Browse content similar to 16/05/2017. Check below for episodes and series from the same categories and more!
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I think professional sport is looking strong in Newport at the | :00:23. | :00:27. | |
moment and I wondered if you would join me in paying tribute to all of | :00:28. | :00:33. | |
those people involved in making that a reality and particularly the | :00:34. | :00:37. | |
grassroots support? Absolutely. I saw the scenes at the | :00:38. | :00:41. | |
end of the game, the scenes of joy when the second goal went in against | :00:42. | :00:46. | |
Notts County so I am more than happy to congratulate Newport county. The | :00:47. | :00:51. | |
dragons have a bright future as well. The financial stability seems | :00:52. | :00:58. | |
to be coming together and I fully recognise the importance of sporting | :00:59. | :01:04. | |
development. The FA W over the past two years has been transformed, an | :01:05. | :01:08. | |
organisation that now has a training facility in place. In terms of the | :01:09. | :01:12. | |
importance of individual physical activity, I know how important this | :01:13. | :01:17. | |
is and I know indeed that the member has spent the last 18 years telling | :01:18. | :01:22. | |
me how important it is and I failed to follow his advice! We continue to | :01:23. | :01:33. | |
take a broad range of actions to support the manufacturing industry | :01:34. | :01:37. | |
against Wales. UK industrial output shrank for a third month in a row | :01:38. | :01:41. | |
with the manufacturing industry falling by 5.6%. As a country, in | :01:42. | :01:51. | |
Wales, with a proud manufacturing and industrial past, it is sad that | :01:52. | :01:54. | |
the proportion of apprenticeships in manufacturing fell from 6% in 2006 | :01:55. | :02:03. | |
to a dismal 2% in 2014 and those are stats Wales figures, including the | :02:04. | :02:06. | |
First Minister wants to accuse me again of misrepresenting the facts. | :02:07. | :02:10. | |
Does he agree with me that it is acceptable to did for over a year | :02:11. | :02:14. | |
with a new economic and industrial plan for this country and what hope | :02:15. | :02:18. | |
is there for a future in industry in Wales on a global level when we're | :02:19. | :02:21. | |
not providing the next generation with the skills to deliver? We will | :02:22. | :02:30. | |
fund 100,000 apprenticeships in this Government, something we think is | :02:31. | :02:34. | |
very important. He is right to put out manufacturing is of greater | :02:35. | :02:39. | |
importance to the Welsh economy than it is to the UK as a whole. I do not | :02:40. | :02:44. | |
accept what he says about dithering. We brought Aston Martin into Wales, | :02:45. | :02:52. | |
we brought Qatar Airways into Wales. We currently work with 88 companies | :02:53. | :02:56. | |
looking to expand or locate in Wales. We have been hugely active | :02:57. | :02:59. | |
and investment figures speak for themselves. Question ten, Russell | :03:00. | :03:10. | |
Jones. Superfast Cymru scheme in Montgomeryshire. | :03:11. | :03:22. | |
It will be rolled out. We are now eight months away from the job dead | :03:23. | :03:34. | |
date when the superfast Cymru projects, it seems to have | :03:35. | :03:39. | |
continuing issues with residents. We were contacted by one constituent | :03:40. | :03:45. | |
who complained that even though he had confirmation of superfast | :03:46. | :03:50. | |
broadband via fibre to the premises technology in February this year, he | :03:51. | :03:54. | |
also confirmed in writing by the Minister, he has now been told the | :03:55. | :03:57. | |
situation has changed and the technology to be used is eager for | :03:58. | :04:04. | |
the Cabinet and now he is too far away from the Cabinet to benefit | :04:05. | :04:09. | |
from the upgrade. That situation is unacceptable and one minute he is | :04:10. | :04:13. | |
told he will receive up to 330 megabytes and then the goalposts are | :04:14. | :04:16. | |
changed and he finds he will not benefit at all. In February, they | :04:17. | :04:21. | |
could have been other solutions but they are no longer available. Would | :04:22. | :04:25. | |
you agree that it is important people are given the right | :04:26. | :04:29. | |
information in the first place. Absolutely, perhaps if the member | :04:30. | :04:32. | |
could write to me with the details of a problem I will of course | :04:33. | :04:38. | |
investigate. The next item is the business statement and announcement | :04:39. | :04:41. | |
about Korber Leader of the House, Jane hunt. The business committee | :04:42. | :04:50. | |
has agreed to table a motion to suspend standing orders immediately | :04:51. | :04:52. | |
after the business statement to allow tomorrow's short of eight to | :04:53. | :04:54. | |
take place after today. I recently visited my GP and I had | :04:55. | :05:13. | |
to go very early in the morning, 8am, and what I saw is unthinkable, | :05:14. | :05:19. | |
I had to go past a couple of surgeries and people were waiting, | :05:20. | :05:25. | |
7:30am to 8am, outside with children, able and disabled and | :05:26. | :05:32. | |
senior people, with of course sickness. You have to make an | :05:33. | :05:34. | |
appointment to see the doctor before 8am and the surgery door never | :05:35. | :05:41. | |
opens. That is a surprisingly 21st-century. People waiting outside | :05:42. | :05:44. | |
and not getting into it in this weather earlier in the morning and | :05:45. | :05:48. | |
the surgery staff are already inside. So would you kindly make a | :05:49. | :05:55. | |
statement about GP appointments in Wales, that includes, it will | :05:56. | :06:00. | |
definitely have many surgeries in this country that all stood outside | :06:01. | :06:04. | |
without shelter in this weather, could not some matter allow these | :06:05. | :06:09. | |
patients to wait inside the surgeries and possibly a use of | :06:10. | :06:15. | |
ticketing or numbers to be given and they can have a lot of numbers to | :06:16. | :06:21. | |
see the nurses or the people who are inside give the appointments for the | :06:22. | :06:26. | |
doctors. I think it would be great help for sick people, young and old, | :06:27. | :06:31. | |
to make sure that statement is made on doctor appointment surgeries in | :06:32. | :06:37. | |
Wales. The member raises an important question and it gives me | :06:38. | :06:41. | |
the opportunity to say that our GPs in Wales provide a first class | :06:42. | :06:47. | |
service to the population, the national survey continues to show | :06:48. | :06:52. | |
high level of satisfaction, patients satisfied with GP services. We are | :06:53. | :06:58. | |
continuing to invest new money in private care, 42.6 million this | :06:59. | :07:06. | |
financial year alone. In terms of GP practices working together, | :07:07. | :07:09. | |
collaboratively, we are investing 64 primary care clusters across Wales. | :07:10. | :07:16. | |
That all means that in terms of access to GP surgeries, this Welsh | :07:17. | :07:22. | |
Government is not only investing, supporting, but also patients | :07:23. | :07:23. | |
increasingly satisfied with those services. Play-offs for a Government | :07:24. | :07:32. | |
statement in the importance of universities and what the Government | :07:33. | :07:38. | |
is doing to support the university sector. The importance as you say of | :07:39. | :07:54. | |
universities is quite clear. The higher education sector makes a | :07:55. | :07:56. | |
substantial contribution to the economy of Wales. University of | :07:57. | :08:01. | |
Wales contributes more than ?3 billion a year in gross expenditure. | :08:02. | :08:05. | |
Employee over 20,000 people and turnover in excess of 1.5 billion. | :08:06. | :08:11. | |
Of course also contributing to sustainable, economic growth in many | :08:12. | :08:16. | |
ways. Developing a highly skilled workforce through engagement with | :08:17. | :08:21. | |
local communities. Clearly, there are examples the university sector | :08:22. | :08:24. | |
can learn from across the world but I think we have real opportunities | :08:25. | :08:33. | |
as the diamond review recognises, investment in higher education can | :08:34. | :08:36. | |
bring those benefits for the economy. Thank you, if I can ask the | :08:37. | :08:47. | |
Cabinet secretary for two statements. The first is quite | :08:48. | :08:53. | |
simple, we have just announced that all parties in Wales are in favour | :08:54. | :08:56. | |
of scrapping the Severn Bridge tolls. I look forward to that but it | :08:57. | :09:01. | |
does leave one bridge in Wales which does have a toll and that is the | :09:02. | :09:13. | |
Thamwong -- that is the Cleddau bridge and that is wholly in the | :09:14. | :09:23. | |
hands of the Welsh Government. What is the Government's intention in | :09:24. | :09:28. | |
terms of scrapping the Severn Bridge tolls and I believe the only bridge | :09:29. | :09:33. | |
in Wales where it a bridge goes from one part of an enterprise to another | :09:34. | :09:37. | |
so let's make sure Wales is free of tolls following, realising the | :09:38. | :09:42. | |
dreams of the daughters of Rebecca at last. The second statement is a | :09:43. | :09:48. | |
