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

Thank you, Presiding Officer. We seem to have lost the gallery, First Minister—  

[Inaudible.] [Laughter.]

It could be something to do with that, I think, Mike. First Minister, today, the chair of the British Medical Association has come out and said that, as a profession, they could very often be criticised for maybe calling wolf on staffing numbers within the health service in Wales, but, actually, on reflection, and the current situation that they find themselves in, the wolf is definitely in the NHS, as there is a massive shortage of staff within our hospitals and our primary care settings. Do you agree with the comments of the chair of the BMA today around the critical and very acute situation that hospitals and the primary care sector are finding when it comes to retaining and attracting staff?

Well, Llywydd, I want to distinguish between two things. And I thought it was a brave statement by the new leader of the BMA to recognise that, on many occasions in the past, the word 'crisis' has been used by the BMA, and that has devalued that term. The two things I want to distinguish are these: I absolutely accept the struggle and the stress that there is in the Welsh NHS, that recruitment is difficult in some places and that it's not always an attractive prospect to come in to a service that, day after day, is portrayed in the media and in newspapers as not providing the service that the people who work in it would wish to provide. So, I absolutely do recognise that. But I do think it's worth just putting some facts on the desk as well, because, if you look at medical and dental staff in the Welsh NHS, we have 1,654 more doctors and dentists working in the NHS than we did a decade ago. We have 1,256 more consultants and doctors working than we did five years ago. Of the 966 more medical staff than we had three years ago, 242 of those are consultants, and, Llywydd, I could go on. We have thousands more nurses working in the NHS, thousands more scientific, therapeutic staff working in the NHS. The fastest growth of all has been in ambulance staff working in the Welsh NHS. So, while I am happy to—well, I am not happy, because the situation is so difficult—but while I recognise the points that are being made, that is against the background of year, on year, on year rises. There are more people working in the Welsh NHS in every single category of people—[Interruption.]—and that includes every health board as well.

You see, that's the sort of remark that absolutely does not help, because it is simply not factually the case. [Interruption.] I do. Believe me, I prepare when I come here, and that's why I am able to tell you what I've told you today. Yes, I actually do prepare, and the truth of the matter is, in every part of Wales, the numbers of people working in the NHS have been going up. Does that mean we don't need more? Of course not. Does that mean that recruitment doesn't need attention? Does it mean that we don't need to go on making sure we have more people in training than we've ever had before? All of that is true, but it does give you the background to what the leader of the BMA said about being clear about what is true and what is not true about the state of play in the NHS.

First Minister, the other comment that the chair of the BMA made is that, obviously, many more people aren't now full time within the NHS and, actually, choose for various reasons to, obviously, do a shift here and a shift there and can't be classed as whole-time equivalents. Last week, I challenged you on a specific issue about the Royal College of Emergency Medicine's baseline figures. It is a fact that, over the years, we have challenged you on this particular area of staffing, and not one accident and emergency department here in Wales manages to hit that baseline figure when it comes to consultants.

The Presiding Officer might be interested in this: in her own A&E department in Aberystwyth, for example, out of the eight consultants they should have available as the baseline figure from the Royal College of Emergency Medicine, they have one. If you go to north Wales, at Ysbyty Glan Clwyd, for example, there is only a third of the number. Fifteen are required, and only a third of that number is in that particular A&E department. So, after many years of trying to seek improvement in this particular area and being told that there's a plan in place, what confidence can you give us that the Welsh Government do have a serious workforce plan in place to address not just the A&E deficit of emergency medicine baseline figures, but the deficit across the whole NHS here in Wales that, even now, the profession, as you said, has bravely come forward to highlight today?

Llywydd, I do understand that the headline numbers disguise the fact that many of those people will not be working full time and that patterns of work in the health service have altered. But even if you look at those full-time-equivalent figures, there are nearly 10,000 more staff working in the NHS today than there were just three years ago. So, while it is true that work patterns are changing and people are choosing to work fewer hours than they once did, even when you take that into account, there is a very significant rise in the number of people working in the Welsh NHS.

As to the future, the only way that you can offer a sustainable solution to Welsh NHS staffing is by investing in the training of people for the future. Everywhere in the Welsh NHS, we are training more people today than ever before. We had a 55 per cent increase in the number of student nurses between 2016 and 2022; a 95 per cent increase in the same period in the number of people training to be district nurses; a 97 per cent increase in the number of people studying to become midwives; an over 300 per cent increase in the number of students who will emerge from Welsh universities as pharmacists to work in the Welsh NHS. That is true of doctors as well as nurses and those professions allied to medicine.

