Questions Without Notice from the Party Leaders

1. Questions to the First Minister – in the Senedd at 1:47 pm on 24 January 2023.

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Photo of Elin Jones Elin Jones Plaid Cymru 1:47, 24 January 2023

(Translated)

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

Photo of Andrew RT Davies Andrew RT Davies Conservative

Thank you, Presiding Officer. First Minister, many of us would have watched the tv programme last night and found it deeply uncomfortable, the revelations on BBC Wales about the culture, and the weekly and monthly difficulties that women in sport, in Welsh rugby face. These allegations, obviously, some are proven and some are unproven. I make no direct allegations against any individual, but the programme set out a very troubling sequence of events that was corroborated by several witnesses who had been at the coalface at the Welsh Rugby Union.

I understand that the Deputy Minister for Arts and Sport has spoken with the Welsh Rugby Union today, or certainly very recently. Are you able to update what actions the Welsh Government are taking to engage with the Welsh Rugby Union in light of these allegations? And are you minded, on what you've seen so far, to engage further so that these allegations can be put to rest, and make sure that whoever chooses to play rugby here in Wales, whether they are men or women, plays in a safe environment, an environment that values the contribution that they make to the sport and, above all, the national position that the Welsh Rugby Union holds within our great country?

Photo of Mark Drakeford Mark Drakeford Labour 1:48, 24 January 2023

Llywydd, I entirely agree with the sentiments with which the leader of the opposition ended his question. The meeting between Dawn Bowden and the Welsh Rugby Union took place yesterday afternoon. The Welsh Government, in that meeting, made it clear to the WRU that we need to see urgent and transparent action that helps restore confidence in the WRU itself, and that requires a public recognition on the part of the WRU of the scale and nature of the issues that were rehearsed in that programme. We will absolutely continue to engage with the WRU. As Andrew Davies says, it occupies a place in Welsh public life and it needs itself to recognise that significance. We will continue to be in a challenging, where necessary, conversation with them to make sure that a future is set out for the Welsh Rugby Union that commands the confidence of all of those who are players of the game and who are engaged in wanting to see it have a successful future.

Photo of Andrew RT Davies Andrew RT Davies Conservative 1:50, 24 January 2023

Thank you for that response, First Minister. I today have written to the Chair of the Culture, Communications, Welsh Language, Sport, and International Relations Committee here in the Senedd, inviting that committee to give consideration to what role it might be able to play in supporting those who've obviously found themselves on the receiving end of this treatment, but also working with the Welsh Rugby Union to, obviously, put in safeguards and make sure best practice is brought to the fore for our national institution, which many of us care very deeply about.

If I could raise another subject with you, which, as you said in response to an earlier question from the Member from Islwyn, is your responsibility, and that of the health Minister, and that is the fabric of our hospitals here in Wales. Last week, a report highlighted the poor fabric of buildings within the Betsi Cadwaladr University Local Health Board area, in particular the Abergele hospital, where 85 per cent of the estate of Abergele hospital is deemed operationally unsafe and does not meet the requirements of the health and safety regulations that any other place would have to meet. Across the Betsi Cadwaladr health board area, only 62 per cent of the estate meets that operationally safe caveat or requirement. As you said in response earlier to the Member from Islwyn, you are responsible, your health Minister's responsible, this health board has been in special measures for six years under direct Government control, why has this situation developed, and will you apologise for it?

Photo of Mark Drakeford Mark Drakeford Labour 1:51, 24 January 2023

Let me begin for a moment, Llywydd, by agreeing with what the leader of the opposition said in opening this second question, which is that I think that there is a potential role for a Senedd committee in helping to secure a path for the WRU to a better future by using the powers that a committee here has to look into the allegations and to assist in, as I say, finding a better way ahead. 