little more complex, relating to a planning application for a cabin | :09:49. | :10:01. | |
holiday part in Bedd Gelert. The campsite in Bedd Gelert is to be | :10:02. | :10:07. | |
done away with and there is a planning application for holiday | :10:08. | :10:11. | |
cabins in the place which includes hot tubs and also some things, as | :10:12. | :10:16. | |
well as a shop and visitors centre. The plan under pinning this is part | :10:17. | :10:22. | |
of something that has emerged from the old Forestry Commission and | :10:23. | :10:25. | |
therefore, I want a statement from the Government on the role of an RW | :10:26. | :10:33. | |
in this application, as I understand it, NRW as the successor body to the | :10:34. | :10:40. | |
Forestry Commission, has a 20% stake in this scheme and if it does | :10:41. | :10:45. | |
proceed and is successful, in terms of its planning application, NRW | :10:46. | :10:53. | |
will receive ?48,000 per annum in rent for 16 holiday cabins. That is | :10:54. | :11:00. | |
3000 per cabin. The problem here is that NRW is also a regulator for the | :11:01. | :11:08. | |
site and NRW as a regulator, has raised any objections of the | :11:09. | :11:15. | |
development. -- has not raised any objections of the development. I | :11:16. | :11:22. | |
would like to hear from the Government how exactly they expect | :11:23. | :11:27. | |
NRW the balance that position and to make sure everything is done | :11:28. | :11:30. | |
properly to make sure local people can be assured they are doing the | :11:31. | :11:33. | |
proper work and safeguarding the local environment. It is a | :11:34. | :11:40. | |
breakthrough that the Welsh Labour Government and indeed your cells | :11:41. | :11:45. | |
have been crying out for, the Severn Bridge tolls to be removed and now | :11:46. | :11:49. | |
the Tories are responding to our calls here from the Welsh Government | :11:50. | :11:56. | |
and from parties in this chamber. It is very important therefore, we look | :11:57. | :12:02. | |
at how this can progress. Your point about Cleddau bridge is well made | :12:03. | :12:07. | |
and I am sure the Minister will want to update you about. Your second | :12:08. | :12:12. | |
question, it draws attention to a whole range of issues which touch on | :12:13. | :12:17. | |
powers and responsibilities of NRW. You have put it on the record now in | :12:18. | :12:22. | |
terms of this application which does crossover issues relating to Tories | :12:23. | :12:29. | |
and forestry and planning which the Minister has two reserve comment on | :12:30. | :12:35. | |
but you have put it on record. Could I call for two statements, firstly | :12:36. | :12:41. | |
on an issue I first raised 14 years ago and possibly earlier. That is | :12:42. | :12:50. | |
deaf school pupils in Wales. In this UK deaf awareness week 2017, the | :12:51. | :12:55. | |
latest Welsh Government figures have shown deaf school pupils are | :12:56. | :13:00. | |
underachieving at every key stage with the national deaf children | :13:01. | :13:03. | |
society for Cymru saying these pupils are being left behind without | :13:04. | :13:08. | |
urgent action. The figures suggesting the attainment gap having | :13:09. | :13:12. | |
temporarily fallen, has widened again at GCSE level. Having launched | :13:13. | :13:17. | |
to close the gap following a poor set of results four years ago, the | :13:18. | :13:23. | |
society has said the latest figures are unacceptable. Deafness is not a | :13:24. | :13:27. | |
learning disability or difficulty and there is no reason why these | :13:28. | :13:30. | |
people should be underachieving unless and only because they are not | :13:31. | :13:34. | |
access in the appropriate support. As we call for 14 years ago, that | :13:35. | :13:40. | |
means raising deaf awareness, improving acoustics in the classroom | :13:41. | :13:46. | |
and making sure deaf children are supported from the start. I hope the | :13:47. | :13:49. | |
Welsh Government will respond with a statement on this very serious | :13:50. | :13:53. | |
issue. Having given it deep and serious consideration and considered | :13:54. | :14:00. | |
how we might now move forward. Secondly, could I call for a | :14:01. | :14:04. | |
statement on the Health Secretary on rare conditions in Wales, once he | :14:05. | :14:15. | |
has read the spring 2017 edition of vasculitis UK's magazine. An article | :14:16. | :14:21. | |
within it entitled what's up with Wales? This article says we have a | :14:22. | :14:29. | |
really good relationship with all the leading medical vasculitis | :14:30. | :14:35. | |
people in England but in Wales it is a different situation. Having been | :14:36. | :14:39. | |
given diagnosis by the leading people in England, over the border, | :14:40. | :14:44. | |
the advice seems to be ignored. There are various problems in | :14:45. | :14:49. | |
England for people with rare diseases but this seems to be a last | :14:50. | :14:51. | |
century attitude in Wales. Even if that is not 100% accurate, | :14:52. | :15:04. | |
the fact that these people hold that as their experience of treatment in | :15:05. | :15:07. | |
Wales and put it into a national magazine merits attention and hope | :15:08. | :15:10. | |
it will justify a statement accordingly. I am grateful that Mark | :15:11. | :15:15. | |
Isherwood has kept faith, as you do, with these very important issues you | :15:16. | :15:20. | |
have raised with me, I am sure not just 14 years ago, an issue not just | :15:21. | :15:24. | |
for health ministers and responsibilities, but also education | :15:25. | :15:31. | |
ministers and responsibilities as well. Our mission is to raise | :15:32. | :15:39. | |
standards and improve attainment at all levels. We do aim to achieve | :15:40. | :15:43. | |
this through the range of educational reforms that are | :15:44. | :15:47. | |
currently under way. Our ambitious additional learning needs Bill, if | :15:48. | :15:51. | |
passed, will completely overhaul the system for supporting pupils with | :15:52. | :15:55. | |
additional learning needs, including learners with hearing impairments. A | :15:56. | :15:59. | |
20 million package of funding will support implementation and build on | :16:00. | :16:03. | |
our wider plans, including developing workforce, but I do | :16:04. | :16:08. | |
recall again, and I'm sure the Cabinet Secretary for will be able | :16:09. | :16:15. | |
to update us on this, on the ways in which we ensure that in our capital | :16:16. | :16:20. | |
investment programme, 21st century schools will particularly be looking | :16:21. | :16:24. | |
at these issues, when we were developing that ambitious programme, | :16:25. | :16:28. | |
to ensure that we can take this on board in terms in the ways those | :16:29. | :16:34. | |
buildings could assist that and that is very much part of raising deaf | :16:35. | :16:40. | |
awareness for policy makers, as well as for those who are delivering the | :16:41. | :16:44. | |
services. On your second point, in terms of where conditions... I have | :16:45. | :16:50. | |
certainly over the vet met -- over the years met with groups, as you | :16:51. | :16:54. | |
will have done, and with professionals who were delivering in | :16:55. | :16:57. | |
terms of addressing the needs of people with rare conditions and I | :16:58. | :17:05. | |
don't recognise that statement that was given, I know that the Cabinet | :17:06. | :17:09. | |
Secretary will be taking very serious consideration of how we are | :17:10. | :17:12. | |
progressing in terms of meeting those needs. Some six weeks ago, | :17:13. | :17:21. | |
Julie Morgan and I wrote to the Cabinet Secretary for the | :17:22. | :17:24. | |
environment and planning about the threat to the most vibrant live | :17:25. | :17:30. | |
music venue in Cardiff, which is at one in the street, because of the | :17:31. | :17:36. | |
threat of planning applications for a hotel and residency applications | :17:37. | :17:49. | |
-- Womanby Street. I am is ??DELETE alleged she is back after the life | :17:50. | :17:53. | |
changing injuries she suffered in the accident but now she is back, I | :17:54. | :17:59. | |
wonder with a she is able to tell us if it is able to introduce new | :18:00. | :18:03. | |
planning guidelines so it is absolutely clear to any developers | :18:04. | :18:06. | |
that the agent of change in any development has to be met by the | :18:07. | :18:12. | |
person who's making the applications, because under the | :18:13. | :18:17. | |
current planning laws, the whole of Womanby Street could be put out of | :18:18. | :18:22. | |
business if these applicants are successful, and they could then | :18:23. | :18:28. | |
insist that the live music venue has to pay the soundproofing, etc, which | :18:29. | :18:32. | |
in any case is likely to be ineffective because people on the | :18:33. | :18:34. | |
street will cause noise whether they are inside or outside of a venue. | :18:35. | :18:39. | |
There is over nearly 1,000 jobs at risk here, as well as many millions | :18:40. | :18:46. | |
of pounds from music tourism, so I wondered if we could envisage an | :18:47. | :18:51. | |
early statement on how we can change the law to ensure that any new | :18:52. | :18:54. | |
development has to make it clear that they are going to have to pay | :18:55. | :18:59. | |
