The following amendment has been selected: amendment 1 in the name of Lesley Griffiths.

Item 8 is next, which is the second Welsh Conservatives debate this afternoon, on Wales air ambulance bases reorganisation, and I call on Russell George to move the motion.

Motion NDM8172 Darren Millar, Siân Gwenllian

To propose that the Senedd:

1. Recognises the invaluable work of the Wales Air Ambulance service in saving lives.

2. Notes the significant public concerns regarding proposals to centralise the north and mid Wales air ambulance service at a single location.

3. Acknowledges petitions of more than 20,000 signatures calling for the retention of bases at Welshpool and Caernarfon.

4. Calls on the Welsh Government to work with its NHS partners and the Welsh Air Ambulance Charitable Trust to ensure that air ambulance bases in Welshpool and Caernarfon remain in operation.

Motion moved.

Thank you, Deputy Presiding Officer. I move the move motion in the name of my colleague, Darren Millar.

The Wales Air Ambulance Charity is a fantastic service that provides vital support for the people of Wales. The charity was formed on St David's Day in 2001, and operates from bases across Wales. The staff and practitioners are highly skilled—I should say they are employed by the NHS themselves, and they deliver some of the best life-saving services in the world, and they can deliver blood transfusions and undertake emergency operations at the scene of the incident before flying the patient directly to specialist care.

The charity works across all 365 days of the year, and I want to put on record how grateful I am for the incredible service. Not often do I go to a charity event in mid Wales where the donations are not to the air ambulance charity. Proposals emerged last August in a statement from the Emergency Medical Retrieval and Transfer Service, or EMRTS, and the Welsh air ambulance charity, which set out their plans to reconfigure services, which included plans to close bases in Welshpool and Caernarfon. Along with many others, I was surprised and disappointed by this announcement. Often, I hear of a bank closure or a school closure and I'm disappointed, but I'm not surprised. On this occasion, I was surprised; I was gobsmacked that there was even a proposal being considered.

The Llywydd took the Chair.

Our motion today, jointly tabled with Plaid Cymru, sets out a number of factual points and then goes on to ask the Welsh Government to work with its NHS partners and the Welsh ambulance trust to ensure that air ambulance bases in Welshpool and Caernarfon remain in operation. I've so far seen no evidence that moving a base further away from mid or north Wales, as proposed, will be of benefit to those people living in those areas that depend on those services. There have been significant public concerns raised by the proposals. We've seen a paper, an online petition, of over 20,000 people, calling for the retention of the Welshpool and Caernarfon bases—and, of course, many people who signed the petition also donate to the service—and expressing their concerns over the centralisation over this base into one location.

Now, I represent a constituency in mid Wales, so I can talk about the views in mid Wales, and I know that colleagues representing north Wales will make similar points. People in rural Wales just feel left behind. Public transport is poor, we have poor road infrastructure, and many public services are being gradually deteriorated. All this means that people are genuinely and deeply hurt by the proposals to close the Welshpool base. Now, the original proposal was brought forward last August. That's now effectively on hold, and we're now waiting for a further proposal to be brought forward by EASC, or the Emergency Ambulance Services Committee, another service within the Welsh NHS, which is of course ultimately the responsibility of the Welsh Government. The whole process and information surrounding these proposals has been confusing, and I wouldn't blame Members across this Chamber for not being able to keep up with what I've outlined so far.

In August, I first met with the air ambulance charity to raise both my and residents' concerns, and the charity indicated to me that they owned the process and the trust committed to a genuine consultation with residents. There were discussions about a potential public meeting happening in September, and they also confirmed that they would publish data the following month. That said, the charity later said that the data in question did not belong to them, it belonged to EMRTS Cymru, the service within the Welsh NHS. Now, in August, the charity, when I spoke to them, seemed absolutely certain that their proposal would lead to a better service for all of Wales, despite the analysis that sat behind the proposals not being completed and ready to be published. In September, that's when I raised my first concerns here in the Senedd with the First Minister, pointing out that mid Wales suffered from years of poor access to health services, also stressing that we have no district general hospital, either in my constituency or the county of Powys, and very poor road connections. So, it is vital that we have access to good emergency services and that people can be transferred quickly to emergency care if that is needed. 

I asked the First Minister to publish the data that sat behind the proposals, and the First Minister said that the data that sat behind the proposals is not owned—. He said that the data that's sat behind the proposals is owned by the charity, despite the charity saying at around about the same time that it belonged to the Welsh NHS EMRTS service. When I raised this in the business statement in October with the Trefnydd, the Trefnydd seemed to suggest that the data wasn't ready for publication, so implying it is owned by the Welsh NHS and the Welsh Government. So, if Welsh Government Ministers are finding it difficult to follow and understand this process and who is responsible for leading this and who is responsible for the data, then I do ask how difficult it is for the public to follow.

