Opening the debate, Rhun ap Iorwerth said that preventative has to be the attitude we take towards health, and I want to speak to the part of our motion that calls for the placing of preventative measures at the heart of all health-related policy and activity involving all Government departments.

Plaid Cymru has emphasised time and again when we debate health in all its aspects the need to give preventative measures better prominence and greater priority. In addressing the current crisis, the health Minister spoke about the need for people to assume greater responsibility for their health and well-being. We agree, of course, that prevention is better than cure. So, why does our motion call for all Government departments to be involved in this aspect of our plan for the NHS? What the health Minister failed to take full account of while making that call was the role of deprivation and poverty in people’s ability to do so.

How are people meant to be looking after their diet when they can’t afford to turn the oven on, when they’re cutting down on food? How can they ensure they don’t exacerbate or cause health conditions when they live in cold, damp, draughty houses they can’t afford to heat? When you are thinking about where the next meal is coming from, how to be able to afford the hot water to clean yourself and wash your clothes, when you’re working two jobs, juggling childcare, worrying about that bill you know that’s going to land that you can’t pay, how do you have the means—let alone the headspace—to attend a gym or go for a run? And how can people access leisure and sporting facilities, libraries, theatres—crucial to well-being—as well as fitness, when they are facing extensive cuts to funding?

The relationship between health and poverty is well understood: deprivation causes ill health, causes inequality in health outcomes, increases the pressure on health services. Ill health is costly to society, puts pressure on our health service. And at a time of economic constriction, at a time of raging levels of poverty, the prevention agenda is absolutely key, and in Wales, where over a third of children are in poverty—the highest level in the UK—and 45 per cent of households are struggling and trapped in fuel poverty, the need to prioritise prevention is urgent.

If we are to truly embed a preventative approach to health, we must take account of the socioeconomic circumstances when building that approach. Poverty and inequality are cross-governmental issues. In addressing the NHS crisis, we must take full account of the differences in the opportunities people have to lead healthy lives, and that must be a cross-governmental responsibility. The Food Foundation’s most recent annual report, ‘The Broken Plate’, asks important questions around how free people are to make healthy food choices around diet, noting that the poorest fifth of UK households would need to spend 43 per cent of their disposable income on food to meet the cost of the most recommended healthy diet; that compares to just 10 per cent for the richest fifth.

Health inequalities can also be related to access to care or services, the quality and experience of care, and we know this to be a long-standing issue in Wales. Health Inspectorate Wales’s national review of mental health crisis prevention, for example, emphasised that services in Wales needed to be better designed and focused around the needs of the individual. It highlighted a gap in Wales between primary care and secondary mental health services, with people falling between the criteria of different services that can provide support.

The Welsh NHS Confederation Health and Wellbeing Alliance report, ‘Mind the gap: what's stopping change?’, also highlighted that addressing the factors that cause ill health in the first place should be a central focus for the Welsh Government and local government, and yet there remains an implementation gap in tackling the underlying health inequalities. The recent update to that report, in partnership with the Royal College of Physicians, ‘Everything affects health’, spells out why they are calling on the Welsh Government to take cross-Government action to tackle those health inequalities. The report gives details of many examples across Wales and Welsh health boards and local authorities of preventative measures in action, with many public and third-sector organisations helping to reduce ill health and health inequalities among the most vulnerable in our society, but it's a patchwork.

These are the people who are most at risk of harmful behaviours such a smoking, excessive drinking and drug use, or are most likely to be socially isolated, in poor or temporary housing, have poor access to transport and well-being opportunities, or digitally excluded. The conclusion of this report is that cross-sector working of this nature should be supported and encouraged by the Welsh Government, with a cross-Government action plan. We agree that a cross-Government delivery plan setting out what every department is doing to tackle poverty and health inequalities, how success would be measured and evaluated, and how Welsh organisations can collaborate to reduce ill health, is long overdue. Public Health Wales—