21/01/2014 am.pm

Good afternoon. Welcome to the programme, and our

weekly coverage of questions to the First Minister. There was never any

doubt that Carwyn Jones would face questions on the proposals for local

government re-organisation and, in fact, that's the very first topic on

the order paper. He can also expect to be quizzed on energy pricing, the

NHS and the state of the economy on Welsh high streets. So that's what

we expect AMs to be talking about, but is there anything you want to

talk about? If you want to comment on the programme or any other

political news then please get in touch. You can reach us via Twitter,

we're @walespolitics, or send us an email to [email protected]. Well,

business in the chamber is already underway so let's go over to the

Senedd for today's questions to the First Minister. National Assembly

for Wales is now in session. Question one Llyr Gruffydd.

You may be aware that the... Hadera spawned from their evidence to that

inquiry on the heart of North Wales councils that working across organ

sedation and geographic boundaries can bring complexity and bring

confusion and we can accountability? It is said you are

hundreds of different cost curves all bathing differently. The member

makes the case for reorganisation. By seeing the evidence is not there

or it is too complicated. It also identifies the problems due to a

lack of collaboration which has not taken place between many local

authorities in Wales. ministers? We have raised our

concerns. The cost of energy is too high and we remain concerned about

the ability of the UK to remain competitive with energy costs as

they are. Thank you for that answer. Lastly, the foundation companies

wrote to the UK Government asking for a level playing field. If

companies can compete on the global market. These companies bring huge

investment into Wales. Do you agree that the UK Government has failed

those companies and their employees by failing to tackle energy costs

and will you raise with the Prime Minister of those issues so he can

change his approach to funding and energy prices? Have raised the issue

with Vince Cable. It is an issue which is of crucial importance to

those industries which are important to the Welsh industry which are high

energy users. They have taken steps to reduce heavily the amount of

energy they use. I would urge the UK Government to address this position

as quickly as possible. In order to secure the future of our

manufacturing industries. Russell George. One way to mitigate higher

energy prices for the future is to improve the energy performance of

new and existing buildings, both domestic and nondomestic. Why is the

Government significantly reducing its regulation targets for

greenhouse gas emissions, which could go a long way to lowering

energy prices? That is to assist the construction industry. I welcome

that, actually. To help the construction industry to improve its

performance over the next two years. The Minister made it absolutely

clear that he wanted to make sure targets were reached within a

reasonable time but they were not introduced so quickly as to stymie

the recovery of the construction industry. Alun Ffred Jones.

It wouldn't be possible to subsidise any company. We would have to find

some means of funding the company. Which goes against it. It wouldn't

be possible to establish any company that would work in any way that

wasn't competitive. If you want a competitive market then it is

important that all companies are competing on a fair basis, which, of

course, that is another matter. You would have to have a company to

build their own and not work in a way which is contrary to European

regulations. We have a leader of the opposition. First Minister, you said

recently you were confident that the Welsh Ambulance Service or NHS Trust

has the resources it needs. You are aware of the tragic incident of the

death of Mr Fred Pring who died after waiting 42 minutes for an

ambulance. The reason, because there were no Ann Jones is available to

attend. We were told that the situation was that there were six

vehicles waiting in Wrexham and three more. If an ambulance had been

available, the optimised suspects for his survival would have been

greatly increased. When you hear of these events, do you believe the

Welsh Ambulance Service has the resources it requires to actually

stop events like this happening? First of all, could I express my

condolences to the family of Mr Fred Pring? It is right to say that the

coroner did not say he would have lived had an ambulance arrived. It

is right to say he would have had a better chance. That much is true.

That said, of course, this was not a typical event in the history of the

Welsh Ambulance Service nor is it typical of their performance over

the last year. But it is important we continue to improve as they have

done in order to minimise events such as this are carrying in future.

I asked you did do Ambulance Service have the resources it requires to

try to stop events like this quest Dominic. Your own District General

Hospital had, I'm told, ill Ann Jones waiting outside -- LF in

ambulances. That potentially could have affected the outcome of the

patients ability to survive the incident they were presented for at

the hospital. I ask you again, given that I have cited two examples in

very recent weeks, does the Welsh Ambulance Service have the resources

to help mitigate and stop these types of events happening at our

district general hospitals? Yes. Could I just pointed to one aspect

which affects ambulance response times? That is the time it takes to

get through A It can become overloaded from time to time and

that delays ambulances. The answer is to get more people through A

That is why we are so keen to ensure that we have a structure for the NHS

that enables that to happen. This is not just about ambulance resources,

it is about ensuring hospitals can admit agents as quickly as possible.