We've had a little bit more of a clearer picture now. In October, the Welsh NHS EASC team announced that they were now leading the proposals that sat before us, and the chief commissioner for the ambulance service would be responsible for the engagement process—the chief ambulance service commissioner, Stephen Harrhy, who's now leading that process. Interestingly, when I met with the charity last month, they said that the proposal was now not theirs; they were now consultees in the proposals themselves. So, EASC published an update last week—here it is—with the Welsh NHS logo on the top, and this clearly says that they will be deciding and making the final decision. So, I hope that all can appreciate and the Minister can confirm this is very much a decision for the Welsh NHS and the Welsh Government—that's where it clearly lies. And that's why we won't be supporting the Government's amendment today, as I think it is misleading. The Welsh Government and the Welsh NHS were clearly involved in the process.

I want to challenge some of the assumptions made in the original proposal. The Wales air ambulance could attend up to 583 additional missions every year. This was a big part of the proposal to close both bases; that was a key element. Now, this should not be about missions attended, this should be about attending the most crucial incidents, which I would suggest are going to be in the most rural parts of Wales, due to poorer road infrastructure and the time it takes for an emergency service to get to an incident by road. And whilst at the time the charity and EMRTS seemed absolutely confident with their proposals, after much challenge, I think that 583 figure is now perhaps not so accepted. And it would be interesting to see any updated figures in the new proposal document. 

I don't think the original proposals adequately reflect weather conditions, something that really should have been front and centre of considerations, bearing in mind the challenges of flying in and to parts of mid and north Wales. And proposals for moving bases also mean the rapid-response vehicle, which is also an important element to this, won't be rapid in large parts of Gwynedd and mid Wales if they are also moved. Now, there are huge areas of mid and north Wales where emergency and A&E facilities are over an hour to get to by vehicle, and we have seen a confused process since last August—confusing for the Welsh Government also, it seems, and confusing for the Welsh public. So, I would urge the Welsh Government to work with their NHS partners to ensure that updated proposals include for air ambulance bases in Welshpool and Caernarfon to remain in operation so that there is adequate emergency air ambulance cover across all of Wales.

So, I do hope that, as this debate now moves forward, we can work together on how we can achieve that, for both bases to remain open. I hope that this debate will lead to an outcome where the Welsh Government and the Minister can intervene and allow for that process to happen. 

I have selected the amendment to the motion, and I call on the Minister for health to move formally amendment 1, tabled in the name of Lesley Griffiths. 

Amendment 1—Lesley Griffiths

Delete all after point 1 and replace with:

Notes the Emergency Ambulance Services Committee is undertaking formal engagement as part of a review of the Emergency Medical Retrieval and Transfer Services (EMRTS) Cymru service.

Notes the review is intended to ensure patients who need the service can access it no matter where they live in Wales or when they need it.

Notes no options or proposals have yet been agreed, nor decisions made.

Amendment 1 moved.

Formally.

That has been moved. Rhun ap Iorwerth.

Thank you very much, Llywydd, and Plaid Cymru is pleased to co-submit this motion. It's very important that there is cross-party support here, and I do appeal to Members on the Labour benches to support the motion.

Let me take you back to August, the Bull pub in Llannerch-y-medd. And I don't know how exactly to describe the community extravaganza of the sheep shearing. There was a fair there, there was a party, an auction, and £50,000 was raised in one afternoon and evening, and all of that funding donated to the air ambulance. Why? Because everybody appreciates this service and what it means to our more rural communities, in that case. Certainly, it's a service for all parts of Wales, the urban and the rural, but one of the major drivers behind the service and its establishment was the fact that there are so many parts of Wales that are long distances from hospitals, difficult to reach with ambulances, or a long way from specialist care.

Over time, the service grew: one, two, three, then four helicopters, with the inception of EMRTS teams transforming things further, and now this is a service provided in all parts of Wales, all parts covered by helicopters, with Caernarfon and Welshpool serving the north-east, the north-west and mid Wales. But now that's under threat. The intention is to close those two sites, Caernarfon and Welshpool, and to move to one site in central north Wales, and I fear that that will be a mistake if it happens. Why is this even being proposed? Well, quite simply, according to EMRTS, more people will be reached, a higher number, and more calls will be responded to by the air ambulance teams—by air or with their response vehicles. Because of course this is a service that works in two ways—on-road vehicles as well as helicopters. But I fear that it's a matter of hitting a statistical target, that that's what we have here, rather than considering the true purpose of the air ambulance service. If it's possible to reach more people—and EMRTS say that that's the case—and to deliver against that statistical ambition, well, I fear that it'll be through serving more people in the more populated areas of the north-east at the expense of the population in the more rural areas. Now, as I said, this is a service for all parts of Wales, and it's important that EMRTS can reach as many people as possible in the north-east too. So, isn't the solution to provide a team with a road vehicle in that area, a team that could reach a very wide area quickly, with helicopters still being available, of course, from their current bases, if needs be?