for the costs of any mitigation that is resulting from a new development. | :19:00. | :19:05. | |
I thank Jenny Rathbone for raising this very important issue, again, | :19:06. | :19:09. | |
this important campaign that Julie Morgan also raised with you. Lesley | :19:10. | :19:15. | |
Griffiths is back in business, certainly wanting to meet with you | :19:16. | :19:21. | |
to discuss this issue. She certainly is very concerned to make sure that | :19:22. | :19:26. | |
the principle of making agents of change responsible for managing the | :19:27. | :19:31. | |
impact of new development is made very explicit in any future revision | :19:32. | :19:39. | |
to planning policy in Wales. It is already there, already contained | :19:40. | :19:43. | |
within planning policy Wales, but clearly needs to be more explicit | :19:44. | :19:48. | |
and I think the Cabinet Secretary, now of course for environment and | :19:49. | :19:51. | |
rural affairs, is willing to meet with you to discuss how it can be | :19:52. | :19:57. | |
taken forward. TRANSLATION: Thank you. I was very | :19:58. | :20:03. | |
pleased a few days ago to see the Welsh Government noting can guess | :20:04. | :20:14. | |
the station is one that could be reopened if in the future, the work | :20:15. | :20:21. | |
my predecessor did on the feasibility study on opening the | :20:22. | :20:29. | |
line through Llanelli which would bring huge benefits to Anglesey and | :20:30. | :20:33. | |
I know that we would be more than happy to discuss this issue further | :20:34. | :20:36. | |
with Government, but would it be possible to have a statement from | :20:37. | :20:41. | |
the Cabinet Secretary for transport on the additional work that needs to | :20:42. | :20:46. | |
be done now in order to transform this exciting idea into reality? The | :20:47. | :20:53. | |
Cabinet Secretary, as you have acknowledged, recently announced the | :20:54. | :20:56. | |
prioritisation of 12 new railway stations across Wales. That decision | :20:57. | :21:01. | |
was made assessing a number of proposals against the well-being | :21:02. | :21:05. | |
goals set out at the well-being and future generations act. And clearly | :21:06. | :21:11. | |
now, it is about working with local authorities, partners and all those | :21:12. | :21:17. | |
who can progress proposals for those stations, including the station in | :21:18. | :21:21. | |
your constituency, with a view to future considerations, so I know the | :21:22. | :21:25. | |
Cabinet Secretary will want to update the Assembly on this matter. | :21:26. | :21:31. | |
Can I call the two statements, please? One in relation to the | :21:32. | :21:36. | |
regulation of drones and light aircraft. I've received a number of | :21:37. | :21:40. | |
complaints recently from residents in my own constituency about the use | :21:41. | :21:44. | |
of drones in residential areas hovering over people's back gardens, | :21:45. | :21:48. | |
filming local residents and invading their privacy and in addition to | :21:49. | :21:54. | |
that, there have been complaints about the use of light aircraft on | :21:55. | :22:00. | |
beaches which are right adjacent to the rail infrastructure and indeed | :22:01. | :22:04. | |
the trunk road network and, of course, if any of those microlights, | :22:05. | :22:08. | |
etc, had an accident, that could cause a serious problem on those | :22:09. | :22:13. | |
particular pieces of infrastructure, so I would appreciate a statement | :22:14. | :22:16. | |
from an appropriate Cabinet Secretary about the way we can best | :22:17. | :22:20. | |
regulate these whilst still allowing people to use them for leisure | :22:21. | :22:24. | |
purposes. Can I also call for a statement on access to GPs. I know | :22:25. | :22:28. | |
my colleague has also raised this as an issue but the National pensioners | :22:29. | :22:35. | |
a report recently on access to GP services in Wales and it found there | :22:36. | :22:40. | |
was significant problems with accessing some appointments in some | :22:41. | :22:46. | |
surgeries and it was largely due to the inconsistency around appointment | :22:47. | :22:49. | |
arrangements. So it reported that while some surgeries were offering | :22:50. | :22:54. | |
same-day appointment only, others were allowing people to book in | :22:55. | :22:58. | |
advance and offering a more flexible approach, which seemed to be much | :22:59. | :23:03. | |
better for patients in terms of their patient experiences, so I do | :23:04. | :23:06. | |
think it is about time we had a statement on GP access and how to | :23:07. | :23:11. | |
improve that overall and I would appreciate it if one could be | :23:12. | :23:19. | |
scheduled. I think the importance of access to GPs, I've already | :23:20. | :23:21. | |
commented on that in response to an earlier question, but I think the | :23:22. | :23:31. | |
changes to the GP contract for 2017-18 is important in terms of the | :23:32. | :23:37. | |
ways in which you can provide for new, enhanced services and also to | :23:38. | :23:43. | |
take forward the quality and outcomes, which is where ready to | :23:44. | :23:47. | |
see the consistency in terms of delivery. That's going to free up | :23:48. | :23:53. | |
more capacity for GPs and also access to practice nurses, which we | :23:54. | :23:57. | |
must of course remember is equally important in terms of the primary | :23:58. | :24:04. | |
care team and services provided. And also, it means patients can be seen | :24:05. | :24:10. | |
by the most appropriate professional for their needs. This is an issue | :24:11. | :24:14. | |
that in terms of GP surgeries, we are addressing. On your first | :24:15. | :24:17. | |
question, I will obviously take back and identify which Cabinet Secretary | :24:18. | :24:24. | |
is appropriate to answer your important question. Indeed, if we | :24:25. | :24:28. | |
have powers at all in terms of the use of drones and the impact in | :24:29. | :24:36. | |
terms of invasion, if you like, of Private space and the use of them as | :24:37. | :24:46. | |
well. Could we find time for a statement on the detrimental impact | :24:47. | :24:48. | |
on Welsh Government policies of well-being and promoting prosperity | :24:49. | :24:55. | |
of cuts, existing cuts and possible future codes to disability benefits | :24:56. | :24:59. | |
in the South Wales valleys and throughout Wales? A ?30 a week cut | :25:00. | :25:05. | |
to some new claimants of the employment and support allowance | :25:06. | :25:09. | |
came into effect last month, so disabled people put in the | :25:10. | :25:13. | |
work-related activity group will now receive ?73 a week. I will just | :25:14. | :25:17. | |
repeat that, ?73 a week. I wouldn't be able to live on that and also | :25:18. | :25:21. | |
cope with the additional challenges and costs that people with | :25:22. | :25:25. | |
disabilities have. The Prime Minister Theresa May says this lower | :25:26. | :25:30. | |
rate of support will, in her words, "Encourage disabled people to find | :25:31. | :25:37. | |
work." Yet over 30 disability charities, authoritative disability | :25:38. | :25:40. | |
charities, said the cuts do not incentivise work at all but they do | :25:41. | :25:44. | |
make life harder for disabled people who face extra costs of living and | :25:45. | :25:48. | |
they mean some people will be unable to afford basic necessities. Last | :25:49. | :25:53. | |
week, the Prime Minister refused to rule out further cuts for people | :25:54. | :25:59. | |
with disabilities, so if things are bad now, we can only imagine what | :26:00. | :26:03. | |
things might be if a Conservative Government is elected for the next | :26:04. | :26:06. | |
five years. So can we have a statement to shine the light on | :26:07. | :26:13. | |
effect of these prove who you delete -- of these punitive decisions and | :26:14. | :26:19. | |
the communities they live in. I am very grateful it has been brought to | :26:20. | :26:22. | |
our attention in the chamber today and I have to say that in my | :26:23. | :26:28. | |
constituency capacity, I am being approached by people who are now | :26:29. | :26:31. | |
suffering directly as a result of the further cuts to welfare benefit, | :26:32. | :26:38. | |
particularly affecting disabled people, the 1st of April. People who | :26:39. | :26:47. | |
are struggling and are losing access to notability, for example, and then | :26:48. | :26:55. | |
having contradictory expectations, which, of course, cannot be | :26:56. | :26:59. | |
delivered, and all reducing their income levels. We Remain deeply | :27:00. | :27:04. | |
concerned about UK Government's changes for employment support | :27:05. | :27:09. | |
allowance claimants assigned to the work-related activity group, which | :27:10. | :27:13. | |
started in April this year. It will see new claimants receive | :27:14. | :27:16. | |
approximately ?29 per week less, existing claimants -- than existing | :27:17. | :27:23. | |
claimants and it is the cuts on new claimants, we have to remember that, | :27:24. | :27:27. | |
the DWP estimate 500,000 families in Great Britain will be affected and | :27:28. | :27:31. | |
in the longer term, 35,000 affected claimants will be in Wales and it is | :27:32. | :27:37. | |
the local authority areas in the South Wales valleys, particularly | :27:38. | :27:40. | |
