Diolch, Ddirprwy Lywydd. I'd like to begin as well by thanking Sarah for bringing this prominence to corporate parenting. I think that your work in this area has been a credit to the Senedd. So, diolch, Sarah, for that. I want to work with you to make things better in this area.
It is a tremendously powerful thing that the needs of care-experienced children and young people have been placed on our agenda so early in this Senedd term. We can't underestimate the difference we can all make to the lives of care-experienced children. This is where our collective corporate parenting role is vital, supporting a child to navigate the transition to adulthood, and that requires the active involvement of key agencies and partners, as has been laid out in this debate.
I was struck by the contribution that Beca Brown made last week in another debate, by saying that it takes a village or community to raise a child and how that phrase has to mean something. Because what is our society other than that, that collective responsibility we share to ensure everyone is given a fair chance at life?
Now, I have an open mind about what happens in this space. I'm still learning. I want to work with people who have lived this. Legislation is clearly an important lever. I'm absolutely willing to consider that option. The two choices would be—. I don't see them as necessarily binary, either/or. I don't see it as right versus wrong, I see it as right versus right. Because there are very positive aspects to the Welsh setup we have too, which we wouldn't want to lose no matter what happens in the future. Its being voluntary gives it more flexibility, able to encourage innovation, creativity and true buy-in to the concept, rather than simply being an obligation, without organisations possibly truly doing more than the statutory minimum. I'm not saying that that means that we should not consider legislation; I'm just saying what we don't want to lose if we do that.
There are also complications, of course, that we would need to get over arising from what is devolved and what isn't. So, what I would want to do is to make sure we get the right balance between strengthening our situation, which we absolutely need to do, and also ensuring that we don't lose that good that's been nurtured in the system that we have, that flexibility that allows organisations to shape their own pledges, to go further than statutory obligations, though I do take the point that Lynne made that, actually, if those pledges are not being communicated very well, then they're not doing the job that they're meant to be doing, are they? Again—
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Absolutely. In terms of some of these—. In terms of local authorities, they are statutory obligations, of course. This is about—. I don't disagree at all with what you're saying. I don't. Again, I'm not seeing this as an either/or. I want to make sure that the system that we develop has the good of both, and that's why I want to make sure that we are doing this with care-experienced young people as well. So, no, I don't disagree at all, Jane, of course.
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Mae ein siarter corfforaethol yn ymwreiddio rhianta corfforaethol ar sylfaen llawer ehangach na'r ddeddfwriaeth yn Lloegr. Dim canolbwyntio'n syml ar gyrff y sector cyhoeddus ydym ni, rydym ni hefyd yn meithrin partneriaethau â'r sector preifat a'r trydydd sector i adlewyrchu'r ffordd mae cymdeithas yn gweithio, oherwydd mae Cymru yn genedl o gymunedau. Mae'r siarter wedi cael ei ddatblygu ar y cyd â phobl ifanc sydd â phrofiad o fod mewn gofal—so, dŷn ni eisiau gweithio, yn amlwg, gyda'r grwpiau hynny hefyd. Mae pob egwyddor yn cyd-fynd ag erthyglau Confensiwn y Cenhedloedd Unedig ar Hawliau'r Plentyn. Hyd yn hyn, mae dros 70 o sefydliadau wedi llofnodi'r siarter, gan gynnwys pob awdurdod lleol a bwrdd iechyd. Nawr, ydy, mae llofnodi'r siarter yn wirfoddol, ac mae'n rhaid i ni edrych ar hyn. Ond mae gofyn hefyd i bob sefydliad sydd yn llofnodi i wneud adduned sy'n nodi'r hyn y bydden nhw'n ei gynnig. Gyda'r cafeat y mae Lynne wedi'i gyflwyno yn gynharach, mae yna rai enghreifftiau sydd wir yn rhagorol; dwi eisiau rhannu rhai o'r rheini. Mae gan Gyngor Caerdydd strategaeth rhianta corfforaethol sy'n canolbwyntio ar bum blaenoriaeth. Maen nhw wedi cynnal digwyddiad yn ddiweddar ar rianta corfforaethol yn benodol i ddangos y gwaith sy'n mynd rhagddo. Mae Premier Forest Products—y cwmni sector preifat cyntaf i lofnodi—yn cefnogi unigolion trwy leoliadau gwaith sy'n cynnig cefnogaeth gan fentoriaid a chymorth addysgol i symud ymlaen yn llwyddiannus i fyd gwaith. Ac mae Bwrdd Iechyd Prifysgol Cwm Taf Morgannwg wedi gwneud adduned i ddarparu tîm iechyd sy'n benodol ar gyfer unigolion â phrofiad o fod mewn gofal. Maen nhw hefyd wedi addunedu i gyflwyno rhaglen bontio a fydd yn cyflawni dull strategol sy'n ystyriol o drawma. Mae profiad gwaith a phrentisiaethau yn cael eu cynnig ganddyn nhw ac maen nhw'n gwarantu y bydd plant sydd â phrofiad o fod mewn gofal yn cael y cyfle i gymryd rhan mewn prosesau i ddewis ymgeiswyr.