Now, in closing Caernarfon and Welshpool, it's not just the aircraft that would disappear, the vehicles would be gone too, and you don't need an expert on Welsh geography to realise that trying to serve the north of Anglesey, the far end of the Llŷn peninsula, south Meirionnydd or Powys from Rhuddlan with a vehicle as an emergency service is never going to work.

What we have asked for is a genuinely independent review of the proposal and the statistics that underpin it. The modelling system used wasn't designed for this the sort of thing. Many of the additional patients that apparently could be reached have already been addressed by enhancements to the Cardiff base. Remember the recent reports on the service, highlighting the need to enhance the Caernarfon service? Taking it away will never be an enhancement. Even with one of the helicopters having night-flying abilities, which we would all welcome, remember that means shifting one of the Caernarfon/Welshpool helicopters to an afternoon shift, meaning you'd have an enormous geographical area served by just one helicopter much of the time, and, in that scenario, the more densely populated areas of the north-east again are likely to be a big draw on resources.

These aren't just my fears; they're the fears of air ambulance operators, who point to the much increased flying time to some communities, and of doctors and paramedics. And let me finish with one last very important point: the air ambulance is a very, very powerful recruitment tool. Take away their Caernarfon base for example, and there goes that very valuable carrot to attract new emergency medicine doctors to Ysbyty Gwynedd, for example.

So, let's step away from the brink here, let's have proper engagement, let's really review what this proposal means independently and so avoid risking the amazing and well-merited goodwill and support shown to the Welsh air ambulance by the public in all parts of Wales.

I'd like to thank my colleague Russell George for opening this debate and his efforts in this campaign of highlighting it on a national stage. The air ambulance is an essential part to the people of mid Wales, and it's a lifeline to the people who live there. As a rural area, we don't have many of the things that people in more densely populated parts of Wales take for granted. You know, it's one of the blessings and a curse of living in a rural area, really, that we don't have the services that other parts of Wales rely on. As a result, services like the Welsh air ambulance take on an even greater role. It's literally a lifesaver for many people in my constituency. Shutting the Welshpool base will reduce the ability of the air ambulance to fulfil its role in my area. It's where it's needed most; it will mean longer travel times for the air ambulance coming from north Wales and a reduced ability to get to where it needs to get to in poor weather conditions, something that has been highlighted by many people.

The slow ambulance response times in parts of mid Wales are also a big problem, and also the lack of health provision—as my colleague Russell George said—that we don't have a district general hospital, and this again means the air ambulance plays more of a vital role. It really does save lives, and the public in mid Wales and in Brecon and Radnor know this. Of course, it doesn't just impact the people from my constituency; the air ambulance sometimes crosses over the border into Herefordshire and Shropshire to help people who've had major accidents there, and, if the base is put into north Wales, that will affect the delivery of that to help those people across the border who need that help in their hour of need. So, this will be felt far wider than just mid Wales; it'll be felt into England as well.

So, I recently attended a public meeting in Knighton organised by the SAVE Wales Air Ambulance campaign, and I'd like to pay tribute on the record to all their hard work and what they're doing in leading this campaign. The event in Knighton was attended by campaigners, members of the public and local councillors, and it was clear in that meeting about the passion that local people have for our air ambulance. The amount of money that is raised for that air ambulance is surely astronomical; it's probably one of the best funded charities in Wales, because people right across Wales understand how important it is. So, if this move happens and it goes away, it'll just have a devastating impact on the people of Powys and my constituency, as my colleague Russell George has said.

Of course, it is disappointing that the consultation process has been delayed, but we understand that there are huge pressures in the NHS and the staff are needed to tackle those problems. But once the consultation gets started again and gets back on track, I hope that that consultation will be wide ranging, very open and transparent, because it is clear that the bulk of public opinion is on the side of keeping that Welsh air ambulance base in Welshpool and in mid Wales.

Previously, I met with the chief ambulance service commissioner and expressed my concerns about this proposal and asked him for clarity about the consequence of a potential move. I hope, as the consultation process proceeds, that we will actually get that clarity that we want and shine some more light on the data—what my colleague Russell George has also said. But let me be clear: keeping the Welsh air ambulance bases in Wales is of the utmost importance for everybody, and if this is taken away, lives will be lost in my constituency and wider.

I'm proud to campaign for the retention of the air ambulance base in Welshpool alongside all of my Welsh Conservative colleagues here and my colleagues across the Chamber in Plaid Cymru. I call on the Welsh Government and its partners to do everything they can to make sure that ambulance base stays in Welshpool and to stand up for the people of mid Wales. I say to other political parties in the Chamber: please support our motion today in the interests of the people and the lives of the people in mid Wales. We need this service in mid Wales, so please don't take our lifeline away, and vote for our motion today. Thank you.

Thank you to Russell George for tabling this important debate this afternoon. At the outset, I want to emphasise that we on these benches and, I know, those on the opposite benches too are friends of the air ambulance. We approach this issue as critical friends, and the reason for that is because this excellent charity and the wonderful service that it provides are so crucially important to Dwyfor Meirionnydd and other communities in north and mid Wales. I've held public meetings in Porthmadog, Towyn and Pwllheli, and the hundreds of people who have attended those meetings and discussed their own personal stories and experiences are testament to the invaluable service provided.