those claimants, affected on the higher PSA rates. And as a Welsh | :27:41. | :27:48. | |
Government, we are taking action to help people to manage the effects of | :27:49. | :27:55. | |
the UK Government's welfare benefit changes and we will continue to | :27:56. | :28:00. | |
analyse the impacts of such cuts and monitor those impacts, putting more | :28:01. | :28:04. | |
money into our advice services, credit unions and support services | :28:05. | :28:10. | |
is crucial. It would be very helpful is crucial. It would | :28:11. | :28:18. | |
for us to bring to the wider for us | :28:19. | :28:22. | |
discussion a statement by the Cabinet Secretary, it would be very | :28:23. | :28:23. | |
helpful to this chamber and disassembly. Three brief areas, if I | :28:24. | :28:30. | |
may. Firstly, can I support Mark Isherwood's earlier call for a | :28:31. | :28:36. | |
statement of support given by the Welsh Government for rare diseases. | :28:37. | :28:40. | |
You mentioned vasculitis, an area of concern close to my heart. Many of | :28:41. | :28:44. | |
these sufferers of the rarer diseases do often feel left out. It | :28:45. | :28:50. | |
is natural for large diseases, cancer, heart disease, to get the | :28:51. | :28:54. | |
lion's share of funding but over time, it is important that we do | :28:55. | :28:58. | |
send a signal to sufferers of rare diseases that they are being taught | :28:59. | :29:01. | |
about and policy is filmed around them too. Secondly, I think it is | :29:02. | :29:07. | |
six months now since the Cabinet Health Secretary made a statement | :29:08. | :29:12. | |
giving the go-ahead for the specials and critical care centre income | :29:13. | :29:20. | |
bran. I think 2022 was the date given for a solution backstreet | :29:21. | :29:27. | |
completion for that project. Can we have an update -- was the date given | :29:28. | :29:32. | |
for completion of that project Chris Watt can we have an update on that? | :29:33. | :29:36. | |
Finally, I drove along the heads of the valleys road on the weekend and | :29:37. | :29:42. | |
it is good to see that coming on. That's a fantastic piece of road and | :29:43. | :29:45. | |
there are many economic potential benefits, I can see the member | :29:46. | :29:53. | |
nodding vigorously at that. However, just down the road, you have got the | :29:54. | :29:59. | |
a 40 that links Abergavenny to Raglan and Monmouth in my | :30:00. | :30:04. | |
constituency, which is an ageing concrete road causing hassle for | :30:05. | :30:08. | |
commuters and people living in adjacent areas, so if we are going | :30:09. | :30:11. | |
to have this fantastic piece of road kit up at the heads of the valleys, | :30:12. | :30:15. | |
it doesn't make any sense to have a poorer piece of road infrastructure | :30:16. | :30:18. | |
feeding into it, so I wonder if we could have a statement from the | :30:19. | :30:21. | |
Cabinet Secretary of the transport are Harry intends to build on the | :30:22. | :30:24. | |
development of the heads of the valleys and make sure the | :30:25. | :30:27. | |
surrounding network is also build up to standard. | :30:28. | :30:33. | |
The Cabinet secretary for health and well-being and sport is sitting here | :30:34. | :30:38. | |
listening to your first two questions, one of which I did | :30:39. | :30:41. | |
respond to in terms of rare diseases and the importance of the priorities | :30:42. | :30:48. | |
we give to that. But also to the state of play in terms of critical | :30:49. | :30:56. | |
care centre. Wonderful new heads of the valleys roads with more funding | :30:57. | :31:00. | |
coming through innovative finance to complete it. Also, seeing the sign | :31:01. | :31:08. | |
which you will have seen, saying, funded by the European Union, I | :31:09. | :31:13. | |
think strikes me as a back road would not be built without us being | :31:14. | :31:19. | |
a member of the European Union. As well as Welsh Government funding as | :31:20. | :31:27. | |
well. That has made a huge impact in terms of the Welsh economy and | :31:28. | :31:32. | |
access to your constituency and then of course, nick Robinson, you | :31:33. | :31:36. | |
mentioned the roads that came up to be a full 65 and that is a matter of | :31:37. | :31:41. | |
our work and partnership together with your local authority. Thank | :31:42. | :31:49. | |
you, Leader of the House and the next item is the motion to | :31:50. | :31:53. | |
temporarily suspend standing orders, to allow the short debate scheduled | :31:54. | :32:00. | |
for the 17th May to be debated as the last item of business today. I | :32:01. | :32:04. | |
call a member of the business committee to move motion. The | :32:05. | :32:11. | |
proposal is to suspend standing orders. The motion is therefore | :32:12. | :32:19. | |
agreed in accordance with standing order 12.36 and the next item is a | :32:20. | :32:24. | |
statement by the Cabinet secretary for health, well-being and sport on | :32:25. | :32:29. | |
end of life care. I call on the Cabinet secretary. On 27th of March | :32:30. | :32:35. | |
this year, I published the updated palliative and end of life care | :32:36. | :32:39. | |
delivery plan. This plan reaffirms our commitment to make sure people | :32:40. | :32:43. | |
have a realistic, healthy approach to diet and can plan appropriately | :32:44. | :32:48. | |
for the event. We want people to be able to end their days in the | :32:49. | :32:53. | |
location of their choice. Be that home, hospital or hospice. And we | :32:54. | :32:57. | |
want them to have access to high-quality care wherever they live | :32:58. | :33:03. | |
and die, whatever the underlying disease or disability. This plan | :33:04. | :33:06. | |
covers all aspects of palliative and end of life care. Delivered by both | :33:07. | :33:11. | |
primary and secondary sectors and involving specialist palliative care | :33:12. | :33:17. | |
by the NHS and third sector providers. To build on the success | :33:18. | :33:26. | |
of the first plan, it has been updated to reflect the latest change | :33:27. | :33:30. | |
and has strengthened children and young people and research sections. | :33:31. | :33:35. | |
We no care at the end of life has improved greatly since the | :33:36. | :33:37. | |
publication of the first delivery care plan in 2013. Consultants in | :33:38. | :33:43. | |
palliative medicine are now available on call 20 47 across Wales | :33:44. | :33:47. | |
to provide advice and support to other professionals and visit | :33:48. | :33:52. | |
patients where required, enhancing the service provided by clinical | :33:53. | :33:55. | |
nurse specialist at weekends. The support is now in place for | :33:56. | :34:02. | |
specialist teams the work seven days a week. This provides front line | :34:03. | :34:06. | |
staff with valuable support at weekends, enabling patients with end | :34:07. | :34:12. | |
of life care needs to avoid hospital admission where appropriate and | :34:13. | :34:15. | |
patients with complex needs to remain at home. Also we are | :34:16. | :34:24. | |
improving hospice at home provision. All general practices have a ratio | :34:25. | :34:28. | |
of patients with supportable palliative care needs. We have | :34:29. | :34:35. | |
established a 24 hour out of our telephone advice service which is | :34:36. | :34:41. | |
now available across Wales. Dying is of course an inevitable event. I | :34:42. | :34:46. | |
fully appreciate it is not a subject many people are comfortable talking | :34:47. | :34:50. | |
about but it is vital people let their loved ones know how they wish | :34:51. | :34:54. | |
to end the days when the time comes. Planning for the end of life through | :34:55. | :34:58. | |
open conversations can result in a better death and certainly help the | :34:59. | :35:01. | |
grieving process for those left behind. Last week, I attended a | :35:02. | :35:06. | |
conference and was pleased to launch the new website for advanced care | :35:07. | :35:12. | |
planning. Today, you can find most of the information online and it | :35:13. | :35:15. | |
will be useful to have that resource on the internet at their fingertips. | :35:16. | :35:21. | |
We have provided ?150,000 to train staff in end of life care. This | :35:22. | :35:26. | |
enables colleagues to begin and manage serious illness conversations | :35:27. | :35:30. | |
with parents, families and carers. The end of life care implementation | :35:31. | :35:34. | |
board provide strong leadership and oversees the delivery of the plan. | :35:35. | :35:39. | |
As is the case with all major health conditions, the board sees ?1 | :35:40. | :35:42. | |
million annually to support the priorities. The Welsh Government | :35:43. | :35:47. | |
allocated an additional million pounds to further enhance end of | :35:48. | :35:52. | |
life care provision. The board has identified provisionally this | :35:53. | :35:58. | |
funding will be used in a compassionate community approach for | :35:59. | :36:03. | |
palliative care. Supporting the development for an all Wales | :36:04. | :36:08. | |
development record and take research priorities and the poor GP clusters | :36:09. | :36:14. | |
in Wales. The Government provides also ?6.4 million in funding support | :36:15. | :36:18. | |
specialist palliative care services provided by hospices and health | :36:19. | :36:22. | |