That is why there have been proposals to look at the structure

of A That is where we will disagree. I do not believe by

shutting A departments you will help. One of the key problems of

people progressing through A is to be taken through to the hospital

environment and the loss of beds is one of the big obstacles for people

to build a pass-through and ambulances being able to discharge

patients into A We have the worst waiting times in the UK,

regrettably. What key actions will you undertake to see that there is

improvement? I would suggest immediate in pregnant in our A

times so the events I have outlined previously can cease to be an

occurrence within the Welsh NHS and patients and families will not go

through that, those individual families have gone through

recently. I disagree that we have the worst times. In Belfast, they

have bad times there. But what can we do to increase throughput? The

extra resources we have put into the NHS, ?570 million will assist in

that. People also need to go to the right A in terms of the condition

may have. That means making sure that people go to the right AMD Mac

-- A in the first place. The organisation is being taken forward

across Wales. But also there is a responsibility of all of

individuals. Many people go when they don't need to. Speaking to

consultants on my own hospital, it accounts for between one third and

one half of cases they see are people who shouldn't be there in the

first post. Because they have been to a GP and they have said there is

nothing wrong so they go to A People need to accept a level of

discipline. I don't see the point in telling people... In order to

minimise the tragic occurrences which have happened in the past

year, it is important that resources are there. First Minister, the

Williams commission report has helped to showing a very concerning

light on public services in this country. The commission confirmed

that public service performance in places is poor and patchy and too

complex and lacking in ambition. Do you accept this verdict? It talks a

little about the Government. It is concerned mainly with local

government and other public services. The reality is, if you

look at the report, it talks about situations where some public service

bodies see regulation and inspection as a burden or something to be

resisted. The reality is it is about services and the public. You are in

charge of public services in Wales and what can be said about local

Government can be applied to our National Health Service. There are

many people affected by poor public services. We have just heard about a

patient who laid for 40 minutes waiting for an ambulance while his

wife watched him die. Surely you would agree that this is something

that should never ever happen in our country. I agree with that but in

relation to the Williams commission, I will remind her that

her party did not come forward for the idea of a commission like this,

and I do await now what hope he will be on the Williams commission. I

reiterate the point... There needs to be a level of cross party

support. I want to talk to the other leaders to establish how much of

that is possible. This is a major change to local Government and I

would like to see this done on a basis of cross-party agreement. I am

interested in reaching a consensus with you but I would content you are

not starting the process in the correct manner. This morning, a

woman there was clearly a capacity issue. Rather than centralised and

cut services further which would put pressures on ambulances and A

departments, why don't you back our proposals to increase doctor

recruitment? I would be in a better position to support you if the

doctors themselves supported you. They do not. If you look at what

doctors are saying, the vast majority of them says there needs to

be change and yet you keep on opposing change. They will say to

you, doctors will say to you that the difficulty is throughput of

patience, you cannot create a situation where there are more

coming through the hospital unless you have a service that is more

centralised. Unless you are prepared to ignore the advice of doctors,

then you cannot create a Shangri-La situation that you want. We want a

sustainable help service based on the guidance that doctors themselves

give. You want to ignore that. Where doctors say a service is unsafe, you

want to ignore that. That is not sustainable. I look forward to

working with Plaid Cymru and other parties with a view on getting a

consensus on the way public services are delivered in Wales. Kirsty

Williams. First Minister, in your programme for Government, which you

are very fond of referring to, you list a whole series of targets that

you will use to measure NHS performance. On Sunday, you said it

is difficult to see what the justification is for them and that

there was no logic for them. If there is no logic to them, what were

you doing including them in your programme for Government less than

three years ago? Because they exist. If you look at the clinical

reasoning for the targets, that much is true. When I went around

hospitals in the summer, doctors said, if you have targets with

regard to A, we have people who come here, have spent 13 hours in a

end E but the alternative is to keep them in hospital for longer. I am

aware that revisiting the targets without reaching some of them...