Let us not forget that the air ambulance came to north Wales following a campaign by Nia Evans from Dolgellau following an appalling road accident that she and her fiancé at the time, Kieron Wilkes, suffered near Harlech in 2002. The sadness is that Mr Wilkes lost his life in the accident, but Nia was saved after the police air ambulance took her to Ysbyty Gwynedd. She successfully petitioned to have an air ambulance centre in north Wales. So, consider the Harlech area, or indeed Llangrannog or Llangynog; they are remote, rural areas, a long way from all core services. Since then, the charity has proved to be one of the most popular in north and mid Wales, with our rural communities raising hundreds of thousands of pounds, as we've heard already, for the charity, because they understand the value of the service.

I had the privilege of going to Dinas Dinlle to speak to the workforce and the doctors there last year, and the whole thing is quite incredible. The glory of the Dinas Dinlle site is that it's just a stone's throw from Ysbyty Gwynedd, which means that the workforce there can improve their medical skills in the hospital too, which of course enhances the experience of all.

Although the air ambulance is its name, it is far more than that in reality. It's not a service that just carries patients; it's a small airborne hospital or one on four wheels, with talented, committed people being able to reach the most remote areas to save lives on the spot. Because there's more to the air ambulance than a helicopter.

The most important element, of course, are the medics who are part of the team, but the rapid response vehicles, the RRVs, are also a core element. For those of you who know Dwyfor and Meirionnydd, you will know, despite the incredible beauty of the constituency, the sea, the lakes and the rivers do often leave us in a blanket of fog and mist, and when this happens, the helicopters can't land and we are reliant on the rapid responsive vehicles that are part of the charity's service. Now, if the service was centred in Rhuddlan, how quickly do you think a rapid response vehicle could reach from there to somewhere such as Anelog at the far end of the Llŷn peninsula, or Llanymawddwy? It would take hours. It would be impossible for them to get to any of these places in time. So, despite the fact that computer modelling suggests that more lives could be saved, the truth is that our coastal and rural communities will suffer.

That brings me to my final point: I want the Government here to give us an assurance that they have full confidence in the Optima modelling programme that's been used to justify these recommendations. These are the Welsh Government's health figures that are being inputted, and EMRTS is making the assessment, so the Government can't wash its hands of this. Because, as I understand it, the figures focus on the number of incidents that can be reached, as Russ mentioned earlier, but without taking account of whether these are the most serious incidents, because Optima is drawn up for ambulances in more general contexts, not for the needs of an air ambulance covering a large rural area.

To conclude, therefore, this service has proven itself to be crucial to our communities, and the recommendations made suggest that our rural communities will lose out. The people I represent and I are seeking assurances that we won't lose any level of service here, and that this isn't an exercise in reaching targets at the expense of the health and well-being of the people in my constituency. Thank you very much.

I'm afraid the Welsh Labour Government claims to be in favour of universal healthcare, but it's once again proving that this is not the case. Rather than be universal, it's showing itself just to be south Wales healthcare, and north Wales, once again, being left behind by politicians in Cardiff Bay.

We've rightly called the Welsh air ambulance service invaluable, because it is invaluable to the people of mid and north Wales who often live in rural communities or far away from the nearest hospital, as has been mentioned. And also, on top of that, the areas of mid and north Wales attract a lot of tourists, particularly in the summer months, and because of the geography of the area, it attracts a lot of people wanting to engage in outdoor pursuits, which, as enjoyable as they are, do pose a risk. And, unfortunately, you will always get people who are willing to climb up Snowdon in the summer wearing shorts, T-shirts and flip-flops, which, obviously, poses a higher risk, which is why we need these vital services in rural areas to cater for those needs of the area. 

Again and again, residents are being increasingly isolated by the policies of the Welsh Government and rightly feel that they've been left behind compared to people down here in Cardiff. A combined base in north Wales risks not adding any benefit to the service or for those who need it the most, and I fully support the status quo in keeping the Welshpool and Caernarfon stations running and operating and doing the good job that they're doing on a daily basis. I applaud the 20,000 residents who have signed a petition to prevent base closure, and those who have taken part in a banner campaign. This shows that residents want the Welsh Government here in Cardiff Bay to listen to their deep concerns over the NHS, and it also shows that the Welsh Government are not considering the bigger picture. By removing the availability of air ambulance to people in mid and north Wales, it will just add to the pressures on ambulances and the waiting times that we see day in, day out across our healthcare services, particularly at Betsi Cadwaladr University Health Board. So, I urge all Members of the Senedd to support our motion unamended this afternoon. Thank you.

I'd like to begin by putting on record my thanks and the thanks of all of us here, I'm sure, to those volunteers who are part of groups such as SAVE Wales Air Ambulance—Welshpool Base for their tireless work to raise awareness of the proposals that we are discussing here this afternoon.

