2. Will the Minister provide an update on ambulance waiting times in South Wales East? OQ58685

4. Will the Minister make a statement on ambulance response times in Blaenau Gwent? OQ58699

5. What steps is the Welsh Government taking to cut ambulance waiting times? OQ58708

Ambulance response times across Wales are not where they should be, but performance against the national target for red calls in the Aneurin Bevan health board area was the best in Wales in September. A national plan is in place to drive ambulance improvement, supported by £3 million of Welsh Government funding.

Thank you for that response, Minister.

Minister, nearly every week, there are questions relating to the unacceptable delays that patients face while waiting for ambulances, and every delay risks people's lives. I've been contacted by a constituent who witnessed one such delay in Abergavenny earlier this month. The constituent was in a wedding anniversary party and someone present became very unwell and fell unconscious. The emergency services were called and my constituent said that, to the shock and horror of those present, they were told that there was a seven-hour wait for an ambulance. Now, fortunately, the person in question recovered consciousness, but it could so easily have turned out very differently. The same constituent remembered how, when they witnessed a similar incident six years ago at Christmas time, an ambulance was requested and attended within minutes. They've said that the more recent incident has led them to feel that if they were to be suddenly taken ill, it would be pointless calling for help. So, Minister, what assurance can you give me, please, and my constituent, that the situation will improve?

Well, I can assure you that it's not just your constituent who's asking questions; I'm asking questions very, very consistently of the ambulance service in Wales. I met them on Monday, or yesterday, just to go through the detail of their performance. The irony is that they're actually getting to more people than they've ever got to before. So, actually, in terms of performance, their performance is improving. The problem is that the demand is going through the roof, and that's where the real issue is. And that is really, really challenging and obviously, we've already recruited 250 people over the past couple of years.

I was really delighted just now, I happened to be out on the street where I passed a couple of ambulances—whenever I see an ambulance, I go and check up and check out, 'Why aren't you picking somebody up?' and, love them, you can imagine their terror when they see the health Minister coming along—and, love them, they were people who were training; they're the next cohort, the next 100 people who are in training who are going to get out on the streets as soon as possible. They've got their test tomorrow and I was wishing them all the best, because, actually, we need them out on our streets. But I'm really delighted that that is really working through now.

And the other thing I think to bear in mind is, if we hadn't put lots of measures in place already, the situation would have been a hell of a lot worse than it is now.

I'm grateful to the Minister for that earlier response. It's certainly true that people want that level of reassurance that an ambulance will be available should they, or a member of their family, become seriously unwell and require an ambulance. And it's important that we're able to provide that level of confidence to people. And one of the things that people raise with me isn't simply the waiting times, but also the structure of a service to deliver the sort of response that people require.

You will be aware that there's been a considerable debate about the rostering of paramedics and ambulance staff and also the movement of resources and assets to different locations around and across the country. You'll also be aware that my constituency has one of the more difficult waiting times, not just in Aneurin Bevan University Health Board, but elsewhere as well. So, can you provide the reassurance that you are working with the ambulance service to ensure that we have the staff where they need to be and the assets and resources where they need to be to provide the most comprehensive response to people wherever their need happens to be or whatever their location? 

Yes, thanks. And I think it's really important that people understand all the background that's gone into this. So, what you can't do is, week after week, come and tell me, 'You need to do this, that, and the other to improve efficiency'. We get an independent group in to take a really good look at efficiencies—how do we get more out of the system? The independent review looks at the analysis, tells you, 'Actually, you do need to restructure—you can make this system work better if you reroster', and actually, rerostering is going to improve the number of people equivalent to an extra 74 people on the front line. So, it may be a little bit uncomfortable for a little, while that rerostering is going on, but in terms of the overall system, I've got to make the overall system work better, and those 74 additional equivalent places is an efficiency as a result of rostering. So, you can't have it both ways—you can't tell me to restructure, and then I say, 'Right, I'm going to get efficiencies', and then tell me, 'Oh, we don't want it like that'. Those are the calls I have to make as health Minister, and I'm making that call.

Minister, you've constantly said that you're looking at a whole-system approach, from GPs to delayed transfers of care, and we'd agree with this. But it's been over a year now since you published your six goals for emergency care, and the situation has got worse. None of this, of course, is the fault of hard-working paramedics, but the poor planning from this Labour Government. Minister, we haven't forgotten that the last Minister said that it would be foolish to publish a plan for recovery whilst the pandemic was still going on, and now we're paying that price. Minister, we're coming up to winter, as you outlined earlier; we know the situation will deteriorate, even without the prospect of a nurses' strike. What urgent measures are you taking to ensure that our ambulance service don't pay the price of this Government's poor planning?

Do you know, I'm not going to put up with this any more; I'm really getting fed up of it. The amount of work that we've put into this, the difference that the £25 million that we've put in to the six goals for urgent and emergency care—I stay awake at night, not just worrying about the future, but just worrying about what the future might have looked like had we not put all that investment in. So, just to give you a few examples: we've now got same-day emergency care services; we've seen emergency admissions in October, they were 20 per cent below pre-pandemic levels—that's because we've made the change, it's because we've put that investment in. So, I know it's bad; it's because the demand has gone up. But it's really important that people understand how bad it really might have been had we not put those systems in. The urgent primary care centres—we're seeing 5,000 people a month who might have been heading into accident and emergency—[Interruption.] Of course it's not enough. It would help if your Government wasn't going to cut our funding on Thursday, frankly, in order to help us to put more money into the system—

Oh, come on. You're responsible for the—[Inaudible.]

I am responsible, but I'll tell you what, it hasn't helped that, actually, I have people now working in the NHS who, as a direct result—a direct result—of Liz Truss's Government, who didn't last very long, have their mortgages going up—[Interruption.] Their mortgages are going up, and that's your fault and your problem, and you've got to take responsibility for that.

Presiding Officer, I would like to use my question to raise the issue of ambulance handovers at hospital, which contributes to increased waiting times. The Minister will be acutely aware of the recent report by Healthcare Inspectorate Wales into A&E services at Grange Hospital, which highlighted many shortcomings. And I'm not critical of the staff at all here; I'm critical of the systems. The report highlights that, on the day that HIW's inspection took place, the average offload time at the hospital was over four hours. One patient had waited 18 hours in the back of the ambulance, and another for 13 hours. And there are many other handover breaches in the report, i.e. using ambulance trollies for long periods of time, and it was just not suitable. And it highlights the real issue of handover. I know that that's going to be dealt with separately, but, Presiding Officer, it's clear that, if we do want to cut ambulance waiting times, then we need to improve handover procedures, which, in turn, means creating additional capacity at A&E facilities, so that people can be triaged quickly.

Minister, how confident are you that the additional money that has been announced by the Government to support urgent and emergency care services will lead to increased service capacity, particularly as we head into winter? And how is the Welsh Government working with local health boards to ensure that patients who have to wait in an ambulance before entering hospital receive sufficient care and support and dignity, and the medication and equipment that they need?

Thank you very much, Peter. And you're absolutely right—the challenges around handover in health boards are something that I, as the health Minister, am really keeping the pressure on. What's interesting—. So, we've asked every health board now to demonstrate to us what is their plan. And it's really interesting, because the plans are quite different from health board to health board. And I'm going to give a shout out to Cardiff and Vale health board, because they've really focused and really said 'Right, these are the things we're going to do.' And we've seen, as a result of that focus, those four-hour handovers improve. And, so, what we need to do now is to make sure that everybody else learns from that example. So, we know what works; let's get everybody else to do it. And the benefit of having a Welsh health service is that we've got that kind of co-ordinating ability.