1. Will the First Minister make a statement on ambulance response times? OQ59013

I thank Jane Dodds, Llywydd, for that question. Record levels of demand have placed real pressures on ambulance response times, with lengthy delays for some patients. Nevertheless, in December—the most difficult month—the service responded to the highest ever number of red calls within the eight-minute target.

Thank you for that response.

It's 13:30. If somebody phones 999 now because they have chest pains, when would you expect an ambulance to arrive? I'm sure you'll recognise that question from the leader of the Labour Party in Westminster, Keir Starmer, to the Prime Minister. The Prime Minister refused a straight answer, so I'm hoping that we can get a straight answer from you this afternoon. But, from NHS Wales stats, we know that, for the person who's just called 999 with those chest pains—surprisingly not a red call, but an amber call—they will likely wait over an hour for an ambulance to arrive. If the person who'd just called 999 was in a life-threatening situation—a red call—they could wait as long as 15 minutes in Powys. The target, as you know, for those red calls, is eight minutes, and the last time those targets were met was July 2020, and the figures have been in free fall ever since. Our ambulance staff work incredibly hard under very difficult circumstances. 'Diolch' to them all. So, could you tell me when you expect these targets to be met? Will it be another two and a half years before the red call targets can be met? Diolch. 

Well, Llywydd, let me, first of all, answer the specific question that Jane Dodds asked in introducing her supplementary question. The management information provided in the Welsh NHS suggests that, last week, the week beginning 16 January, had it been a red call, the standard waiting time—the median waiting time—from the minute a call is dispatched to it arriving with a patient was seven minutes, 43 seconds. That means, given the time that a first question on a Tuesday normally takes, by the time the question is over, the ambulance would have left and arrived. And if it were an amber call, as Jane Dodds suggested, then the average response time last week—the standard response time—was 38 minutes, 52 seconds. 

On the broader point, when the ambulance service last reached the target that we have set for it, it had done so for 48 months consecutively. And what happened was, in July 2020, the impact of the pandemic undid those four years of absolutely consistently meeting the targets that had been set. It is a slow recovery from all of that. But, Llywydd, as I said, it is not necessarily because the supply of service has diminished; it's because the demand for the service has gone up. In December, more calls than at any other time—more than any month in that 48-month period—more calls were answered within the target time. It is simply that the volume of calls far exceeds anything that happened in any one of those months, and despite, as Jane Dodds very fairly said, the enormous efforts of ambulance staff, when you have a rise in demand of that sort, the percentage of calls that are answered within the target time cannot be sustained. The combination of additional investment and, particularly, additional staff, is the way in which we will succeed in returning the ambulance to the level of achievement that it itself would wish to see for its patients. 

First Minister, in December, less than 40 per cent of life-threatening calls received an ambulance response time within your Government's eight-minute target—a record low. And if that isn't a crisis, then I wonder what is a crisis. But, given the pressure on the ambulance service, which I understand the reasons for, the Wales air ambulance service is, of course, all the more crucial for constituents like mine in mid Wales. So, given the state of the overall ambulance service in Wales, can I ask if the current service levels will be taken into account in the Wales air ambulance review, which is currently under way, and, if they aren't, do you think they should be? As you know, there is great respect and support for the Wales air ambulance, and it's greatly appreciated by the people of mid Wales. There is anxiety at the moment with people who are waiting for an ambulance, and their families as well, but there's even greater anxiety in mid Wales, and I hope you can understand how the current proposals are causing significant anxiety across my constituency.

Llywydd, as I know Russell George will be aware, the chief ambulance service commissioner is leading a review on behalf of the Emergency Ambulance Services Committee. That review is now in the period of formal engagement; no decision on the outcome has been made. And the points that the Member makes, and makes powerfully on behalf of his constituents, will of course be heard in that review, alongside all the other evidence. The aim of the Wales air ambulance service, which is absolutely a very highly respected and very effective service, is to use the resources it has in a way that reaches the largest number of patients and delivers them that effective service. That will be the basis of the review.

There are so many things, of course, that contribute to the pressures on the ambulance service, the kinds of pressures that forced a constituent of mine to wait 24 hours for an ambulance, having broken her hip. Now, the five-point plan for health and care services, published today by Plaid Cymru in partnership with many health organisations, touches upon some of the elements that could help in the short term and the longer term in responding to those pressures: the need to settle the pay dispute, supporting the workforce, improving patient flow through the system, and operating in a more preventative way in order to reduce pressures on the ambulance service and other services. It all interweaves. Does the First Minister agree with me that what we are seeing in the pressures on the ambulance service is the best example, possibly, of the unsustainable health system that we have, and a health system in crisis, and that we must acknowledge that in order to start providing solutions and resolutions?

Llywydd, I thank Rhun ap Iorwerth for that question. I've had a brief opportunity to have a look at the plan that Plaid Cymru published today. What the pressure on the ambulance service means is that demand for health services over the winter has been very great—greater than at any time in the history of the NHS. We have a plan already. Of course, we're willing to consider the points in the Plaid Cymru plan to see whether there is more that can be done. But, through the financial investment that we're making, but also, as I said in my reply to Jane Dodds, our investment in more people to work in the area, that's the way to try and help us to do better in the future.

First Minister, it is important that all of us here in Senedd Cymru, the Welsh Parliament, are candid about the real challenges facing our beloved national health service right across the four nations of the United Kingdom. In England, in December, calls from people with life-threatening illness or injuries saw an ambulance response time of 10 minutes and 57 seconds. In Wales, in December, the average response time was 10 minutes, where previously the average, over the four years up to that month, was six minutes. So, two neighbouring countries with almost identical ambulance response times in December for the most urgent calls. Yet, there is one fundamental difference between Wales and England: Wales is led by the Labour Party, which created the national health service and will do all that it can to forever ensure that it continues to be free at the point of care for those who call on its services, whilst in England, the Tory UK Government and ex-English health secretary Sajid Javid are openly theorising about introducing changes and charges to even see a GP—privatisation through the front door. First Minister, what assurances, then, can you give the people of Islwyn and Wales that our NHS will be prioritised in Wales as a truly national, free public health service that lives up to its illustrious legacy, is fit for purpose and offers peace of mind that, when 999 is called, an ambulance will promptly arrive? 

Well, Llywydd, the urgent call ambulance that was dispatched when Jane Dodds asked me her question has now been at the scene for the last three minutes. I say that just to give colleagues here some sense of the service that continues to be provided in every part of Wales. I give Rhianon Passmore an assurance, of course, that here in Wales there are no plans to use the pressures faced by the national health service as an excuse to do away with that service. There's no doubt at all, is there, that there are elements in the Conservative Party nationally who think that the pressures that the health service faces are an excuse to undo the work that that service provides across the whole of the United Kingdom. We will never do that here in Wales, where the health Minister and the First Minister, who are responsible for these services in Wales, are able to give Rhianon Passmore exactly the assurance she was asking for.