The fact that there have been over 20,000 signatures, as we have already heard, opposing the closure of the Welshpool base demonstrates the strength of feeling locally towards the service, encapsulating that special relationship that exists between the air ambulance and the communities that it serves. And this relationship reflects the fact that hundreds of lives have been saved by the air ambulance, and is further exemplified, as we have already heard, by the thousands of pounds donated every year by people across mid and west Wales, who give generously from their own pockets to support this special charity. And it's disappointing that the air ambulance’s roots in its community, and the sense of local ownership of the service, are at risk due to the plans to relocate the service.

As has been highlighted during this debate already, many communities in mid Wales are feeling increasingly abandoned in their access to wider health provision. There's no general hospital in Powys, and previously available services—at Llanidloes and Newtown, for example—have been downgraded, and ambulance response times continue to fall shamefully short of critical targets. Under the wider pressures of austerity, this running down of services has often been justified by the sparseness and rurality of the mid Wales population. Despite consistent warnings from Plaid Cymru about its long-term consequences, there has been a historical drive to centralise services in more urban settings, and we are therefore seeing the dire consequences of this playing out this winter.

It is precisely the rurality of mid and west Wales’s communities that makes an effective local emergency response all the more vital. We have an ageing population, high numbers of people undertaking open-air activities, high numbers and prevalence of farming and agricultural activity, and what have been recently acknowledged as the most dangerous roads in Britain. This all means that our rural communities are rife with potential medical emergencies, to which timely responses are both critical and made difficult by a complex geography. While local healthcare provision has been hollowed out in these communities, the air ambulance has been the one constant—seen by many as a vital safety net.

I acknowledge that the air ambulance has pledged that this rapid response that it offers will continue in any process of centralisation, and I certainly welcome that commitment. However, like others, I am particularly concerned about the impact that any such centralisation could have on the effectiveness, as Mabon mentioned earlier, of the rapid response vehicle service provided by the charity. We have seen in Welshpool, and in other areas, that these road response services have been vital when the helicopter has been unable to fly because, perhaps, of poor weather. Indeed, in 2021, of the 3,544 response journeys made by the air ambulance across Wales, almost half—47 per cent—were attended by a rapid response vehicle.

I am concerned, therefore, that the centralisation of these vehicles in north Wales will drastically hamper the effectiveness of rapid response vehicles. And at a time of such severe strain on the ambulance service, this concern is particularly grave.

This debate has highlighted many things, from the magnitude of local feeling, to questions regarding the data used by the air ambulance service in its decision making. I share all of the concerns expressed this evening about the implications of any centralisation plans. I would urge Welsh Government, therefore, to work with its NHS partners and the Welsh Air Ambulance Charitable Trust to ensure that any reorganisation does not endanger the lives of people living in mid and west Wales.

Thank you to the Conservatives and to Russell George for setting out these important issues.

Across the Chamber, I think it's fair to say, we are in awe of the Welsh ambulance service. It is an absolute life-saver, and I am very clear that I’ll be supporting this motion this evening. Both the Welshpool and Caernarfon air ambulance bases provide mid and north Wales respectively with a lifeline in the form of emergency medical support and transit.

Rural healthcare is challenging, we know. But we need more rural healthcare, not less, and what this proposal, as we understand it at the moment, is saying is that we will have less coverage across rural areas, particularly for Mid and West Wales, which I represent. It’s my strong view that the Welsh air ambulance and the Welsh NHS have not been able to demonstrate by independent evidence that more lives will be saved, in particular in those areas where the bases currently reside, and therefore it is really clear we must oppose the potential and proposed closures. It’s hard, really, to describe—unless you live, in my case, in Mid and West Wales—the absolute public outcry about the proposal. There is real, genuine fear that people will lose lives. We need to be clear that that is not going to be the case. There is not a shop, there is not a cafe around where I live, and where many of us live in Mid and West Wales—and perhaps the same in north Wales as well—where there isn’t a poster saying 'Save the Welsh Air Ambulance'. Many people, as you’ve heard, are not just thinking it’s about their lives, their relatives’ lives, their neighbours’ lives—it is about the fact that they’ve invested their heart and soul in fundraising for this absolutely important service.

It's worth noting that, since these proposals were leaked to the press, the air ambulance and Welsh NHS have been so far unwilling to provide the data. Communication is key to this, and, let’s be honest, it’s been a mess up to today. Russell George has helpfully tried to navigate us through the changes, and the mixture in who’s responsible for what. We maybe have got our heads around it, but the people who are investing their lives and the pennies and the pounds that they put into it will not have done. At the moment, I can see no option but to maintain the service as it is and commit to the bases remaining where they are until there is absolute clear, independent scrutiny of the figures and there is a much better communications plan of the data, and an openness to listen to the people that this will affect. Thank you. Diolch yn fawr iawn.