As to the second question that the Member asked, we have committed more than £335 million in this financial year, in capital expenditure, to the Welsh NHS. We will commit a further £375 million next year for the same purposes. We face sites that are 30 years and more old, where there are compliance issues being identified, as organisations undertake survey work. And the call on that capital is huge. Last week, I answered a question from the leader of the opposition's colleague Darren Millar, who made a case that he's made regularly on the floor of the Senedd, for investment in a new hospital that would serve people in his constituency. I said then that that scheme would have to be assessed by the board, alongside its many other priorities. It is simply the fact that the call for capital expenditure in the Welsh NHS exceeds our ability to fulfil that demand—and some of the figures, actually, you have to treat them a little bit more carefully than I think the leader of opposition was treating them in his question—and you have to find a way of meeting the most urgent demands from the capital that we have for those purposes.

Photo of Andrew RT Davies Andrew RT Davies Conservative 1:53, 24 January 2023

First Minister, the figures I have quoted you are directly out of the board papers from the Betsi Cadwaladr health board. They're not figures that I have made up. At Abergele hospital, only 15 per cent of that hospital is deemed operationally safe. As I said, across the Betsi Cadwaladr health board area, only 62 per cent of the health estate is deemed operationally safe. Across the whole of Wales, that figure rises ever so slightly to 72 per cent.

If we are ever going to get on top of the waiting times, if we are ever going to offer staff and patients a twenty-first century environment to work in, surely making sure that the health estate across Wales—leave alone the Betsi Cadwaladr health board area—is operationally safe should be a priority for your Government, which, as you said, is your responsibility, and your health Minister's responsibility. So I ask you again: will you apologise to the staff who have to work in the environment that I've described in my question to you? And can you give us an indication of when we will start seeing real improvement in the health estate in Wales, so that we do not find hospitals where 85 per cent of their area is operationally unsafe?

Photo of Mark Drakeford Mark Drakeford Labour 1:55, 24 January 2023

The capital budgets available to the Welsh Government go down every year; they are 8 per cent lower next year than they are this year. Where does the Member think the money comes from to do the things that he suggests? Not only that, but our capital borrowing limit has remained unchanged since 2016. These are not decisions of the Welsh Government; they are decisions of the Government that he supports.

I would just say to him again—I'll do it slowly, so that he can think about it—that the amount of money available to the Welsh Government is—[Interruption.] I would prefer that he didn't point at me from where he is sitting. I'll try again, because he doesn't listen, but I'm going to try again to explain to him that if your capital budget is falling every year and your ability to borrow is capped at the level that it was, now, seven years ago, then our ability to do the things that we would like to do is constrained by decisions that are not in the hands of the Welsh Government, but are in the hands of his friends and his colleagues, and there we are. Let him think about that and maybe he'll have a better question for me next time.

Photo of Elin Jones Elin Jones Plaid Cymru 1:56, 24 January 2023

(Translated)

Leader of Plaid Cymru, Adam Price.

Photo of Adam Price Adam Price Plaid Cymru

Diolch, Llywydd.

'So for one week will he stop blaming others, take some responsibility, and just admit that on his watch the NHS is in crisis, isn't it?'

I'm quoting the leader of the Labour Party, Keir Starmer, to Rishi Sunak last week at Prime Minister's questions, but they're words that could equally apply to you, First Minister. Labour in Scotland has described the situation in the NHS as being in a state of crisis there also. Why is it that you, as a party, are prepared to declare the NHS to be in crisis everywhere else apart from here in Wales, where you have responsibility and have done so for over 25 years?

Photo of Mark Drakeford Mark Drakeford Labour 1:57, 24 January 2023

Well, Llywydd, I will have lost count of the number of times that I have said in this Chamber that the NHS in Wales is under enormous pressure and that it is not able to do all of the things that we would like it to do in the way that we would like it to do them. If the leader of Plaid Cymru thinks that attaching a label to that somehow, by itself, makes all of that any better, then that is not a point of view that I share.

Photo of Adam Price Adam Price Plaid Cymru

Well, words matter because actually admitting that it's a crisis is an important acknowledgement of the scale, the seriousness and the urgency of the challenges that we face. I think the reason that you don't want to use that word is because the crisis has developed and deepened under you and under your Government. Health is devolved. Five Ministers in your Government—a majority in the Cabinet—have been health Ministers, and it's time you took collective responsibility for the mess the NHS is in.