We are increasing the number of places at the Cardiff medical school and at the Swansea medical school, and, of course, we are creating a new clinical school in north Wales, and there will be further numbers there. If you look over the period ahead for which we have plans, in August 2019 we had 339 what are called F1 and F2 posts in Wales; that will be 450 by August 2024. Those are all extra doctors coming into the system, trained here in Wales. We know they're more likely to work in Wales as a result, and that's why we can offer some comfort to those people who, rightly, are occupied by the stresses and strains that the system currently faces.

I asked you specifically about the Royal College of Emergency Medicine's baseline figure, and I have successively asked you this on numerous occasions. From the numbers I've put before you today, First Minister, we clearly can see that there has been little or no improvement in reaching those baseline figures. So, are we going to see an improvement, given the figures you've just put forward, so that when, in six or 12 months' time, we revisit this, we will see that improvement in consultants in A&E departments here in Wales?

And importantly, the statement that the Government put out this morning of short-term plans being put in place to address the concerns that the BMA have highlighted today, can you highlight exactly what those short-term plans are to get us over this particular pinch-point? I appreciate you've highlighted training programmes and training schemes, and you and I can debate and argue about numbers, but it is a fact that the chairman of the BMA has come out today and highlighted the pressure points, so if you could address the specific short-term plan, so that we can have confidence that the Government have sight of this, then hopefully doctors, nurses and other clinical professionals can have confidence that the pressure they feel on a daily basis when they go into work will be alleviated in the short, medium and long term.

Llywydd, let me give the Member just two examples of the actions we can take in the immediate term. One—and there'll be a statement on this next week by the Minister for Health and Social Services—will be to increase the bed capacity of the NHS over this winter, and that's both bed spaces in hospitals, but community services as well, so that people who are in hospital today can be back home or being looked after in the community, and we will provide details next week of the number of bed and bed-equivalent places that we've already been able to create for this winter, and the more that we expect to come. That will relieve some of the pressures, particularly those pressures in emergency departments that the leader of the opposition referred to. 

In terms of staffing, let me say that I welcome the signs from the UK Government that they are about to review the pension arrangements, which have got in the way of so many doctors continuing to work in the NHS, not just in Wales, but across the United Kingdom. He will know that if you are a GP, for example, you hit a point where your pension pot that you have built up is so heavily taxed that you're practically paying to be in work, and very understandably we have seen a whole swathe of people retiring early from the health service in Wales because the financial circumstances created by the pension rules mean that it's simply not viable for them to continue. Now, I've seen reports this week that that is being actively revisited by the UK Government, and that they are about to propose changes to those pension arrangements that would allow people to come back into the workplace who didn't wish to leave it. They may not want to come back full time, we understand all of that, but they want to make their contribution. And if those pension arrangements change, we can be sure that there will be people in Wales who are not in the workplace at the moment and who could, as part of those short-term measures, come back into the workforce to reinforce the people who are working so hard, and under very difficult circumstances, and with three years of really challenging times behind them, to help sustain them in the jobs that they do.

Questions from the leader of Plaid Cymru, Adam Price. 

Thank you, Llywydd. You will have seen the census figures that demonstrate a further decline in the number of Welsh speakers in Wales, and a significant fall in terms of young people between the ages of three and 15 who speak the language. Now, this demonstrates, doesn't it, that a central element of the Welsh Government's policy, namely developing Welsh-medium education across Wales, is failing. Ten years ago the ambition of a million Welsh speakers was put in place as part of the response to the decline in the census figures at that point. Don't we now need to recognise that the actions are not sufficient to reach the target by 2050? As with climate change, goodwill is not the same as delivering against targets. So, wouldn't the most positive response to today's news be to ensure that the proposed Welsh education Bill would provide Welsh-medium education for all children in Wales within a clear and adequate timetable?

Well, I don't agree with the final point that the leader of Plaid Cymru raised. I don't think that people in Wales will be willing to support the point that he made, and I think that the most important thing about the Welsh language is to maintain the support of people in Wales for everything that we're trying to do. We've succeeded in doing that. There is a strong feeling for the Welsh language in every part of Wales, and we want to use that goodwill that exists to continue to have more people learning Welsh and using Welsh, and so forth.

The things that underpin the things that we've seen in the census are complex, and I think it's worth finding some time to consider what underpins what we've seen. We are seeing growth in the Welsh language here in Cardiff, in Rhondda Cynon Taf, in the Vale of Glamorgan and in Merthyr Tydfil as well. We see growth in the use of the Welsh language among young adults as well. Where the decline has been is among the three to 15 cohort. Why has that happened? Well, there are fewer young people in the whole of Wales in that age cohort. So, that's one thing to consider.