boards throughout Wales. This significant investment is a | :36:23. | :36:24. | |
reflection of the importance of this Welsh Government places on end of | :36:25. | :36:29. | |
life care. It is vital individuals receive the best possible care in | :36:30. | :36:33. | |
the location of their choice at the end of the days. Direct feedback | :36:34. | :36:37. | |
from patients and their families about specialist palliative care | :36:38. | :36:44. | |
services in Wales have shown that year, these services make a huge | :36:45. | :36:46. | |
difference to people's quality of life in the closing days. 93% of | :36:47. | :36:53. | |
responses to the patient evaluation of the experience of palliative care | :36:54. | :36:58. | |
was positive and the average score was 9.5 out of ten across all | :36:59. | :37:02. | |
domains. This would not be possible of course without the dedication and | :37:03. | :37:07. | |
professionalism of our workforce. I do want to take a moment at the | :37:08. | :37:11. | |
stage to acknowledge the work of our clinicians, nurses and other staff | :37:12. | :37:15. | |
providing care for people at the end of their lives. They can be fewer | :37:16. | :37:19. | |
jobs, more or mostly demanding yet more necessary. I'm sure you'll all | :37:20. | :37:24. | |
join me in recognising and thanking our staff for work. Dying is a | :37:25. | :37:30. | |
social matter. How well we care for people who were dying reflect on how | :37:31. | :37:35. | |
we care as a society. Advances in modern medicine and treatment have | :37:36. | :37:39. | |
resulted in a growing population living longer with incurable | :37:40. | :37:46. | |
diseases. It is vital good end of life in palliative care is made | :37:47. | :37:49. | |
available across Wales. The delivery plan was developed through effective | :37:50. | :37:53. | |
partnership working, that continued cooperation between the Government | :37:54. | :37:58. | |
of Wales, implementation board, NHS, professional bodies at the third | :37:59. | :38:02. | |
sector is key to delivering outcomes at a greater pace and with greater | :38:03. | :38:06. | |
impact. We should recognise the challenges ahead are many other | :38:07. | :38:09. | |
significant but we can look forward to the future with a sense of shared | :38:10. | :38:18. | |
direction and confidence. This week is dying matters awareness week | :38:19. | :38:23. | |
2017, placing the importance of talking about dying, death and | :38:24. | :38:28. | |
bereavement firmly on the Welsh and UK agenda. I very much welcome as | :38:29. | :38:33. | |
chair of both the cross-party group on hospices and palliative care at | :38:34. | :38:37. | |
the cross-party group on funerals and bereavement, with an estimated | :38:38. | :38:42. | |
32,000 people dying in Wales each year, that is affecting somewhere | :38:43. | :38:46. | |
between 160,000 and one third of a million people directly. In Wales | :38:47. | :38:52. | |
each year. Many vulnerable to serious additional problems, | :38:53. | :38:57. | |
suicide, lonely dice, social isolation, anxiety, depression and | :38:58. | :39:02. | |
social problems. The majority of end of life care in Wales is provided by | :39:03. | :39:07. | |
hospices across a range of settings including inpatient units and | :39:08. | :39:14. | |
hospice and home services. There are lessons the NHS could learn from | :39:15. | :39:18. | |
hospices, especially about the integration of care services in the | :39:19. | :39:23. | |
home Community Hospital and hospice. I've been asking successive health | :39:24. | :39:27. | |
ministers and our Health Secretary for many years, to start asking or | :39:28. | :39:36. | |
making sure NHS will start asking our wonderful community, hospice | :39:37. | :39:39. | |
movement, how it can help them deliver more for the resources | :39:40. | :39:46. | |
available in modern Wales, delivering services with them. And | :39:47. | :39:50. | |
too many still feel that is not the case. I wonder if you could respond | :39:51. | :39:57. | |
to that point. Hospices Cymru, as you will be aware, are receiving | :39:58. | :40:03. | |
Welsh Government funding on a ring-fenced basis through health | :40:04. | :40:07. | |
authorities over three years period. That period finishes in 2018. Can | :40:08. | :40:13. | |
you provide assurance to them whether that funding will continue | :40:14. | :40:19. | |
to be ring fenced when the existing funding expires because they need to | :40:20. | :40:23. | |
go for the forward planning, and if not, can you indicate when you might | :40:24. | :40:28. | |
be able to provide that assurance or at least information? 16 to 20% | :40:29. | :40:34. | |
hospices in Wales still receive far less Government funding, that's | :40:35. | :40:37. | |
Welsh Government and Welsh NHS funding, than the English and | :40:38. | :40:43. | |
Scottish counterparts. They also highlight a postcode lottery of | :40:44. | :40:47. | |
hospice services with the disparity of care available between different | :40:48. | :40:52. | |
parts of Wales. When will the Welsh Government finally in the context of | :40:53. | :40:59. | |
my previous question, recognise that by discussing and designing and | :41:00. | :41:03. | |
delivering with them on a more balanced funding basis, it is win- | :41:04. | :41:11. | |
win for everybody and a means of delivering in a strict budget | :41:12. | :41:16. | |
environment? At the end of life implementation board, as you | :41:17. | :41:19. | |
indicate, has been allocated an extra million pounds in 2017-18 and | :41:20. | :41:24. | |
one of the provisional areas identified for that is developing a | :41:25. | :41:30. | |
compassionate community 's approach the end of life care. To a half | :41:31. | :41:36. | |
months ago, I went to a lecture on a compassionate community approach the | :41:37. | :41:39. | |
end of life care. Highlighting the need to provide people near the end | :41:40. | :41:43. | |
of their lives with the support they need to remain in their communities | :41:44. | :41:48. | |
by providing health, promotion and community development principles, | :41:49. | :41:50. | |
and providing support to those who are dying and those who are | :41:51. | :41:56. | |
bereaved. How therefore do you respond, not just in terms of a | :41:57. | :41:59. | |
provisional part of ?1 million for one year, but to the call by married | :42:00. | :42:04. | |
here for Wales to become a compassionate nation following the | :42:05. | :42:08. | |
lines of the compassionate community model, that has successfully been | :42:09. | :42:12. | |
developed in numerous towns and communities in the UK, including | :42:13. | :42:19. | |
Somerset. It is not about more money but using the existing money wisely | :42:20. | :42:23. | |
to improve outcomes and lives. How would you respond to the calls by | :42:24. | :42:29. | |
age Cymru on end of life care for the Welsh Government to provide | :42:30. | :42:32. | |
direction on effective collaboration between local health boards and | :42:33. | :42:35. | |
local authorities, to make sure equal access for all the people in | :42:36. | :42:40. | |
hospice care and for the Welsh Government to carry out a robust | :42:41. | :42:43. | |
monitoring of the fermentation, delivery and outcomes of it end of | :42:44. | :42:49. | |
life care delivery plan to determine whether it is delivering real | :42:50. | :42:53. | |
improvements in palliative care and end of life care for older people in | :42:54. | :42:58. | |
Wales is to mark how do you respond to Macmillan's calls for people | :42:59. | :43:03. | |
approaching the end of their life, who will benefit from the support of | :43:04. | :43:08. | |
palliative care services, to be identified said that earlier | :43:09. | :43:10. | |
discussions may start about their care. For people's preferred place | :43:11. | :43:16. | |
of death to be recorded early and for health and social care services | :43:17. | :43:24. | |
to be coordinated so that people can die well in the place of their | :43:25. | :43:30. | |
choice? Are you coming to the end? Thank you for allowing this. | :43:31. | :43:36. | |
Hospices Cymru is supporting the ambitions for palliative and end of | :43:37. | :43:46. | |
life care framework... This has ambitions for each person seen as an | :43:47. | :43:52. | |
individual, to have the access to care and coordinating care and much | :43:53. | :43:57. | |
more. How would you respond to the call for this model to become more | :43:58. | :44:00. | |
integrated into the Wales end of life care delivery plan, so that we | :44:01. | :44:08. | |
can all learn from each other and benefit together? Thank you for the | :44:09. | :44:14. | |
series of questions which I'm aware the member has raised on a number of | :44:15. | :44:19. | |
occasions in the past. He is consistently interested in this | :44:20. | :44:23. | |
area. It was dying matters week last week which is when I attended a | :44:24. | :44:27. | |
conference. I spoke to them about their work and recognise what they | :44:28. | :44:31. | |
have done in promoting this as a more national and natural | :44:32. | :44:35. | |
conversation to have. There is more work to be done with them but also | :44:36. | :44:40. | |
among all of us and the community we represent. I certainly don't | :44:41. | :44:44. | |
