Questions now from the party spokespeople. The Conservative spokesperson, Joel James. 

Thank you, Llywydd. Can the Minister make a statement on how the Welsh Government supports applications to the National Lottery for funding for good causes in Wales, and provide an update on how often the Welsh Government meets with stakeholders to provide oversight for funding distribution? Thank you. 

Well, thank you very much, Joel James. We don't have any influence on how and who the National Lottery funds. We meet regularly with both the director and, indeed, the Wales representative for National Lottery funds. The overall responsibility actually lies with my colleague Dawn Bowden, the deputy Minister, in terms of overall understanding and liaison in terms of the use of the funds. 

Thank you, Minister. It's my understanding that, up until 2020, on the twenty-fifth anniversary of the lottery, Wales had received about £1.75 billion of funding for good causes. Whilst I acknowledge that this is an enormous amount, I'm nonetheless conscious that it only represents around 4 per cent of the total amount of funding provided in the UK, which was in the region of £40 billion. Even if you look at this from a percentage of population point of view, with Wales having about 5 per cent of the UK population, it would seem that Wales has not received a representative share of the money available. 

Minister, I don't think that this was intentional on the part of the National Lottery, and it feels more likely due to either a low number of applications or a high number of poorly presented applications. So, with this in mind, will the Minister outline what steps the Welsh Government has taken to increase the number of applications to maximise the success rate? Thank you.

As I said, we meet regularly. I certainly meet regularly with the National Lottery in relation to those areas of policy relating to social justice. We also visit projects. I visited a very exciting and innovative project in Plas Madoc, in my colleague Ken Skate's constituency, where we saw a really innovative partnership with children and young people, and older people as well. This was us looking at how important the National Lottery funding and investment is. I don't have that information, Joel, in terms of how they are encouraging more applications, but we work very closely with them, and I will ask them to report. I'd be very happy to write to you to give you an update on the awards they've made most recently, on the themes, which they do look at—for example, the cost of living is a key area for criteria at the moment—and, indeed, how they, as we do, encourage people to take up applications.    

Thank you, Minister. I look forward to receiving your letter. With regard to the change now with the National Lottery to Allwyn Entertainment Ltd, which is scheduled in 2024, has the Welsh Government had any engagement whatsoever with Allwyn Entertainment Ltd with regard to funding distribution in Wales? Do you anticipate any changes to the funding of good causes in Wales as a result of this new ownership? Thank you.  

No, I haven't had any engagement, but I certainly will respond to that when I correspond about lottery application take-up and distribution. 

Plaid Cymru spokesperson, Sioned Williams. 

Diolch, Llywydd. A UK-wide public consultation on the interim service specification for specialist gender dysphoria services for children and young people closed recently on 5 December. Although published by NHS England, the proposed changes will impact on young patients who are the commissioning responsibility of NHS Wales. Concerns have been raised by Stonewall and others that access to the interim service will include an additional consultation stage for young people before joining the waiting list, which may cause even further delays to accessing care or even deny access to it completely. There's no reference either to the newest international best practice guidelines for trans healthcare. One of the most worrying aspects is that the service specification seeks to treat social transition as a medical intervention, which is only recommended after receiving a diagnosis and experiencing clinically significant levels of distress. Do you agree, Minister, and Deputy Minister, that social transition, such as changing one's name, pronouns and/or gender presentation, is not a medical intervention?

As you know, the Tavistock gender identity development service—GIDS—is closing next spring. Two regional centres are expected to open: one in London, one in the north-west of England. But there are concerns this will lead to further gaps in provision and lengthen waiting times, which are already high. I'd like to know if the Welsh Government is aware of these proposed changes. Have they been raised with the Welsh Government? Has there been an impact assessment as to how this will affect Wales and children and young people in Wales needing to access gender dysphoria services? How will these changes impact the LGBTQ+ action plan? Did the Welsh Government contribute to the consultation? It obviously will have an impact on young people in Wales seeking support and care. Diolch.  

Thank you very much. This is very much a cross-Government responsibility—principally my colleague the Deputy Minister for Social Partnership, but also the Minister for Health and Social Services as well. We are aware of that interim consultation on gender services for children and young people, and it will have a direct impact on NHS Wales services for the same groups. I think we can update—. In fact, perhaps I will—. Llywydd, can I ask my deputy to update on this?  

No, you can't. That request should have come from Plaid Cymru before the question started.  

Perhaps if I can just say that we'll feed that back. I think what is important—that I can respond to—is the fact that we have got our Wales gender service developing. It was launched in September 2019 and that's a multidisciplinary Wales gender team, based at St David's Hospital in Cardiff. It is very important that it actually has shorter waiting times for first assessments, which is what you raised as a concern.

Diolch. Of course, the service we have in Wales here is for people who are over 18, isn't it? That's the difference. I recently met with the British Medical Association to discuss their 'Sexual orientation and gender identity in the medical profession' report, which highlights that LGBTQ+ doctors are regularly suffering abuse and discrimination. While it is concerning that this is even taking place, it is equally worrying that these staff often report they feel unable to voice their concerns with management for fear of being labelled troublemakers or that they may be outed. Both Scotland and England have independent mechanisms in place across their hospitals for staff to voice concerns about this and other issues in a safe way, but there is nothing in place across Wales yet, despite a 'freedom to speak up' framework being worked on. Could I therefore ask the Minister to liaise with the health Minister to ensure this framework is developed and implemented as soon as possible so that front-line LGBTQ+ healthcare staff get the support that they urgently need?

Thank you very much for that really important question as we lead towards the launch of the plan in the new year, the LGBTQ+ action plan. We had a huge response to the consultation, and I'm sure that this response and concern was part of that. What is important about the plan is it is a cross-Government plan, very much similar to our 'Anti-racist Wales Action Plan', so virtually every Minister has a role to play, including of course the Minister for Health and Social Services. We will be able to take this up with her in terms of that feedback you had with LGBTQ+ doctors recently with the BMA.