Official English translation
Our corporate parenting charter enshrines corporate parenting on a far broader footing than the legislation in England. We're not simply focusing on public sector bodies, we're also establishing partnerships with the private and third sectors to reflect the way that society works, because Wales is a nation of communities. The charter's been developed alongside young people who are care-experienced—so, we want to work, clearly, with those groups too. Every principle is aligned with the articles of the United Nations Convention on the Rights of the Child. To date, over 70 organisations have signed the charter, including every local authority and health board. Now, yes, signing the charter is voluntary, and we do need to look at this. But every organisation that does sign it is asked to pledge what they will offer. With the caveat that Lynne introduced earlier, there are some excellent examples that I would like to share with you. Cardiff Council has a corporate parenting strategy that focuses on five priorities. They've recently held an event on corporate parenting specifically to demonstrate the work being done there. Premier Forest Products—the first private sector company to sign the charter—supports individuals through work placements that provide support from mentors as well as educational support to move forward successfully into employment. And Cwm Taf Morgannwg University Health Board has pledged to provide a health team specifically focused on care-experienced individuals. They've also pledged to introduce a transition programme that will deliver a strategic approach that is trauma-informed. They offer work experience and apprenticeships, and they guarantee that care-experienced children and young people will have the opportunity to participate in candidate selection processes.
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These are some of the examples of the creativity, the innovation that I would not want to lose. And we need to find a way, I think, of making sure that where we move to still encourages that innovation and that it is being nurtured from the ground up, as well, potentially, as being from top to bottom. Now this autumn, as we've heard—Sarah had referred to this—we will table strengthened guidance through a dedicated chapter on corporate parenting within the Part 6 code of practice, and that will set out a strengthened strategic and partnership approach to corporate parenting. That isn't to say that that is enough. I know we can improve things further. That is why I very much welcome this constructive scrutiny and cross-party dialogue that is fostered through motions like this. This Government is committed to expanding the corporate parenting network in Wales as part of our future vision for children's services. Now, for the purposes of today's debate, the Government will abstain on this motion, and we will keep this position under close review. I do not intend for this to be the end of this conversation. We are in no way ruling out possible statutory options. I'm keen to make sure that we get this right. And I'm also determined that we make sustained progress in building upon that great work, that enthusiasm, that goodwill that's already in evidence amongst our committed partners. And I would very much welcome further discussions with Sarah so that we can work together to improve opportunities and outcomes for the children and young people of Wales. Diolch, Ddirprwy Lywydd.
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Diolch, Lywydd. Dwi'n ddiolchgar am y cyfle yma i nodi fy ngweledigaeth a fy mlaenoriaethau. Fel Gweinidog, dwi eisiau helpu i daflu goleuni ar y meysydd hynny sydd heb gael y ffocws y maen nhw'n eu haeddu—ar iechyd meddwl, ar iechyd menywod, ac, ie, ar y system gofal cymdeithasol, sydd heb gael sylw digonol ers cyhyd. Mae'r meysydd hyn yn haeddu mwy o sylw ac amlygrwydd. Maen nhw'n haeddu llais o galon y Llywodraeth, a dwi'n addo y byddan nhw'n cael hynny gen i. Rŷn ni'n falch, fel plaid, o gyflymu'r gwaith tuag at wasanaeth gofal cenedlaethol i Gymru, gan gynnwys sefydlu academi gofal cenedlaethol o fewn tymor y Senedd hon. Byddaf yn goruchwylio rhaglen o gryfhau trefniadau comisiynu, deall gofynion cyllido'r dyfodol, a datblygu opsiynau cadarn ar gyfer gofal personol am ddim yn nhymor y Senedd nesaf.
Official English translation
Thank you, Llywydd. I'm grateful for this opportunity to set out my vision and my priorities. As Minister, I want to help shine a light onto areas that haven't had the focus that they deserve—on mental health, women's health, and, yes, on the social care system that, for too long, has not had sufficient attention. These areas deserve more attention and prominence. They deserve a voice at the heart of Government, and I promise that I will give that to them. We are proud, as a party, to accelerate the work towards a national care service for Wales, including establishing a national care academy within this Senedd term. I will oversee a programme of strengthening commissioning arrangements, understanding future funding requirements, and developing robust future options for free personal care in the next Senedd term.
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I will champion policies aimed at strengthening the value that we give to our carers. For our paid workforce, we will work to ensure that far more workers receive the real living wage as a minimum, and progress work towards fairer pay and conditions, but they should also receive parity of esteem. Why is it that social care receives less prominence in debate than the NHS? Why shouldn’t care workers hold the same space in our psyche as nurses and doctors? I’m put in mind of Michael Rosen’s words about the NHS that 'these are the hands that touch us first'. For many people in care homes, in palliative care, workers there will be the hands that touch us last. This is what I want to champion in Government: those who help the least heard and the lost. The carers and workers who support people at their most vulnerable, who bring comfort to the dying and support to the sick. The value we place on this vital work has to be greater, and I will drive for that to happen as just one pillar of the foundations for a truly national care service in Wales. Unpaid carers, of course, support hundreds of thousands of people. I have listened to concerns about recognition, support and financial pressures, and to the plea for policies, not praise. We are investing in the carers support fund and short breaks scheme and will continue to press the UK Government for changes to carers allowance and local authorities on respite provision. Llywydd, providing the best start in life for all children is fundamental, and this includes reinforcing and redoubling our societal responsibilities to care for those in vulnerable and disadvantaged situations. The programme to remove profit from the care of looked-after children in Wales was a major feature of our co-operation agreement, and we will bring this world-leading initiative to fruition within the current Senedd term. We are also expanding the corporate parenting charter into the private sector as part of our 2030 vision for this significant area of work.