underplay the contribution of the hospice movement. And the variety of | :44:45. | :44:50. | |
hospices around the country which was the main focus of the questions | :44:51. | :44:52. | |
and comments made. Most members in this chamber Wardle | :44:53. | :45:02. | |
the local hospice their constituents attend, if not having hospices in | :45:03. | :45:08. | |
constituencies oral regions and I have regularly visited a number of | :45:09. | :45:12. | |
hospices in this role but have two in my own constituencies, so I | :45:13. | :45:15. | |
understand perfectly well the role they play in engaging with | :45:16. | :45:19. | |
clinicians and the public and designing the care that better meets | :45:20. | :45:22. | |
a person's needs. One of the significant steps forward in the | :45:23. | :45:27. | |
last plan and carrying on in an Exxon is promoting the hospice at | :45:28. | :45:30. | |
home movement, so people don't need to go into a hospice but can run | :45:31. | :45:35. | |
their hospice care at home, there have been real strides made forward. | :45:36. | :45:45. | |
In the way the carers commission and boards do, hospices are very much | :45:46. | :45:48. | |
part of the design and delivery of this plan and I don't necessarily | :45:49. | :45:53. | |
share the member's rather pessimistic approach and assessment | :45:54. | :45:59. | |
of the contribution designing this strategy, but also understand the | :46:00. | :46:04. | |
success its impact on palliative end of life care. And in terms of the | :46:05. | :46:10. | |
financial matters raised, well, as I've indicated, the million pounds | :46:11. | :46:16. | |
goes to each of the major conditions, each has ?1 million | :46:17. | :46:21. | |
allocated and I mentioned the 6-4p spent recurrently in this area. I am | :46:22. | :46:27. | |
aware of the issues in fruit that he mentioned about the pastoral | :46:28. | :46:32. | |
community approach and approaches have been made to see what happens | :46:33. | :46:37. | |
in that particular community and it is something to build upon here in | :46:38. | :46:40. | |
Wales and I look forward to having the ongoing concession I will have | :46:41. | :46:44. | |
with the end of life care board and all of its members and supporters, | :46:45. | :46:51. | |
for us to be a more compassionate notion. And I will end with your | :46:52. | :46:55. | |
point about outcomes and delivery, because part of the strength of the | :46:56. | :46:59. | |
delivery plan approach that we take is that we take an issue of major | :47:00. | :47:05. | |
significance. We bring together people from Government, from the | :47:06. | :47:08. | |
health sector and the third sector and leading clinicians in the field, | :47:09. | :47:13. | |
and there is a constructive and helpful tension created both an | :47:14. | :47:17. | |
understanding and agreeing priorities and the priority is being | :47:18. | :47:21. | |
carried forward and of the dialogue is open and honest and there are | :47:22. | :47:25. | |
times when the delivery plans, there are times when the delivery plans, | :47:26. | :47:27. | |
their associated delivery wards, recognise they haven't made all the | :47:28. | :47:33. | |
approach is needed. I look forward to honest reporting on how we have | :47:34. | :47:40. | |
not done and priorities in the future. TRANSLATION: May I thank the | :47:41. | :47:44. | |
Cabinet Secretary for his statement and for all of work done by staff | :47:45. | :47:49. | |
and volunteers in the Health Service and the third sector in providing | :47:50. | :47:54. | |
end of life care and palliative care across Wales. I don't think there is | :47:55. | :48:03. | |
much new, if truth be told into Dave's statement, although it is | :48:04. | :48:06. | |
always useful to have an update, so may I refer perhaps to what should | :48:07. | :48:13. | |
happen in the mind of one of the organisations involved in this area | :48:14. | :48:17. | |
and I will list some of the requirements they have set out. They | :48:18. | :48:21. | |
want palliative and end of life care to be an entirely central part of | :48:22. | :48:26. | |
care planning for those with chronic and long-term conditions. They want | :48:27. | :48:29. | |
better coordination between local authorities and health boards in | :48:30. | :48:34. | |
order to give equal opportunity for everyone in the population to have | :48:35. | :48:40. | |
access to hospital care. They want end of life care commissioned by | :48:41. | :48:44. | |
local health boards to include comprehensive care for people in | :48:45. | :48:50. | |
care homes. They want every institution and professional work to | :48:51. | :48:53. | |
get the necessary training and ensure continuity of training | :48:54. | :48:58. | |
throughout their working lives. They want to see or rather, they want the | :48:59. | :49:08. | |
orders to not attempt resuscitation or ceasing to provide food and drink | :49:09. | :49:13. | |
not to be put in place without full consultation with family or other | :49:14. | :49:17. | |
carers and finally, they want an assurance of very careful monitoring | :49:18. | :49:22. | |
on the implementation and delivery of end of life care plans, so that | :49:23. | :49:28. | |
it does deliver better care, so we are in a situation where some steps | :49:29. | :49:31. | |
have been put in place by Government, there is clearly more to | :49:32. | :49:36. | |
be done in the eyes of those involved in this area, so three | :49:37. | :49:41. | |
questions emerging. One, do you disagree with any of those | :49:42. | :49:44. | |
recommendations and if you don't, when can we be given an assurance | :49:45. | :49:48. | |
that those will have been implemented. Secondly, the annual | :49:49. | :49:55. | |
report mentions improvements in palliative care for children and | :49:56. | :49:58. | |
naturally, that is something that we welcome, but there are far too many | :49:59. | :50:03. | |
children who can't spend their last days in their own homes. Would you | :50:04. | :50:10. | |
agree that there is some work to be done in that area and do you | :50:11. | :50:15. | |
acknowledge that we need to strengthen services to support the | :50:16. | :50:24. | |
siblings of those who have suffered bereavement. And finally, minority | :50:25. | :50:29. | |
ethnic groups are particularly identified by Marie Curie as an area | :50:30. | :50:33. | |
where services need to improve, so what are the Government intend to do | :50:34. | :50:39. | |
about that specifically? Thank you for the series of questions and | :50:40. | :50:46. | |
comments and in terms of the priority that age country | :50:47. | :50:48. | |
identified, it is in the work I outlined of the board is taking | :50:49. | :50:51. | |
forward. Part of the strength of the work we are doing is having that | :50:52. | :50:57. | |
cross-section of people with a genuine interest in the area setting | :50:58. | :51:01. | |
a list of priorities. We often get different bids and not having a | :51:02. | :51:11. | |
cohesive approach. But the things you mention, they are priorities for | :51:12. | :51:19. | |
the board in the year ahead. The second particular issue, paediatric | :51:20. | :51:21. | |
palliative care. There was a concern about whether this had been properly | :51:22. | :51:27. | |
taken account of in moving forward and I met a group of paediatric | :51:28. | :51:33. | |
palliative care conditions and it was a very constructive conversation | :51:34. | :51:38. | |
and I think they have moved forward and her understanding that their | :51:39. | :51:41. | |
issues are properly taken account of and there is a definite step forward | :51:42. | :51:46. | |
in this iteration of the plans, progress has been made, but in | :51:47. | :51:51. | |
almost every area which I attend this chamber to speak, there is | :51:52. | :51:54. | |
always more to be done and there has to be an essential honesty about | :51:55. | :51:59. | |
that as well. That includes bereavement support, again | :52:00. | :52:02. | |
identified in my opening contribution, as an area for | :52:03. | :52:05. | |
improvement, for the family left behind. That is part of our | :52:06. | :52:10. | |
challenge and it is also why having a national conversation is somewhere | :52:11. | :52:13. | |
where we should take time in this chamber to do that. If we don't | :52:14. | :52:17. | |
normalise a conversation in this place about the importance, we are | :52:18. | :52:24. | |
unlikely to have a national conversation in the wider part of | :52:25. | :52:27. | |
society, so that is a normal conversation that takes place about | :52:28. | :52:29. | |
what we want. It is also why the advance care plans website has been | :52:30. | :52:34. | |
launched, so people have that conversation at a time when they can | :52:35. | :52:38. | |
make choices, much more active choices, about what they want, it is | :52:39. | :52:42. | |
really important because of people know they are coming to end of life | :52:43. | :52:47. | |
care. All those people on the end of life care registers and receiving | :52:48. | :52:50. | |
palliative care and primary care, there should be efforts to improve | :52:51. | :52:54. | |
the number of people that have come forward and had an advance care plan | :52:55. | :52:57. | |
drawn up that they have contributed to. We made real progress leisure to | :52:58. | :53:02. | |