I would like to put on record also my thanks, on behalf of the constituents also of Aberconwy—our thanks and our appreciation for the vital contribution of our air ambulance service. Now, the Welsh Air Ambulance Charitable Trust, and every single team member, provide an essential life-saving emergency medical service for the critically ill and injured across Wales. Only in the last 12 months, there’ve been several occasions where the air ambulance has landed on a local playing field, on a busy main road here, and various other places that I didn’t even realise a helicopter was capable of landing, but such was the need for their help and that rescue. That their team is capable of reaching a critically ill patient anywhere in Wales within 20 minutes of receiving a call is testament to their selfless dedication. With the advanced standard of care that the crews deliver at the scene of an incident, and the rapid transfer of patients to specialised medical care across Wales, including throughout the night, it can perhaps be all too easy to forget that this is a charitable organisation reliant on the support of the public, and it’s my understanding that this is how they’ve always wanted it to be. They’ve wanted to be that independent rescue service. However, every year they need to raise £8 million to keep the helicopters in the air and rapid response vehicles on the ground. Now, I had the privilege of seeing first hand and discussing the fantastic work of the air ambulance team when I visited their north Wales operating base recently—well, a few weeks ago, before Christmas—with my colleague Sam Rowlands. We both were very impressed with the setup at Dinas Dinlle, and it was extremely efficient and very effective. However, I completely agree with everything that Russell George has said. In the depths of a winter crisis in our NHS, with strikes still continuing unresolved, this does now seem to me to be the worst possible time to even think about closing down air ambulance operating bases.

Unanswered questions still remain on the impact this would have on any constituents affected, certainly my constituents and residents across the whole of north Wales. We also need to know the amount of time it takes for the air ambulance to fly from, say, Dinas Dinlle and Rhuddlan to different points in Aberconwy, so that we can actually compare what the effects will be. As I said, I will always be very grateful for the service the air ambulance provides, but we really do need more data—and your Government could provide this, Minister, or the organisation—so that we can carefully establish what impact the proposals are going to have on those constituencies and the patients who will be affected by any closures.

As many others have said, closing Welshpool and Caernarfon could not only put patients at risk, but it could have knock-on consequences for other areas. Wales is already facing increased ambulance waiting times. In north Wales, appallingly, last September alone we had 35 red calls for life-threatening emergencies that took over an hour to be reached—with two of those taking half an hour to be reached and two of those taking over an hour. We've already seen the impact of these chronic pressures in my constituency and the north Wales region, with critical care incidents being declared by Betsi Cadwaladr University Health Board due to the overwhelming volume of patients needing care.

Aberconwy, of course, is a constituency with a large rural and older population, and we have many areas that have poor roads and phone reception, and they can be more difficult for regular ambulances to reach in time. So, this alone underlines the crucial importance of having a wide-ranging air ambulance service, with good geographic coverage across all areas of Wales. The problems in our ambulance service are already acute enough without risking adding to the pressures. The centralisation plan, in my opinion, leaves too many unanswered questions for me and, indeed, for my constituents, and, again, I endorse the 20,000 who have already signed a petition against these closures. I guarantee that those numbers will increase dramatically. We risk worsening demands on our ambulance services at the worst possible time. I would therefore ask all colleagues in the Senedd to support our motion—no other amendments, just support our motion—and let's ensure that we show our support to our air ambulance service. Diolch.

Many constituents have contacted me on this issue, and the strong feeling is that the north-west is in danger of being excluded from a very important service once again. I know how much the service means to local people, the lives that have been saved and the benefits of having this rapid response service on our doorstep. So, I call upon the Welsh Government to prove—to prove—that the proposed change won't endanger the availability and the response times of the service for those communities that are, to all intents and purposes, dependent on the air ambulance in emergencies. 

There is a clear message being shared in the Senedd today, and I do truly hope that the Minister is listening and can do everything within her power to share and pass on that message, and to take action as a Government too. We have to retain this service in Caernarfon and in Welshpool.

The Minister for health to contribute to the debate—Eluned Morgan.

Diolch, Llywydd, and very many thanks for allowing me to reply to this opposition debate.

I'd like to begin by placing on record that I recognise the invaluable partnership between the Wales Air Ambulance Charity and Emergency Medical Retrieval and Transfer Service Cymru, known as EMRTS, in saving lives and in optimising outcomes in Wales. The air ambulance service in Wales is making a huge difference across Wales. An evaluation of the service between 2015 and 2020 has highlighted an increased chance of survival, with a significant 37 per cent reduction in mortality after 30 days for patients with blunt trauma. Sixty-three per cent of patients had treatments at the scene of their incidents that previously they could only have had within a hospital. Forty-two per cent of patients bypassed local hospitals to be taken directly to specialist care, saving time for the patient and extras resources for the NHS. And 12 new consultants have been recruited into Wales, due to the attraction of working with Wales air ambulance.