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Mae gofalu am ein plant a'n pobl ifanc hefyd yn golygu sicrhau bod mecanweithiau cymorth ar gael i ymateb i gamdriniaeth, esgeulustod a chamfanteisio. Rŷn ni i gyd yn ymwybodol o'r etifeddiaeth gywilyddus o fethiannau sefydliadol yn y maes hwn, ac rŷn ni'n ymrwymo i unioni'r diffygion hanesyddol hyn. Mae'r Llywodraeth hon yn cynnal cysylltiad agos ag ymchwiliad y Deyrnas Unedig i gamfanteisio’n rhywiol ar blant ar sail grwpiau er mwyn sicrhau bod y cyd-destun Cymreig unigryw yn cael ystyriaeth briodol, gan hefyd cryfhau'r fframweithiau y mae'r Llywodraeth hon yn gyfrifol amdanynt yn uniongyrchol. Rŷn ni'n gweithio'n gyflym i weithredu'r adolygiad cryfhau llywodraethiant diogelu a'n hymrwymiadau maniffesto ein hunain, er mwyn dod â gwahanol elfennau o'r gwaith yma o ddiwygio'r maes diogelu at ei gilydd mewn rhaglen genedlaethol gydlynol. Bydd hyn yn cynnwys gweithio gyda phartneriaid ar draws meysydd iechyd, gofal cymdeithasol, addysg, plismona a'r trydydd sector i wella camau atal ac ymyrryd cynnar, cryfhau'r broses o adnabod niwed yn gynnar trwy well defnydd o ddata a gwybodaeth ac, yn bwysicaf oll, sicrhau bod pryderon plant a phobl ifanc yn cael eu trin yn hollol o ddifrif a diamod bob amser.
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Caring for our children and young people also means ensuring that support mechanisms are there to respond to abuse, neglect and exploitation. We are all aware of the shameful legacy of institutional failings in this area, and we are committed to righting these historic wrongs. This Government is engaging closely with the ongoing UK inquiry into group-based childhood exploitation to ensure that the unique Welsh context is properly captured, whilst also strengthening the frameworks for which this Government is directly responsible. We are working at pace to implement both the strengthening safeguarding governance review and our own manifesto commitments, so that safeguarding reform can be brought together into a coherent national programme for Wales. This will include working with partners across health, social care, education, policing and the third sector to improve prevention and early intervention, to strengthen early identification of harm through improved data and intelligence use and, most importantly, ensure that the concerns of children and young people are, without exception, treated with the utmost and unconditional seriousness.
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On mental health, I aim to oversee a fundamental change in how our services are delivered, moving towards open-access, same-day mental health support, a fundamental shift from a traditional model to one focused on recovery and prevention. NHS Wales Performance and Improvement has been commissioned to develop a new mental health clinical plan, covering same-day access, modernisation of community mental health services and action to prevent escalation to in-patient care. I will review progress in September. On the vital area of suicide prevention, I have met Professor Ann John, national adviser for suicide prevention and self-harm, and I'll provide a written statement imminently setting out this Government’s early priorities in this area, with a particular focus on male suicide.
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Fel yr un sy'n arwain ar ddementia yn y Llywodraeth, dwi wedi ymrwymo i ddatblygu strategaeth dementia newydd sy'n canolbwyntio ar iechyd yr ymennydd, gwella diagnosis a chryfhau cymorth. Dwi'n benderfynol o helpu pobl ag anableddau dysgu yn well trwy gryfhau cymorth cymunedol, lleihau derbyniadau i'r ysbyty a byrhau arosiadau yn yr ysbyty. Trwy ein gwaith i sefydlu safon gofal cyson ar draws meysydd iechyd, gofal cymdeithasol a thai, fe fyddwn ni'n gweithredu yn unol â'n maniffesto ar yr ymrwymiadau sy'n deillio o'r ymgyrch Bywydau wedi'u Dwyn a'r adroddiad 'O Ysbytai i Gartrefi.' Dwi wedi ymrwymo i sicrhau bod pobl niwrowahanol yn gallu cael mynediad at gymorth amserol o safon uchel ble bynnag maen nhw'n byw, trwy leihau'r amseroedd aros am asesiadau i blant a chael gwared ar y cyfnodau aros hiraf. Fe fyddwn ni hefyd yn gwella gwasanaethau awtistiaeth ac ADHD i oedolion, yn buddsoddi i ddatblygu'r gweithlu ac yn sicrhau bod gwasanaethau'n cael eu siapio ar y cyd gyda phobl niwrowahanol a'u teuluoedd.
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As lead in Government for dementia, I am committed to developing a new dementia strategy that focuses on brain health, improving diagnosis and strengthening support. I'm determined to better help people with learning disabilities by strengthening community support, reducing hospital admissions and shortening hospital stays. Our drive to establish consistent standards of care across health, social care and housing will deliver, in line with our manifesto, on commitments arising from the Stolen Lives campaign and the 'From Hospitals to Homes' report. I'm committed to ensuring neurodivergent people can access timely, high-quality support wherever they live, by reducing children’s assessment waiting times and eliminating the longest waits. We will also improve adult autism and ADHD services, invest in workforce development and innovation, and ensure that services are shaped alongside neurodivergent people and their families.