improve the numbers of people who have a plan like that but we | :53:03. | :53:06. | |
understand it is only just over a third of people are primary care | :53:07. | :53:09. | |
register who have an advanced care plan in place. So significant | :53:10. | :53:14. | |
progress last year but lots more to do to get people into a place where | :53:15. | :53:17. | |
they can receive the care they want at the end of their life. On black | :53:18. | :53:22. | |
and Asian communities in Wales, there is a real challenge about some | :53:23. | :53:24. | |
of the care they want to receive. Some of this is a vote to differing | :53:25. | :53:30. | |
nature of family support that exists in those communities and the way | :53:31. | :53:33. | |
they feel about looking after relatives but also the work that | :53:34. | :53:38. | |
Marie Curie themselves have done. I attended the launch both of the | :53:39. | :53:41. | |
consultation stage and the final Report Stage and they recognise that | :53:42. | :53:44. | |
the hospice movement, as well as the Health Service, need to promote the | :53:45. | :53:50. | |
opportunities that exist for end of life care and different choices. | :53:51. | :53:53. | |
Something about the Health Service and hospice that provide care going | :53:54. | :54:01. | |
out and be more proactive with the committees that don't take | :54:02. | :54:03. | |
palliative care in the wake other communities do to say this is an | :54:04. | :54:06. | |
option and I am pleased to see they recognise they had a problem and | :54:07. | :54:10. | |
want to do something about it and certainly interested to see whether | :54:11. | :54:15. | |
that does take place. Over the time of this plan, you will see more | :54:16. | :54:18. | |
people in different communities having more access to palliative | :54:19. | :54:21. | |
care and making active choices about their end of days. I declare an | :54:22. | :54:28. | |
interest in the subject, as I'm the vice president of George Thomas | :54:29. | :54:32. | |
Hospice care based on the grounds of a hospital in Cardiff North that | :54:33. | :54:37. | |
delivers specialist palliative care to allow people to live in their | :54:38. | :54:41. | |
homes and maintain independence for as long as possible and I think it | :54:42. | :54:44. | |
is a good example of partnership working between the voluntary sector | :54:45. | :54:49. | |
and the statutory sector, written the Welsh Government and the local | :54:50. | :54:53. | |
authority and also, I think we would all want to pay tribute to the | :54:54. | :54:57. | |
long-standing investment of the voluntary sector in the hospice | :54:58. | :55:01. | |
movement from which you screw. I think that this plan is a very | :55:02. | :55:06. | |
important plan, the palliative and end of life care delivery plan, and | :55:07. | :55:12. | |
a crucial plan and I would like to play show view to professor and | :55:13. | :55:16. | |
Baroness Laura Finlay who has been so instrumental in this plan and is | :55:17. | :55:21. | |
standing down as a national clinical lead for end of life care in July. I | :55:22. | :55:25. | |
have worked for many years with Laura and I think she has made a | :55:26. | :55:28. | |
tremendous contribution to this area of work. One of the issues I am very | :55:29. | :55:35. | |
concerned of, which the Cabinet Secretary did referred to in his | :55:36. | :55:40. | |
introduction, was the really crucial issue of people when they are very | :55:41. | :55:47. | |
ill being moved into hospital for treatment when, basically, it would | :55:48. | :55:51. | |
be better if they were to stay at home if the support services there | :55:52. | :55:55. | |
could be given for them to Remain at home and this does happen with many | :55:56. | :55:59. | |
seriously ill people who have been receiving this report but when the | :56:00. | :56:04. | |
situation becomes much worse, they then go into hospital, so it is | :56:05. | :56:08. | |
fairly managed to keep people in that situation at home and I have | :56:09. | :56:12. | |
had several examples of that in my own constituency where, actually, at | :56:13. | :56:16. | |
a weekend, someone who was very near the end of their life was taken into | :56:17. | :56:21. | |
hospital AMD because the on-call doctor was so concerned about their | :56:22. | :56:26. | |
condition, whereas I think with a bit more collaboration and working | :56:27. | :56:29. | |
together, they could have remained at home with a bit to increase | :56:30. | :56:34. | |
support. So I think that is one of the crucial areas and I don't know | :56:35. | :56:37. | |
if the Cabinet Secretary can save a bit more about that? I welcome the | :56:38. | :56:43. | |
point made that we need a review of the capacity of existing bereavement | :56:44. | :56:48. | |
services. I think these are a vital part of planning for end of life | :56:49. | :56:56. | |
care. And in George Thomas Hospice care, the consultant has described | :56:57. | :57:01. | |
to me about how they are providing free bereavement counselling, the | :57:02. | :57:04. | |
children who have a parent or grandparent or perhaps a sibling who | :57:05. | :57:08. | |
is dying, and she says that this helps enormously if you do it before | :57:09. | :57:13. | |
the loved person dies and that that does mean you tend to need less | :57:14. | :57:19. | |
frequent follow-up sessions afterwards. So I wondered if the | :57:20. | :57:25. | |
Cabinet Secretary had any news about that and whether this was something | :57:26. | :57:31. | |
that was happening to any extent throughout Wales. And then of | :57:32. | :57:35. | |
course, there is the whole issue of Children's Services for the small | :57:36. | :57:39. | |
but very important group of children who do need palliative care and I'm | :57:40. | :57:49. | |
sure is aware of the work of the Short-lived body, which has put | :57:50. | :57:53. | |
forward several proposals. And then the final point I wanted to make was | :57:54. | :57:59. | |
in terms of advance planning. We have to take account now the number | :58:00. | :58:02. | |
of people diagnosed with dementia who will lead end of life care and | :58:03. | :58:08. | |
we're having a on that later on in the afternoon, about dementia, but | :58:09. | :58:16. | |
in George Thomas Hospice care, 75% of their patients have cancer and up | :58:17. | :58:19. | |
until now, the next group that they were working with other people with | :58:20. | :58:25. | |
heart disease. But now, the next biggest group is people who have | :58:26. | :58:30. | |
dementia and I think that is something we have really got to take | :58:31. | :58:34. | |
into consideration in planning for palliative care, if people do have | :58:35. | :58:40. | |
dementia, and I do note that, I think it was Macmillan, has said we | :58:41. | :58:44. | |
need to do a lot of preplanning with older people and I think we have got | :58:45. | :58:48. | |
to take into account the fact that a large number of people have | :58:49. | :58:53. | |
dementia. And then I just want to say that I do agree with all of the | :58:54. | :58:57. | |
issues about trying to learn from the compassion of communities | :58:58. | :59:03. | |
movement and we do need been conversation and to move onto make | :59:04. | :59:10. | |
that much more part of life. -- to make death much more part of life. | :59:11. | :59:20. | |
Just took speak on the pivot adventure and advanced planning, | :59:21. | :59:23. | |
people can make choices to actively do so and decide what they want, | :59:24. | :59:27. | |
rather than leaving it for other people to second-guess what they | :59:28. | :59:30. | |
might have wanted at a different time in their life and actually, | :59:31. | :59:34. | |
supporting people with dementia is politically difficult. The process | :59:35. | :59:40. | |
of going through and losing someone losing the personality, or parts of | :59:41. | :59:44. | |
it and then to lose them physically, it is a particularly challenging | :59:45. | :59:47. | |
time for the individual who is going that and their families as well. I | :59:48. | :59:52. | |
already mentioned the progress on paediatric care but what I haven't | :59:53. | :59:56. | |
mentioned is the additional work we have had done on a transition | :59:57. | :59:59. | |
between paediatric and adult services. It can be really difficult | :00:00. | :00:02. | |
time for the individual young person, as well as their family and | :00:03. | :00:06. | |
this can be particular difficult when relations are built up through | :00:07. | :00:10. | |
paediatric service and how it is transferred on but we have a | :00:11. | :00:14. | |
particular post within Wales which is a first base in the Children's | :00:15. | :00:18. | |
Hospital in Wales that looks of the transition from paediatric | :00:19. | :00:18. | |
palliative medicine into adult. It is recognised, that the earlier | :00:19. | :00:30. | |
the conversation, the better prepared people are for the | :00:31. | :00:35. | |
bereavement. Your point about George Thomas hospice, you are right, | :00:36. | :00:38. | |
individual and community investment and sustaining it is a huge | :00:39. | :00:42. | |
important part of what keeps the hospice movement special and well | :00:43. | :00:47. | |