In refusing to provide health workers with a decent pay rise, you, the Labour Party, are turning your back on health workers, while it's us, in this party, who are standing shoulder to shoulder with them on the picket line. You're rightly proud in the Labour Party that you were there and responsible for the birth of the NHS, but if you don't fundamentally change your policy then you will be responsible for its demise.

The UK Government is refusing as well to acknowledge there's a crisis; they haven't held any COBRA meetings during the NHS emergency there. In Scotland, the equivalent has met three times over the last few months to discuss the problems in the NHS. How often has the Welsh equivalent been convened over this winter to reflect the national emergency we are now facing?

Photo of Mark Drakeford Mark Drakeford Labour 1:59, 24 January 2023

Well, Llywydd, there were figures published last week of performance in the Welsh NHS. Here is the crisis service that the Member described: all waits in the health service in Wales fell in November. The total number of people waiting fell; the total number of people who were waiting over 26 weeks fell, over 52 weeks fell, over two years fell. The number of people waiting for a therapy appointment fell; the number of people waiting for—[Interruption.] These are the facts of the matter. If you want to describe a service that has succeeded in every one of those things as a crisis, that is fine for you to do.

This was a service that, in November, had recovered in-patient and day cases to 93 per cent of the level before the pandemic. It has been above 90 per cent in three of the last four months. Out-patient activity recovered to 114 per cent of the month immediately before the pandemic began. It's been over 100 per cent in three of the last four months. 

The service is under enormous pressure. There are more people working in it than ever before. There is more money invested in it than ever before. And despite all the additional things it has to deal with—COVID, flu, group A streptococcus, strikes—the service manages every single day to reach thousands and thousands of people who, if the health service wasn't there, would never have access to the services that they need. If he wants to describe it as a crisis and thinks that somehow a psychodrama solution is what the health service needs, it's not the view that I take of it.

Photo of Adam Price Adam Price Plaid Cymru 2:01, 24 January 2023

That is beneath the First Minister, to be honest with you. These are not my words; they're the words of the NHS workforce that we've been speaking to and listening to on the picket lines. We have nurses, doctors and others, through burn-out, who are crying on wards, and patients and their relatives because of the experience that they're facing. I'm afraid the state of denial that we've just heard from the First Minister reflects your complete misunderstanding, your complete disconnection from what is happening on the ground.

I welcome the fact that you're willing to look at our ideas positively in the five-point plan. At the heart of them is getting a long-term workforce plan to address this crisis of recruitment, retention and morale, and the problem of burn-out in the health service. Can being more flexible be part of the solution? Well, you could look at not just our ideas, but the ideas in the Senedd committee presented today in terms of a four-day working week. Could that provide some degree of solution in terms of, as well as improving productivity, reducing overwork and exhaustion, but also providing the dual benefit of a happier, healthier workforce, less stressed and sleep deprived? You're committed, you say, as a Government to being innovative and to evidence-based policy; why not look at this idea as part of the potential solution to the crisis of recruitment and retention in our health service?

Photo of Mark Drakeford Mark Drakeford Labour 2:02, 24 January 2023

First of all, many people in the health service do work less than a five-day week. It's part of the changing nature of the way in which people who occupy those very pressurised roles choose to make their own future. It's part of the reason why we have more people working in the Welsh health service, in every single aspect of it, than ever before.

We're always willing to look at ways in which the working conditions of people across our public services can be improved. It's part of the discussion that the health Minister has been having with our health service trade unions. A four-day working week is something we know that some businesses in Wales have already embarked upon because they believe that it delivers better productivity and a more contented workplace than would otherwise be the case. We will look carefully at the lessons of that. There is to be an experiment in Scotland. It's yet to begin, but I've discussed it with the Scottish First Minister and we will look to see whether there is anything we can learn from that. The notion that a rapid and wholesale move to four-day working in the health service would be likely to lead to better outcomes for patients is something that I think would need a good deal of examination.