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Turning last, but by no means least, to women’s health, I am proud to be Wales’s first women’s health Minister. It is long overdue. For too long, women’s health has been treated as an afterthought, as optional—a 'should', not a 'must'. I want that to change. I will expect that it must change. My first focus will be on tackling women’s pain in healthcare. I'll be hosting a ministerial summit on 16 July that will focus on women’s voices and tackling this normalisation of pain in health, hearing directly from women with lived experience, alongside clinicians. How many women have been told, 'This might hurt', have been afraid to speak up and say that they are in pain? Women’s voices should be heard. Their pain should not simply be endured. I am determined to change this. We will be refreshing elements of the NHS Wales women’s health plan, with action this year focused on improving endometriosis and abortion services. I will want to hear from women directly, we'll be commissioning work to gather women’s feedback, and we're also carefully considering the women’s health hub model to improve consistency. I'm determined to see improvement in maternity and neonatal care through implementing the recommendations of 'The path to safer beginnings'. We'll strengthen data collection of stillbirths and neonatal deaths and ensure bereavement and mental health support are there for families who experience the devastating loss of a baby. Work has begun on a national cancer plan, which will address cancers that disproportionately affect women. A written statement will set out more detail on 15 July. Llywydd, I want women to take up space, be it through women’s health hubs, through theatre space, or for more women to take up the space they need in their GP appointments. How many women listening today have been belittled or ignored? We’ve all had fantastic doctors who get it, and we’ve all had doctors who don’t. No woman should be afraid or embarrassed to ask about pain or things that don’t feel right. We have to see improvements in training, but I also want to empower women to take up that space, to give voice to their worries, to feel certain they’ll be believed and listened to. Because women should be believed about their bodies. As Minister for women’s health, I am determined to see change. Women must see change. These are just some of my priorities for this role. I will work with Members across this Chamber, with committees, to make things better, because that is what my work will be about: making things better for people’s lives. I want to pinpoint where the gaps exist in our policies. I mentioned earlier how I want to shine a light. Leonard Cohen reminded us that 'There is a crack, a crack in everything / That's how the light gets in'. I want to shine that light and to remember always the debt we owe to all those other souls alive at this same moment, in this same place. People in crisis, people who’ve been as good as forgotten. People struggling to get appointments, patients whose needs have not been met. Families waiting too long for diagnoses. Women not being believed. I want to bring hope, to bring change, and, most of all, to be a voice for those who have not been heard. I promise I am listening.
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James, there are lots of really welcome questions there. I really thank you for those. Firstly, there are lots of areas of agreement here. You said that social care has been undervalued but that you personally do not see the need for a national care service. Some of the other things I'm going to be talking about in response to what you talked about the social care element of this brief—. We want to make sure that what we have for people is greater than the sum of those parts, that actually there is parity of esteem for people in the workforce. And without being the same status—. It's bizarre, isn't it, that there's never been a founding moment for the care service in the way that we've had with the NHS. We celebrated the NHS's birthday a few days ago; when I was talking about the same space in our psyche, we should be celebrating this work. Most people will come into contact with the NHS and with other areas of public service throughout the course of our lives. Most people only come into contact with the care service when something has either gone wrong with them or someone else they love. So, the invisibility of it for lots of people—we need to increase that status, but again, there are lots of individual elements where I think that we do agree, but that enveloping principle and status and platform for it is why I want it to be greater than the sum of the parts. I'm glad that you agree about the national care academy. In terms of the timescales, a lot of this will take the course of the Senedd. There are some things in terms of the academy that I would want to bring forward far earlier, linked in with the workforce review that we will be conducting very shortly as well. I'm really glad that you mentioned unpaid carers. As you know, this is something that I feel really strongly about as well, and I know this is something really close to your heart. Yes, we will certainly be making the commitments that you have set out, because unpaid carers save our society—and Government, but our society more generally—billions of pounds. But too often, the work they do falls through the gaps in graphs. I'm put in mind of the words of Bobby Kennedy, when he was talking about the gross domestic product and how it measures everything in society, except for all of those things that make life worth living. And this is one of those examples where we need to give greater esteem to the work that they do so that it doesn't go as unnoticed, because we owe unpaid carers more than words or recognition, we owe them a better life. And lots of the things that you set out are just some of those things. I'm aware that, prior to the election, the Health and Social Care Committee's report on unpaid carers made lots of really valuable recommendations, and I'll be responding formally in September. And the national strategy for unpaid care that you asked about, that will be published in the autumn and it will be covering a lot of the areas that you raised. So, thank you for that. On neurodivergence and the idea of an autism Bill, I'm happy to have further conversations about that. I know that there was an awful lot of really valuable work that Paul and others put in to that. On same-day access, well, the focus would be on the person's biggest concern at that moment and prioritising strength and recovery. Evidently, this would have to work in a holistic way. In terms of how that's going to be working, I think there are 21 demonstrator sites already testing over Wales. In the longer term, we would expect to see a shift, of course, in funding from specialist in-patient care to community support. And that brings me to the point that you made about making sure that people from rural areas won't be disadvantaged. We want to focus more on community prevention, where that's the most appropriate, of course. There will still be a need for in-patient care as well. On the women's health plan, you talked about the hub model. I think we need to look at this. There are some examples where it's going well, other examples where we just have websites. That's not always possibly working well, but we are going to be evaluating that. In terms of how a lot of this will be funded, health boards should be funding a lot of this already, of course, because women's health should not be an optional extra. Women are half of the population. This is something that should be in core funding anyway, but we obviously want to make sure that this is done in a way that's going to be sustainable. And on your point about a men's health strategy—now, I welcome you raising this issue. I acknowledge the passion that you and other Members, of course, have brought to this idea. I am prepared to engage with you and other Members on this as a concept, because, of course, you're right that certain health issues are either only apparent in men, or have a disproportionate effect on men. And there's a lot of work, including what I've said about male suicide. The upcoming cancer plan will look at improving rates of diagnosis in areas like prostate cancer. Whether we need to bring that together in one men's health plan, I am open to the idea, and let's have further conversations. But, diolch. Forgive me, if I've missed out any questions, please let me know.