Now, I'm aware that there has been confusion around the nature of service delivered by EMRTS in collaboration with the charity. To clarify, as Russell explained, the EMRTS team is employed by NHS Wales, which pays for EMRTS staff and medical equipment. This part of the service is commissioned by the emergency ambulance services committee, which is a joint committee of all the health boards in Wales. The charity provides the helicopters, the air bases, the rapid response vehicles, pilots, fuel and engineers. Now, EMRTS works with the charity to provide on-scene specialist critical care services to treat people with a life or limb-threatening injury that could lead to death or disability. On average, EMRTS responds within 50 minutes by air or 40 minutes by road. This is a highly specialist critical care service, not a substitute for emergency ambulance services. It's not a first-response service and, as Mabon explained, it takes the emergency department out to the patient.

Current service provision has four teams based at, as we've heard, Welshpool, Caernarfon, Llanelli and Cardiff. That happens during the day, with access to helicopters and rapid response vehicles. But, at night, there's one team, and that's based at Cardiff, with access to a helicopter and a rapid response vehicle. On average, 1,100 patient calls are reviewed by the EMRTS critical care hub each day. One hundred and forty of those calls are assessed in more detail, and approximately 13 will be assessed as suitable for an EMRTS response. But, under the current service model, only 10 patients receive an EMRTS response per day. So, there is therefore an opportunity for this specialist service to treat more patients every day in Wales. Now, the charity, EMRTS team and the emergency ambulance services committee are keen to increase the number of people seen, if possible, to ensure patients who need it can have access to this specialist service, no matter where they live in Wales or when they need it. I have no doubt every Member in this Chamber shares the aspiration to save more lives and to ensure EMRTS and the charity can treat more patients.

As I stated previously, there are four highly skilled teams in four bases covering the whole of Wales, but some are busier than others.

Everyone involved in the work of commissioning and providing these crucial services is eager to ensure that the funding available to them is spent in the best possible way. They would like to reduce the number of patients who can't access the service. In addition to that, the Wales Air Ambulance Charity wants to make the best use of the donations made by the public and is currently developing a new long-term agreement for helicopters. That's why they want to look at the situation. This is all a valuable opportunity to look again at the way that the service is provided.

Members will be aware that the EMRTS team has brought together a comprehensive and complex proposal to develop the service and presented this to the emergency ambulance committee in November. The committee has considered the content and has asked for further information and unbiased scrutiny. The main commissioner of the ambulance service and the team have started the work anew and have put the original proposal to one side. A review is being conducted of the current service model. The chief commissioner of the ambulance service leading the review on behalf of the committee is currently developing materials to gather views, and that formal process will commence as soon as possible. The review and evidence-gathering process will ensure that the right things are taken into account so that the views and concerns of all crucial stakeholders can be fully understood. I have asked the individual leading that to consider what's been said in this Chamber today. Rhun.

Thank you very much. I appreciate your description of the situation and I'm very pleased that you have asked for today's comments to be borne in mind. But, can I ask for your views on a point of principle? Do you agree with me that it would be inappropriate to increase the number of patients reached in one part of Wales at the expense of those people who live in other areas? We all want to see this service improving for as many people as possible, but it would be inappropriate to decrease service levels for some and to increase it for others. We should be looking at improving the service for those other areas.

I think that some of the points that have been made on the floor of the Chamber today are important and should be taken into account, particularly, I think, the fact that when it's difficult for a helicopter to reach a certain place, you would have to use a vehicle, and that is far more difficult in rural areas. I'm sure that will be taken into account during the inquiry and the review. I would suggest that people do respond to this; that's the whole point of having this review. We need to gather views that people in the Chamber and people in our communities should respond to that process.

The process will help the committee decide what to do next, including developing options to help to improve services and increase the number of patients that receive a response from EMRTS. The process will also consider whether changes are required to the operational centres or not in order to deliver against this target. To be clear, no decision has been made. As part of the evidence-gathering process, the chief commissioner is establishing a robust process to evaluate the options in order to ensure that the best possible decision is made on the future of the EMRTS service in Wales. There's been confirmation that the formal process will take at least eight weeks, and it will be a comprehensive process in order to give an opportunity to those who are interested to make their comments. Once this has been completed, I will make a further statement. Thank you.

Samuel Kurtz now to reply to the debate.

Diolch, Llywydd. It's a real pleasure to close this debate this afternoon because we've heard real cross-party support for something that I believe is distinctly Welsh. The Welsh people take great pride in having somewhat of an ownership within a charity that affects and can affect and can influence everybody's lives in all four corners of this great country.

In opening the debate, Russell spoke about that Welshness and how it was launched on St David's Day 2001. We heard then about the complexities that existed following the announcement back in August from EMRTS and the Wales air ambulance, and he provided us a helpful timeline in terms of that. The notes I made make for difficult reading, so that is the complexity of that—for a layman trying to understand who the responsibility lay with it must be incredibly difficult.

