I was out on the ambulance service picket lines last Monday and Thursday, speaking to Unite members and discussing their experiences, and asked them why they decided to take industrial action. And the conversations with Fiona, Ludwig, Catrin, Robin and the others were very valuable indeed. Their answers were striking, and everyone said the same thing. Salary and recent inflation was part of the mix. Working conditions was another important part of that mix. But the one thing that they all felt strongly about was patient care—the need to ensure that we, the patients, are safe and are given the best-possible care. They experience the crisis in the health service on a daily basis, because of these concerns about patient health. They have chosen a career in care, and because of that care, which drives them, they are willing to lose days of pay and the benefits that come as a result of that in order to ensure that we get the best-possible care. That's what solidarity looks like, and thank goodness for them.

They were keen to analyse the health crisis, reporting their personal experiences, talking about starting a shift by going immediately to an ambulance that was stuck outside a general hospital, and finishing that shift in that same ambulance, in the same hospital, with the same patient. They talked about patients lying on trollies that weren't fit for patients, for hours on end. Their experiences all painted a picture of a crisis. But they were also quite clear on one of the main drivers of this problem, namely the fundamental problems in our ability to provide social care. Despite the fact that they wanted to see improvement in terms of their pay and conditions, they were entirely clear that social carers deserved a substantial increase in salary, and that there was a lack of respect towards them.

We really need to reform social care and tackle integrated care once and for all. Because there is one undeniable fact—Wales is growing older, and we will see a substantial increase in the percentage of older people over the coming years who will need more care in the community. We must face this and prepare for it by investing in hospital-at-home services and securing specialist medical care in the community across Wales. We've already lost many community hospital beds, which has placed more pressure on our general hospitals and which, in turn, leads to an increase in hospital-spread diseases—not C. difficile alone, but things such as flu and COVID too. And older people are more likely to catch these diseases because they are weaker, and bear in mind that a large percentage of people who got COVID, particularly in the more damaging second wave, actually contracted the disease in hospital, and two in five of those people had died. And that's why we must develop community capacity. At a time of pandemic, epidemic or even winter pressures, it is necessary to keep our older people out of our general hospitals and to keep them in their communities.

In order to improve the situation, we must expand the provision of social care in order to enable a more consistent service across Wales, aligned with the health service. So, let us look at one example of good practice: the Carmarthen integrated care team have broken new ground. Now, these are knights in the community, providing a range of health and care services, particularly for older and vulnerable people. The model works in a multidisciplinary way, including seamless integration between health and care, as well as other agencies and the third sector in Carmarthenshire, and their priority is prevention and securing early intervention. People can access community hubs for assessment, for advice, support and treatments, or the team can go out to people's homes. This is an example of those core principles at work, and this is good practice that can be spread across Wales, which will take pressure off our general hospitals.

If we are to have people home sooner and reduce the numbers going to hospital in the first place, then we also have to improve the facilities for patients who don't need acute care. In addition to this, we must also have better co-ordination with local authorities in order to ensure that timely care assessments are made. Without this, what we have is something that is similar to a revolving door, with patients sent home before having to return to hospital soon afterwards. Resolving the community element is crucial if we're to tackle the health crisis or we will continue to see staff growing disheartened, leaving the service, and health and care services being destroyed by the pressures. Thank you.