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Diolch, Jayne, for those questions. So, to take them in turn—in terms of women's health, I would pay tribute to the work that Sarah Murphy did, and Eluned Morgan, in the last Senedd. We are really keen to build on the foundations of this, but to make sure that we are giving it the prominence of having a named Minister, so that I can be tracking that progress. So, I would pay tribute. I look forward to welcoming Sarah back when she's back from maternity. I promise that I will keep up the momentum. This is something that, I hope it's coming across, I care very passionately about. In terms of 100-day commitments, well, without it even having to be in the actual plan, I'm hosting a summit on 16 July, which will be well within 100 days, looking at that normalisation of pain in women's healthcare. It was the first thing that I talked about with officials, and I promise that that's something that is going to be key to the work that we are doing. In terms of endometriosis, yes, that's one of the reasons why I wanted to convene this summit, and it's going to be a summit that is going to be hearing directly from women who have gone through too much pain before their symptoms are recognised, as well as clinicians. I know that probably everyone in this Chamber will know someone or might themselves have gone through something like this. It should not be normal for women to have to go for so many appointments before they get the symptom diagnosis that they deserve. So, I want to look at this in terms of, yes, how it is working in hubs, how it's working in primary care, all the way through to tertiary services as well. It's going to be a focus of the women's health plan. In terms of the hubs, some of them are working well. I think that because of the tight timescales that were surrounding their development, maybe they hadn't been developed as holistically as might have been the case. We want to make sure we're learning from the best examples and improving where we need to, but it is something I'm really keen to keep. In terms of the new guidance on endometriosis, I welcome that new guidance, and we'll be considering the implementation of those tests as part of the priority work that we're undertaking with that. I know that it's going to be part of the primary care pathway development following final recommendations from NICE; I think they're due in October. On social care, I agree entirely with what you say about seamless care. One of the things that we are going to be creating in the first 100 days, or we're going to be opening the recruitment for in the first 100 days, is the director of out-of-hospital care. That role is being scoped at the moment. I am hoping that that role will have quite a fundamental role in overseeing this. You mentioned fair pay agreements—those are to be welcomed. We've said that we will be following the same timescales as they will have in England on this, but, obviously, that's something being brought forward by the UK Government, and we want to make sure that, in the meantime, as we wait for all of that to happen, as many carers as possible are receiving the real living wage as a minimum. I think latest figures suggest that 84 per cent of the workforce are getting that and that is still not enough. So, I give you my commitment that we'll do everything we can with that. As I say, the strategy for unpaid carers will be reporting in the autumn. We have committed to continuing to support the short breaks scheme and making sure that we are providing wraparound support for unpaid carers. As I say, policies, not praise. And, then, finally, you asked about mental health and what these changes are going to mean for patients and for families. It would mean that people can access a variety of services without having to have a referral and that support would be based on need, not having to wait a long time to get that referral and to be seen. The focus would be on the person's biggest concern at that moment. I'm really excited, actually, about how that could utterly transform—. We would be the first country in the world to do this as well. I'll be reporting more detail on this very early in the autumn, but I'm really excited about how that could change things for the better for many, many people's lives. Diolch.
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Diolch, Natasha, for those questions. In terms of the women's health strategy and supporting or strengthening women's voices, that is precisely why I want, when we are reviewing the women's health plan—we're commissioning survey work—to make sure that we're hearing directly from women. I want that not to be a one-off; I want to make sure that we keep, and that I keep, hearing from women. And please, everyone, take this as a plea: I want to hear when things are not going well. I want to make things better. So, thank you very much for raising that. On PMOS specifically, you asked—. I know that the guidance—draft guidance—has been published by NICE; the final recommendations won't be available until December. So, in the meantime, I'd urge as many people as possible to contribute to that to make sure it's evidence-based. I like your idea about education because, yes, exactly, empowering women, what I was talking about: women taking up space. However we can do that—working in education, through public awareness campaigns; there are so many different components. And again, I'm willing and eager to work with Members across the Chamber to make sure that we get this message out to women and that we empower them to use their voice and to know that they will be heard. The two things have to work together, and I will certainly be willing to meet with organisations to discuss how we can do that better. I won't repeat what I've said—because I know I'm probably not in the Llywydd's good books at the moment in terms of timing—I won't repeat what I've said on the hubs, but we are evaluating how well they're working. That detail on the gynaecological cancers, that will be available in the written statement later in July—I think it's 15 July. I agree social care should not be a cinderella service. In terms of how we can improve integration and also making sure that we are improving, making sure we're not having so many people waiting in hospital who are well enough to be discharged, the director of out-of-hospital care will be, I hope, overseeing that work, just looking at how frailty is treated at the beginning of when someone goes into hospital and issues like that. On the workforce, establishing the academy will be fundamental to this so that we're not just looking at getting towards parity of pay, we're also looking at how we can get towards parity of conditions—again, parity of esteem. Because I do fundamentally think we need to get to a place where we have a national care service to have that full parity, and I will be responding to that committee report on unpaid carers in September. On mental health, you, finally, asked about improving data and improving prevention—absolutely.