funded. I want to recognise a point you made about Laura Finlay, much | :00:48. | :00:53. | |
respected right across the UK as a clinician. She says that Wales has | :00:54. | :01:00. | |
much to be proud of but also much more to do and I think it is a fair | :01:01. | :01:05. | |
reflection of where we are. The final point I make is the point you | :01:06. | :01:08. | |
make about maintaining support for people on the last months and year | :01:09. | :01:17. | |
of life. We know too many of those people have unnecessary hospital | :01:18. | :01:19. | |
admissions and so it is something that is part of the focus for | :01:20. | :01:24. | |
improvement. The latest figures show 65,000 admissions of people in the | :01:25. | :01:29. | |
last year of life, 65,000 emissions into hospitals. -- 65,000 admissions | :01:30. | :01:38. | |
into hospitals. Those people can sometimes be cared for in their own | :01:39. | :01:42. | |
homes that is a large part of the improvement for the year ahead. | :01:43. | :01:46. | |
Hopefully next year we will be able to report back on progress that has | :01:47. | :01:48. | |
been made for people across the country. Caroline Jones. Thank you | :01:49. | :01:55. | |
for your statement, the sad fact is that while everyone will eventually | :01:56. | :02:00. | |
die, we don't all die well. Because of the latter, it is essential we | :02:01. | :02:05. | |
have excellent end of life care. I welcome the Welsh Government's | :02:06. | :02:09. | |
palliative and end of life care plan and the commitment to improve the | :02:10. | :02:13. | |
care given to those approaching the end of their lives and those they | :02:14. | :02:18. | |
leave behind. If current trends continue, the number of people dying | :02:19. | :02:23. | |
in Wales will increase by 9%. We know that around 6200 people die | :02:24. | :02:27. | |
each year, do not get the palliative care they need but these figures | :02:28. | :02:33. | |
come from Marie Curie and they are not coming from the NHS. Therefore, | :02:34. | :02:36. | |
they don't feed into the workforce planning. We need an all-round | :02:37. | :02:43. | |
approach to palliative care as for the whole family are involved. | :02:44. | :02:48. | |
Therefore, it is essential staff are properly trained to deal with | :02:49. | :02:52. | |
sensitive situations such as this and it is pleasing to see that | :02:53. | :02:59. | |
?150,000 is provided to train staff in advanced communication skills and | :03:00. | :03:05. | |
end of life care. Although this is a start, a good start in recognising | :03:06. | :03:08. | |
the specialist skills needed, could you provide more information on how | :03:09. | :03:15. | |
many staff you anticipate? And what area will be covered in Wales? Some | :03:16. | :03:22. | |
may be more than others due to logistic situations? Funding to | :03:23. | :03:29. | |
provide access to hospice at home provision is welcome, along with | :03:30. | :03:33. | |
palliative care registered for all GPs who have a register of all | :03:34. | :03:38. | |
patients with supportive palliative care needs. Could you also tell me | :03:39. | :03:44. | |
how these registers are, child because there are some people | :03:45. | :03:48. | |
obviously without families who go unnoticed and become ill and they | :03:49. | :03:52. | |
are reluctant to visit their GPs. I wonder how we can reach these people | :03:53. | :03:58. | |
who sometimes and very often actually, die at home and are | :03:59. | :04:02. | |
discovered days or weeks later. Can we do more to make sure people like | :04:03. | :04:09. | |
this are included? Also, to bring back something said earlier, a Marie | :04:10. | :04:16. | |
Curie report has highlighted, as I indeed highlighted in the last | :04:17. | :04:21. | |
statement, additional barriers faced by bereaved LGBT communities beyond | :04:22. | :04:29. | |
the universal pain experienced after losing a partner. Despite this, | :04:30. | :04:33. | |
there are no specific actions outlined in the delivery plan aimed | :04:34. | :04:38. | |
at addressing these issues. Cabinet secretary, do you agree with me that | :04:39. | :04:44. | |
if we are to improve the end of life care for LGBT and BME communities, | :04:45. | :04:49. | |
we must address the shortcomings in this plan? In England, the NHS | :04:50. | :04:55. | |
conducts a survey of bereaved called Voices, and this shows the level of | :04:56. | :05:00. | |
care and support given to families at the end of their loved ones' | :05:01. | :05:05. | |
lives. We don't conduct such a survey in Wales and if we are to | :05:06. | :05:09. | |
make sure that everyone who needs specialist palliative care gets it, | :05:10. | :05:14. | |
and we are going to make sure that an individual needs and priorities | :05:15. | :05:17. | |
and preferences for end of life care can be identified, documented, | :05:18. | :05:24. | |
reviewed, respected and acted upon, then we must conduct a survey of the | :05:25. | :05:29. | |
bereaved also in Wales. I see there is no privilege for this in the | :05:30. | :05:34. | |
statement. Rather than relying on data collected through the | :05:35. | :05:39. | |
programme, which many patients are unaware of, does your Government | :05:40. | :05:46. | |
have plans to introduce a comprehensive survey of bereaved | :05:47. | :05:53. | |
families in Wales? The website launch is welcome and definitely is | :05:54. | :06:00. | |
the way forward. However, we must not depend on this statement that | :06:01. | :06:05. | |
nowadays, most people find most of the Reformation online. Although | :06:06. | :06:10. | |
this is true, there are many people without access to online services | :06:11. | :06:13. | |
and therefore, we need to be inclusive. It is important this plan | :06:14. | :06:20. | |
is inclusive and beneficial to all. I note consultants and palliative | :06:21. | :06:26. | |
care are now available on-call 24/7. Can you tell me how people will | :06:27. | :06:31. | |
become aware of this service? And the work with the children's | :06:32. | :06:42. | |
hospice, Ty Hafan, and an out of hours telephone service is essential | :06:43. | :06:48. | |
and is very welcome. I thank all hospital staff involved in this | :06:49. | :06:52. | |
extremely sensitive area, whilst also acknowledging the dedication of | :06:53. | :06:59. | |
families to their loved ones. I recognise the positive ongoing work | :07:00. | :07:02. | |
and the commitment shown by the Welsh Government and the Cabinet | :07:03. | :07:05. | |
secretary in this statement, however, I look forward to working | :07:06. | :07:10. | |
with you positively and constructively to further improve | :07:11. | :07:16. | |
the services in palliative care. Thank you for the series of | :07:17. | :07:22. | |
questions and comments. On the point about serious illness conversations, | :07:23. | :07:25. | |
I'll happily provide an update for members about how many staff have | :07:26. | :07:29. | |
gone under trading in the last year and how many more we expect to have | :07:30. | :07:33. | |
that trading over the next year. And more as a result of the additional | :07:34. | :07:37. | |
resources we are putting into it. On your point about the survey, of | :07:38. | :07:43. | |
bereaved families and all patients, I would be happy to consider whether | :07:44. | :07:48. | |
there is a better way forward but in this point in time, no one has | :07:49. | :07:54. | |
suggested to me, it has not been asked from the board, that we have | :07:55. | :07:58. | |
to have a different means of understanding feedback from people | :07:59. | :08:01. | |
directly involved in the care, people involved in receiving the | :08:02. | :08:05. | |
care as well. I would have expected if there was a real call for that, | :08:06. | :08:10. | |
that would have come through the board both from clinicians who are | :08:11. | :08:14. | |
still champions for the patients, as well as for the campaigning third | :08:15. | :08:19. | |
sector as well. If there is real evidence, there is a need to do | :08:20. | :08:22. | |
something different, I am open-minded about it but I would | :08:23. | :08:26. | |
need to be persuaded we don't currently have an adequate way of | :08:27. | :08:32. | |
understanding the quality of the care provided. The point you made | :08:33. | :08:35. | |
about the organisation of palliative care, we have got more people | :08:36. | :08:38. | |
available at different times in the day. We have a service enabled | :08:39. | :08:42. | |
throughout the week. I would need to be persuaded there is a different | :08:43. | :08:46. | |
way in which that should be accessed. Part of the challenge of | :08:47. | :08:50. | |
calls is what happens to those people who die alone. In their own | :08:51. | :08:56. | |
homes. Those people are few and far between but there is a broader | :08:57. | :08:59. | |
challenge as to how we as a society engage... | :09:00. | :09:13. | |
Thank you for coming to join us today, our very distinguished and | :09:14. | :09:25. | |
honourable guest the Prime Minister the reason may. She will just say a | :09:26. | :09:28. | |
few words and an open the floor to the general questions. Can we give a | :09:29. | :09:35. | |
big welcome to the Prime Minister Theresa May. Thank you very much | :09:36. | :09:44. | |
indeed, a great pleasure to be with | :09:45. | :09:45. |