winter, and the health service is preparing for the models that we have seen, where we'll be likely to see a peak, according to the modelling, in December and January, so we do need to prepare for that, and that is the time, of course, not just for COVID issues, but that's when people need to take time off for Christmas and so on, and that's when it's likely that we'll see the impact of flu too. So, those issues are certainly going to have an impact on our ability to hit some of our targets, but that's why it's important that we do have this plan in place, so that people take the opportunity to be vaccinated, so that they can protect themselves.

The fact is that 1,000 people who should be working in the NHS today aren't able to work as a result of COVID. Now, that is going to have an impact on our ability. One of the things that we are doing to plug those gaps is to use agency nurses, which is difficult, and that increases the cost for us in terms of how much we spend on agency nurses. That's not something we want to do, but it is something that we need to do if we want to continue to try to hit the targets that we've set. It will be difficult to hit those targets that we've set for waiting lists, but I do think that it's very important that we do our level best to reach those targets, to reach that target, because what we're talking about here is people's lives, and people need to be seen. I'm certainly urging health boards to make sure this happens as soon as possible. I look forward tomorrow to having a cancer summit with the NHS in Wales.

Thank you, Minister.