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Thanks, Safa. That's a really important question. As I've said, we will be evaluating the hubs model. I don't think that most people would, when they hear 'a women's health hub', I don't think that they would think that a website would—. I know that there are certain things we need to take into consideration when we've got rural populations, a very dispersed population, but, for the most part, I think we need to be looking to see where there can be physical places. Again, it's about taking up that space physically, but also just making sure that women are empowered in spaces to talk about exactly those symptoms so that we can improve diagnosis rates and, ultimately, save women's lives.
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Diolch, Gareth. That's a really, really important question. In terms of waiting times, we have to tackle this. We have to make this better. In terms of psychological therapies, I know in particular that we are not where we need to be, to say the least. And in terms of the expertise that you have, I would be really pleased to work with you to look at how we might be able to improve that. In terms of how, generally, we need to make this better, this is why I want to oversee that fundamental transformation so that we move to same-day access to mental health services, so that people are not waiting all that time, because, as you say, people can only get worse while they are waiting. It can get incredibly serious. And so, yes, I promise you that this is something that we will be prioritising. I'd be very keen to have a conversation with you about it.
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Diolch. Again, so vitally important as a question. In terms of the delays of diagnosis, as you say, women can sometimes wait years. They are being failed. And yes, as you say, the gender pain gap indeed. I am concerned—. I'm aware of the concern about the risk of loss of British Society for Gynaecology and Endoscopy accreditation for one of those centres. Officials are engaging with the health board urgently on this. I've made it clear that I expect these services should continue to be available. Of course, there—. There is another accredited centre in Swansea Bay University Health Board. There are surgical procedures that are carried out in Aneurin Bevan University Health Board. But, still, we need to make sure that the space, again, in theatre is allowed to be taken up by these procedures. Women wait in pain for far too long. But this is something that we are going to be looking at from primary care—again, women being believed, women taking up space in GP appointments—right through to those if someone has deep infiltrating endometriosis, where there will be far fewer women, of course, but, my goodness me, they need that support. So, yes, I promise you that, everything we can do, I will be doing it.
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Thank you, Jane. Thank you for sharing that good news. It is really important to celebrate that, and I will write to you in terms of what that means for us in Wales. But, where there are things to celebrate, where things are going well, we need to do that as well. So, thank you. And I know that the situation in Powys—which is concerning, of course—I know the health board will be looking at that. But, again, just looking at how, across the nation, we can make sure that services are sustainable for the future, again, that director of out-of-hospital care is going to be essential for this. In terms of the specific situation in Powys, again, it’s something for the health board, but if there’s anything that we can do, I will write to you.
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Diolch. A really important question. Obviously, it's quite cyclical that we are in some ways ending where we began, where we were talking about the fundamentals of the social care system that we have, and whether we go back to privatisation, whether we go back to Thatcher. Look, we can't look just at where we've come from; we have to be focusing on where we go from here. Obviously, no-one looking and trying to design a service from scratch would want to design it as it is. There's too much variation. One of the things we're going to be doing is improving data to see which local authorities are spending how much on social care, because it's unhypothecated. We need to make sure that there is, again, as much consistency as possible, as much consistency in commissioning. I want to support local authorities in doing that. They are going to be fundamental partners for us, so we want to work towards a national service with local underpinning, because the people closest to those people who need that support are the people who know the local services, working with regional partnership boards, working with, again, local health boards. We need to be bringing services together, but, again, not just for the sake of services; it's about improving people's lives and making sure that people get that better quality of service. So, yes, that is something fundamental. It's not just important; it underpins where we need to get to, so thank you.
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Diolch, Ddirprwy Lywydd. Hoffwn i ddechrau trwy ddiolch i bob Aelod sydd wedi siarad yn y ddadl bwysig hon. Mae'n arwyddocaol taw dyma ddadl Aelodau cyntaf y Senedd yma, ac rwy'n croesawu'r cyfle i ymateb.
Official English translation
Thank you, Dirprwy Lywydd. I'd like to start by thanking every Member who has contributed to this important debate. It is significant that this is the first Member debate in this Senedd, and I welcome the opportunity to respond.
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Stillbirth and neonatal death are not statistics to those who experience them. They are the loss of a baby, of a precious life surrounded by hope and dreams. The death of a baby is one of the most profound and searing pains that any family will ever endure. It is a grief that parents and families go on experiencing for the rest of their lives. I want to thank every parent who has reached out to me, who has reached out to Members in this Senedd to share their experiences. They are determined that other families should not have to face the anguish they have been through to campaign for better care, for stronger support and safer services. I am so grateful to them for their bravery and for their courage in the memory of those they have lost. Every death of a baby matters. Every stillbirth and neonatal death has to be treated with compassion, and parents deserve answers. We have to ensure that families are listened to, that care is safe and can be accessed by everyone, and that the whole system learns when things go devastatingly wrong and acts to reduce avoidable harm. The motion rightly draws attention to the stillbirth rate in Wales, which is higher than the UK rate. It's vital we take this data seriously. We need, of course, to interpret the figures carefully, particularly in a nation like Wales, where relatively small numbers of births mean annual rates can fluctuate significantly. It's true that MBRRACE-UK has advised caution when interpreting year-on-year changes. They recommend looking at trends over a longer period. And it's true, of course, that since 2016 Wales has seen an overall downward trend. But I contend it is not enough. None of that context will lessen a parent's pain. No caveats can make better what any of the families we've heard about today have gone through. We have to see sustained improvement. We need to understand and address what happens when things go so disastrously wrong. And that means focusing on prevention, safety and quality. It means ensuring women receive the right care at the right time, that concerns are heard and acted on, and that families are treated with dignity and respect. I am horrified to hear of the parents being corrected or brushed aside in the way that Elyn raised. It should not be happening.