Pertinent to Russell in mid Wales, obviously, is the potential closure of the Welshpool base. I think Russell added on to that the confusion after he brought questions to this Chamber around the data, the ownership and the responsibility of that. I think that's something really pertinent. But Russell provided us with a very helpful overview of the situation as it has been over the last couple of months in allowing us to visualise why this debate is so important to us here today.

Rhun then, following Russell, provided that cross-party support and mentioned the Bull in terms of the fundraising element. Yesterday, we heard from Darren with regard to Wetherspoons, the Bull from Rhun today—[Interruption.] A proper pub—and the £50,000 raised in that fundraising effort. I myself, as a member of Pembrokeshire young farmers, cycled up to Blackpool raising money for the Wales air ambulance. It's one of those charities that, wherever you are, in all parts of Wales, you feel that you've raised money, and that's where that ownership of this charity comes from and why that is so important.

Rhun stressed the importance of rural Wales and how difficult it is to access that emergency healthcare when it's required across rural Wales. What Rhun really stressed there as well was how this is an important recruitment tool to areas of Wales where there are these depots—Minister, you mentioned that as well. I think that's really important. When there are difficulties in recruitment in the NHS in Wales, having something of this quality in those four regions of Wales I think is a real tool that we should be singing and dancing about, rather than looking at consolidation and centralisation into one area.

Moving on, we heard then from James, a colleague of Russell's in mid Wales, and the importance around the Welshpool depot—again, the rurality, the difference of healthcare provision in urban and rural settings, and the longer flight times, potentially, from north Wales. Again, he stressed the no district general hospital in Powys—that's why we need that air ambulance—and the importance of the Save Wales Air Ambulance campaign. He spoke eloquently about the local support that he'd had from members in his constituency.

We heard from Mabon, wanting to be a critical friend here, because this is something that we do love, so we want to be supportive in how we can ensure that this is available to all four parts of Wales, and especially mid and north Wales as well. Again, he talked about those personal stories, and the story of Mr Wilkes and Nia and the success from the tragedy of Mr Wilkes, the success of getting a depot in north Wales, a base in north Wales for the Wales air ambulance, and the importance around that, and, again, stressing that this isn't just an ambulance picking up a patient, taking it to a location. This is, in essence, a hospital with rotor blades, taking first-class medical expertise to an incident, which is why this is so very important. He stressed then, again, the weather conditions in Wales and how the rapid response vehicles are so very important.

Gareth Davies spoke about the disparity in healthcare provision in north and south Wales and stressed, then, regarding the tourism and outdoor pursuits, the pressures that that can put on health services and why this air ambulance is so important in north Wales in accessing that. We know full well from Gareth, who's a big advocate for the tourism industry in north Wales, the activities that are available there and why that air ambulance is so important. He stressed again the 20,000 people who have signed the petition and been in the banner campaign. Our thanks go to them for their advocacy of the Wales air ambulance, what they've done in raising the visualisation of why this is so important, this campaign around protecting it and ensuring it exists in north Wales and mid Wales continuously. 

Cefin, moving on, thanked the staff on board, not only the medical staff, but also the pilots and the skills of the pilots, which Janet mentioned as well, in being able to land in so many different positions. I think that's fantastic. Again, Cefin stressed the local ownership that we feel in terms of fundraising. This is something that I think is really important. There are very few charities in Wales that touch so many lives across all parts of our country, and I think that's why this petition has had so many signatures and why this debate is so important this afternoon.

Jane we heard from in terms of your support for our joint motion with Plaid Cymru this afternoon, and we thank you for that, and, again, the disparity of healthcare provision in mid Wales and how this is a necessity in that sense. Janet Finch-Saunders, as I mentioned, was talking about the skilled nature of those on board, and I think that Janet is a fabulous advocate for those in north Wales who provide the excellent facilities that are available to her up there.

Siân Gwenllian was quite candid in calling for the Welsh Government to prove that changes don't endanger patients, and I think that is something that is absolutely important. Any changes such as this should always take into consideration the patient first and foremost and their safety. 

Minister, given the cross-party support today, I think it would be very interesting if you'd be willing to meet cross party to discuss this and the provision of the Wales air ambulance in Wales, especially north and mid Wales, and see if there is a way forward for all these bases to continue. I think that would be really excellent if that could be agreed upon. And something that I just want to stress as well is, in answering questions previously on health provision in north Wales, you've said now is not the time for reorganisation, so shouldn't that be true still for the Wales air ambulance, given the pressures the NHS is under? Should now not be the time for considering any reorganisation? 

I want to close—Llywydd, you've been very kind with my time—in terms of speaking about 'our vision', as the Wales air ambulance write on their website:

'To improve the lives of patients and their families by being a world leader in advanced, time-critical care.'

The time is now for the Welsh Government to listen to the people of north and mid Wales. Diolch.

The proposal is to agree the motion without amendment. Does any Member object? [Objection.] Yes, there is objection. We will, therefore, defer voting until voting time.

Voting deferred until voting time.

Unless three Members wish for the bell to be rung, we will move directly to voting time.