The second thing is that we know that the census was conducted during the time of the pandemic. I remember time and again hearing people discussing the impact of the pandemic on young people in Welsh-medium schools when they were not attending school, and when they weren't hearing a word of Welsh when the schools were not open. So, there are a number of things underpinning these figures, and it's worth taking some time to consider what lies behind them.

That's particularly the case, Llywydd, when you consider that some other sources of data show other things. Why are the figures in the census falling when the figures in the Office for National Statistics annual review of the population are going up every year? I don't understand that myself yet. There's a lot of work to be done. I had the opportunity, Llywydd, to speak with Sir Ian Diamond, who chairs the ONS, about this before the census figures were published. Things are more complex, I think, than what the leader of Plaid Cymru has suggested this afternoon. We need to find time to undertake this work and to return to this to see what the best responses are to continue to do what we want to do—to find a way to achieve a million Welsh speakers by 2050.

I am disappointed with your initial response, First Minister, this afternoon, because there was recognition as the figures were published 10 years ago that we were in a critical situation, and that action was needed. That's what led then to the cross-party debate that got behind the aim of a million Welsh speakers. So, there was an acknowledgement that census figures are important. Every language planner I've ever spoken to has said that it's the census that is the most important source of data. The survey that you referred to is a sample, whereas the census includes everyone. Saying that the number of children in Wales is falling—. Well, yes, it's true in terms of numbers, but it's the percentage between three and 15 that's dropped, whatever the number is. I'm afraid that proves, does it not, that your policy in terms of growing Welsh-medium education across Wales is not successful. 

Llywydd, I'm more of an optimist than the leader of Plaid Cymru, but I'm always more of an optimist about Wales than Plaid Cymru is on almost every point. [Interruption.] Yes, I know. They hate it when you point out to them that every time they get to their feet, it's always to give us the most pessimistic view possible of what Wales can achieve. Llywydd, I'm well enough aware of the difference between a number and a percentage, so I thank the Member for reminding me of that. Let me say this to him. He's offered one solution this afternoon. It's a solution that my party will not adopt; let me be as clear as I can with him about that. Compulsory education for everybody through the medium of Welsh is not the answer to the Welsh language in Wales. It will alienate people who are sympathetic to the Welsh language; it will set the language backwards not forwards. You are perfectly entitled to make that your policy, if you like, but I'm clear with you, as clear as I can: it will not be the policy of the Welsh Government.

Can I turn to—[Interruption.] Yes, I know. Can I turn to constitutional matters? The Labour Party 2017 manifesto included a commitment to devolving policing to Wales. The Silk commission, set up by a Conservative-led administration, recommended it in 2014. Your own Government's Thomas commission recommended the devolution of policing and justice as a whole, and the Labour Party manifesto in 2017 said the Labour Government would work with you in using that report to sort out a failing justice system in Wales. The Brown commission recommendation to devolve just youth justice and probation takes us back 10 years in the devolution debate in Wales. But forget the politics, how about the real-world consequences? The Wales Governance Centre has just said that criminal justice outcomes in Wales are among the worst in Europe. What possible moral justification is there for leaving those powers in Westminster a minute longer than we have to, when they're causing such misery in so many people's lives?

I powerfully welcome the Gordon Brown report, and I powerfully welcome its very specific commitment that the devolution of criminal justice will begin with the next Labour Government. And let's be clear, Llywydd: only a Labour Government will ever be able to set off on that journey and complete it. The Tories won't do it, Plaid Cymru can't do it, only Labour. Only Labour is able to deliver that, and the Brown report commits the party to begin that journey. I think it will be a fantastic thing if, in that next term, youth justice and the probation service are both transferred to this Senedd. That will be the start of that process. Of course, we want that process to go further. It's the policy of the Welsh Government that the whole of the criminal justice system should become the responsibility of this Senedd. But every journey begins with the first step, and those steps are very clearly endorsed in the Gordon Brown report.

If you were serious about devolution, Llywydd, if you were serious about the powers of this place, you would welcome that first step. It's all very well shaking your head in that, 'Oh, dear, aren't they dreadful?' sort of way. Actually, the only progress there will ever be will be with a Labour Government determined to do all the things that Gordon Brown sets out for this Senedd. And not simply in criminal justice, Llywydd, but the other things that that report sets out for this Senedd as well—those constitutionally protected statutes, which mean that the Sewel convention will be made legally binding and inescapable for Governments at Westminster. What protections there would have been for this Senedd since 2019 if that had been in place. I think a welcome for the report on your part would be very welcome, because it puts devolution where we would like it to be, it entrenches the permanence of devolution, it enhances the status of this Senedd, and it widens the power of Welsh devolution. What is there not to welcome in that?