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Mae hefyd yn golygu adnabod anghydraddoldebau. Rŷn ni’n gwybod bod canlyniadau'n gallu amrywio'n sylweddol fel canlyniad i amddifadiad ac ethnigrwydd. Dyna pham mae'n rhaid i ni unioni'r gwelliannau angenrheidiol yng ngwasanaethau mamolaeth a newyddenedigol gyda'n hymrwymiadau i leihau anghydraddoldebau iechyd a chyflawni'r cynllun Cymru wrth-hiliol. Rwyf hefyd yn ymrwymo i gryfhau ein dull o weithredu'r cynllun iechyd menywod i wella iechyd yn y blynyddoedd cynnar, i sicrhau canlyniadau iechyd gwell ar draws y cwrs bywyd, ac, yn bwysicach fyth, bod anghenion menywod yn cael eu clywed a'u gweithredu arnynt. Mae'r adroddiad 'Y llwybr tuag at ddechrau mwy diogel yng Nghymru' yn ganolog i’n dull gweithredu. Cafodd yr asesiad hwn ei lywio gan ddata, gan ymweliadau safle, trafodaethau gyda staff, lleisiau a phrofiadau menywod, teuluoedd a chymunedau. Mae argymhellion y panel yn nodi bod angen rhoi cynnig o ofal safonol i bawb i fynd i'r afael â blaenoriaethau diogelwch clinigol brys, i sicrhau lefelau staffio diogel a deall yr angen, profiadau a chanlyniadau yn well.
Official English translation
It also means that we need to identify inequalities. We know that outcomes can vary significantly as a result of deprivation and ethnicity. That's why we must align these necessary improvements in maternity and neonatal services with our commitments to reduce health inequalities and to deliver the anti-racist Wales plan. I also commit to strengthening our women's health approach to improve health in the early years, to secure better health outcomes across the course of one's life, and, more importantly, that women's needs are heard and acted upon. The report 'The path to safer beginnings in Wales' will be central to our actions. This assessment was steered by data, by site visits, discussions with staff, the voices and experiences of women, families and communities. The recommendations of the panel set out that we need to provide a standard care offer to everyone to address urgent clinical safety priorities, to secure safe staffing levels, and to understand the needs, experiences and outcomes more effectively.
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This Government accepts the recommendations and we will act on them. A three-year programme has been established to oversee delivery, with the oversight board meeting for the first time this month. This is not a report that will gather dust. It is a delivery programme focused on action, on accountability, and on measurable improvement. Work is already under way. All health boards in Wales are now live with Digital Maternity Cymru, which replaces hand-held paper notes with a shared digital maternity record, strengthening data quality and national oversight. I want support to be there for parents when they need it. We are working closely with health boards and the Welsh ambulance service on a dedicated triage and labour line, and supporting improvements to neonatal care with the support of Bliss Cymru. I expect all neonatal units in Wales will achieve at least bronze baby charter accreditation this year. We are also continuing work on early warning surveillance, safer pre-term birth care bundles, and structured learning from incidents where babies' lives are lost. The motion rightly highlights bereavement care. Families must receive compassionate, consistent, high-quality support. I’m deeply concerned about the incidents highlighted today, where clearly that has not always been the case. Bereavement midwives are in place in every health board, alongside third-sector care services. I've heard the point raised about specialist bereavement counsellors. I'll be taking that away, so thank you very much for raising that. The NHS has been working with Sands on five bereavement care pathways covering miscarriage, termination of pregnancy for fetal anomaly, stillbirth, neonatal death, and sudden unexpected death in infancies. These pathways have been published today, with additional implementation support in place. I know the Onnen service in Cardiff and Vale has been raised by a few Members. That will be evaluated robustly to ensure that any national roll-out is as effective as possible, that we learn from lessons there in terms of eligibility criteria, in terms of the length of when that is available as well. Members have called for clear targets to reduce stillbirth and neonatal mortality—I understand why. Targets can focus attention; they can signal ambition. Of course, they must be the right targets, supported by robust data. England's experience shows setting a healthcare target is not enough by itself, but I am interested to look at how Digital Maternity Cymru could improve this, could improve our data. I want to focus as well, of course, on how working across all Government portfolios to tackle causes of health inequalities can play its vital part, and so we will consider carefully how measurable ambitions could be framed for Wales, including how they reflect our population, our data and our commitment to reducing inequalities. [Interruption.] I will take an intervention.