What I said was I would like to see us reach some of those targets and

then consider whether they need to be changed. Let's look at one

target. You promised that you would improve access and patient

experience by ensuring rapid investigations and treatment. Our

work waits for scams, endoscopy is no longer important or is it the

fact the number of people waiting eight weeks for diagnostic services

has trebled in the last two years? Is that one you are planning to meet

or ditch? There have been challenges. We are confident the

extra resources going into the NHS will help to meet those challenges.

It is not just that target. You do not routinely meet your ambulance

response time targets, A targets and the number of people waiting

more than nine months for treatment, that has hit a new time high. If you

are saying those things are not important any more in our NHS, how

are you going to measure your Government 's performance in running

the health service and which one of those are you planning to meet and

which ones are you planning to ditch? We plan to meet them all.

This is not a situation you need to Wales. England misses its target as

war. The reality is, when it comes to cancer treatment times, the

situation is the same in Wales as it is in England. That is not to say

there cannot be improvement. These figures are important. That is why

the health minister has outlined how he intends to see the health service

improves in terms of the resources he puts in but there cannot be

improvement without structural change. One cannot run without the

other and for those parties who oppose all or any change in the NHS,

despite an occasions independent panels of doctors saying there has

to be change, I have to say that to them the NHS will not improve as

long as those parties hold those positions. Can the Minister make a

statement on his priorities for the NHS in 2014? We continue to improve

the quality, sustainability of the NHS. Do you agree there is a crisis

developing deepening in the Welsh NHS, particularly our round other

emergency care. In December, people were told not to attend Morrisons

A Department. Unless there was absolutely necessary. In January,

another hospital had to cancel operations because of pressures on

beds. Wrexham was described as being log jammed. And we have heard about

cancellations of operations in North Wales. Would you agree that your

record-breaking NHS budget cuts are not helping the situation that you

are cutting the NHS budget too far, too fast to coin a phrase, and is it

now a matter of regret for you that you do not have a national

comprehensive winter NHS plan, unlike the UK Government, and what

action are you taking to sort this out? He talks about a winter plan,

there is a winter planned that is working. A and E figures are worse

than ever in England! The reality is that he stands up in this chamber

and he says, that where a advice is given to people, that they should

not attend A departments and less in an emergency, his advice is

wrong. People should not be going to A unless there are genuine

emergencies. The reality is it is quite right people should not attend

A unless it is in an emergency. We have put extra resources into the

NHS. This compares to his party which has cut the NHS in England by

?20 billion. They call those cuts efficiencies. Because if you call

them efficiencies, they are not cuts. We see departments struggling

in England. In Wales we approach this with honesty. We have put more

re-sources in and we have an NHS that properly benefits the people of

Wales not one that is hampered by the cuts in London. First Minister,

one of the reasons that ambulances queue outside A is often there is

a lack of beds on the wards and that is because beds are blocked as there

is a lock of provision in the community. With the exception of

Powys yesterday because the Williams commission did not recommend the

amalgamation of health services there, how are you in 2014 going to

direct health boards and local authorities to amalgamate budgets

and services much better then they are doing at present? That is a very

strong message. It is important they work as closely together as possible

and if we are talking about social services, we are talking about care

services, not adoption. The message has been conveyed to the local

health boards and to the local councils, that it is important they

collaborate in order to ensure that the citizen is given the best

service possible. Last term I raised with you the fire safety

requirements that had to be put in place in one hospital. Since your

intervention towards the end of autumn, that work has been put in

hand. But my question is particularly in the context of your

health Minister's statement with regard to the NHS concentrating more

on the areas we can deliver good rather than delivering harm, would

it not be prudent to consider investing further in that recognised

centre of excellent is, particularly as it could potentially reduce the

burden of cost for expensive and ever escalating drug bills for pain

relief? These are matters for the local health board. I am sure they

would want to invest in such a way that services are delivered better

and efficiently. I am glad to hear that following your question in the

assembly chamber that work seems to be beginning in your constituency.

It was reported last week that many small businesses are paying the

doubled the business rates they should be paying. What actions will

be Welsh Government be taking to support the watch high Street in

2014? Our framework demonstrate an emphasis on the regeneration of the

high Street in Wales. This includes a town centre loan fund, members

will be aware of a cap on a high street support campaign launched in

autumn. I welcome the cup in business rates you mentioned but

your own high-street strategy is now some seven months late. How about

adopting some of the Welsh Conservative policies that were

announced in the vision for our high street in the meantime? There is

some common ground here. We want to see high streets thrive and that is

why we announce the loan scheme. That has been brought forward.