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Diolch, Darren. As you'll know and as you've referred to, this was something that I have raised in previous years as well. It is something that my teams are working on now to evaluate how this could be done. There are problems technically that have hindered, I think, bringing them in before, partly because we don't have a national records service, which means we're different from Scotland and Northern Ireland. We need to make sure that there's a way that that can be done in a way where the bereavement pathway is supportive of parents. But I can assure you that that is something that we are looking at with urgency, and I'm really grateful that you've raised that. It's something that would support, I know, so many families. Thank you so much for raising that. Dirprwy Lywydd, if I could end, please, by speaking directly to parents who are watching this who have lost their babies. Your babies' lives mattered. What happened to them matters, and the loss you have suffered is something no parent should ever have to undergo. I know I can't begin to imagine what you are going through, but I feel it in my heart. I know I don't have all of the answers, but I want to do everything I can so that fewer families have to face this most devastating of griefs, and that those who do get the support they need when they need it. You are not alone, and I promise we are listening.
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Diolch. Llywydd, firstly, I'd like to welcome the Member to her role. I know she brings expertise and experience in this area, and I'm looking forward to working with her to make things better. Can I also say how glad I am that unpaid carers are the focus of spokespeople's questions so early in this Senedd, indeed, in this first question session on health and care? Unpaid carers face too many barriers, including what has been highlighted. Too many are not getting the support they need and deserve. Last week, it was Carers Week, and I visited two events celebrating unpaid carers in Penarth and in the Senedd. I spoke to unpaid carers about the reality of their lives, things going well and the challenges, and they told me that they want policies not praise. I pledge to listen to that. I want to be their voice in Government, to increase the visibility of the work they undertake, work that saves the Government and our society billions of pounds. Now, the Member has raised carers' needs assessments. I am pledging to work with local authorities to make sure that carers receive the assessments when they need them. I understand that, in legislation, there isn't always a guarantee that—. There needs to be a 28-day period for that, but we need to make sure that where there is a need, it happens quickly. The process needs to be streamlined, it needs to be standardised. There is too much inconsistency across local authority areas. They also need to be made more accessible, so it's about the timeliness, it's also about the accessibility, because even the terminology—. You know, we talk about 'assessments'. That can be very off-putting sometimes, I think, for unpaid carers. It can be daunting. I know that the Health and Social Care Committee talked about needing to talk about having a 'what matters' conversation, maybe, instead of an assessment. I pledge that on this and on many other issues, I will do what those carers asked me to do. I will want to be their voice in the Government, I want to be their Minister. I want to keep hearing from them, because they told me, 'Talk to us, not about us', and I plan to honour that.
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Thank you again for that really important question. I know that in terms of what has been raised in that 'At breaking point' report, currently the team is looking at that. When the new committee is established, we are going to be reporting back on that, and we are giving real consideration to some of those recommendations. We have pledged to protect the short breaks scheme, but also to look at how we can expand opportunities for unpaid carers to benefit from respite and flexible working, because we know, and the Member will know as well, that the short break scheme does work. Surveys show that carers feel more hopeful about the future after benefiting from that scheme, and some of those unpaid carers I met last week talked to me about the isolation they can feel, how family or friends can drift away because they don't understand the stress that the carer is under, and about the importance of respite. One of them told me that what you get to do in your own life is too often an add-on. I promise that I will do all I can to see how we can strengthen that.
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Thank you for that final question again. As I alluded to earlier, we are looking in terms of, of course, what funding can be made available, and I'm hoping to be in a position to be able to give more information on that soon, but as well as that extra funding, it's making sure that those assessments are done in a timely manner, that they're standardised, that they actually are meeting the needs of unpaid carers, and that we are strengthening their rights. We also want to make sure that unpaid carers are a designated priority group in Government policy. But, look, I want to be a voice in this Government for some of the people in our society who need it most, and I want to champion their needs, to amplify what they say, and I will work with people from all parties and none who are serious about improving the reality of these people's lives. It's what we are in politics to do, and I plan to focus on that.
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Diolch. Rŷn ni yn cymryd camau wedi'u targedu i gryfhau a sefydlogi'r gweithlu bydwreigiaeth trwy'r cynllun gweithlu amenedigol strategol, ac rŷn ni'n gweithio gyda'r gwasanaeth iechyd cenedlaethol i gynorthwyo graddedigion i symud i mewn i gyflogaeth, gan gynnwys trwy'r summit graddedigion ar 18 Mehefin.
Official English translation
Thank you. We are taking targeted action to strengthen and stabilise the midwifery workforce through the strategic perinatal workforce plan, and we are working with NHS Wales to help graduates move into employment, including through the graduate summit on 18 June.
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Can I thank you, Jayne, for raising this question? It clearly is an issue very close to your heart, and close to your family, and thank you for the empathy that you brought in that question. Look, I do recognise the concern and the distress that's facing lots of newly qualified midwives—those who are unable to secure posts at this time, when maternity services, as you've just been setting out, continue to face these workforce pressures. I do recognise that. This creates a real risk of losing those newly qualified, trained midwives that we need so much before they can even begin their careers here. It's not a situation that any of us would want to be in. Now, as I said, we are working with NHS Wales to better align education commissioning, vacancies and funded posts. I have met briefly with the RCM. I intend to have a far longer conversation with them. There is a graduate summit, as I mentioned, that is being held on 18 June. That is tomorrow, so this is very timely. We are prioritising this to bring partners together and to focus on those practical actions that we need to support those newly qualified professionals into roles. Now, that work obviously sits alongside the implementation of the strategic perinatal workforce plan. We have to do all we can to retain the talent that we have trained here in Wales, to recruit and support, and to deploy them where they are needed. You have just been setting out, Jayne, how vitally important they are in our society. We all thank them tremendously for the work that they do. It is invaluable. So, thank you very much for raising this really vital question.
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Rhun ap Iorwerth.
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