Officials are also working with a small task group to support our high

streets which were launched this autumn and the Minister announced

business rate relief schemes which will benefit town centres by

encouraging construction and speculative developments. The

business rates cuts will help that. First Minister, I am pleased that

you acknowledge there is a crisis facing many of the high streets in

Wales at present and the one thing that impacts up on their image is

empty shops, so would you consider working with local authorities to

see how these could be filled? Possibly with businesses that can't

afford to have large premises or prominent premises at present. The

second thing is parking. Do you believe you could be creative with

parking? That is something for all local authorities in Wales. In terms

of those businesses, I think it is possible for local authorities to

work with businesses to consider whether it would be possible, for

example, to secure a month for a business without having to pay

rates or rent just to see if they can be sustainable and then if they

are they would then have to pay those costs and it would give the

opportunity to some people who perhaps don't want to start a

business and be tied into some sort of contract, just to see if there is

a market for them in terms of what they are selling. One problem we

should consider is, in my opinion, the high-street must rethink the way

it works. Most high-street customers are at work when those shops are

open. They close at 5:30pm, for most people here there is very little

shopping happening in the week. People tend to go to shops which are

open later. We should also consider the opening hours of high-street

stores in order to draw people in during the evenings and not only

during the day. First Minister, what evidence do you have the Welsh

government's to reducing smoking in cars is having any positive impact?

We have also commissioned study of primary and secondary school-age

children's exposure to second-hand smoke in cars. The results will be

available later this year. 80% of the public want smoking percent, --

smoking in cars with children banned. Passive smoking can lead to

asthma, chest infections and even cot deaths. In the past two years,

Jordan have suffered while we are waiting. Isn't it time, First

Minister, to put children's rights to good health above so called

personal freedoms and ban smoking in cars which Jordan passengers? That

option is available to us. If the voluntary approach does not work, we

will legislate. The First Minister will be aware that every year in

Wales many young people are introduced to smoking from peer

pressure. When do you think you could look at this once again? Most

people would like this band to be in place. Could you reconsider

legislation to outlaw smoking in cars with children? We all know,

anecdotally, what the situation is. The point I would make is this. Of

course adults have a freedom to do as they wish in their own cars but

when there are children in the car, the children can't make their own

decisions. That personal freedom of adults to impose smoking on job and

is not something I would support. Simon Thomas. What plans does the

First Minister have to re-establish surgery services at hospital? I know

the board attempted to do this and someone was offered the post in June

last year but they declined it. Since then, unfortunately, the Royal

College has said that they would not support having a specialist

consultant at present because they don't believe that the model of the

hospital is adequate with regards to national standards. Those are the

reasons such treatment is not available right now but there is no

answer to the question of when we will see it. The situation was to be

temporary nine months ago and looks to continue over the next year.

Temporary measures are introduced and then may become permanent. There

were 300 people attending a public meeting ten days ago in Aberystwyth

and they voted unanimously to re-establish this treatment. When

will we see the treatment re-established? At present, the

Royal College says there are not sufficient numbers of patients to

secure the service. As I understand it, only to Mac to three -- to -3

are available. Once they had left, there was nobody left so there was a

problem because of the fact because of the way they undertook surgery

there which didn't match with the most modern ways of doing things.

There was nothing wrong with the way they did things but it wasn't the

practice in other hospitals in Wales. So the young doctors there

could not be trained to undertake the surgery. If the college changes

its mind or standards that nobody can appoint a Doctor in hospital

when the doctor say they can do that. The recent meeting in

Aberystwyth focused on this kind of surgery but no one from the meeting

was from the health board. All health boards should be as

accessible to the possible to people they serve. The health board, I

understand, has said to those who organised the meeting that they are

more than happy to answer any questions sent to them as a result

of it. No such questions have yet been sent. I share the concerns

expressed by members about the lack of engagement by the health board

and the challenges that this decision presents to patients. One

challenge is the transport cost to get to the other alternative centres

for their treatment. I wonder what engagement the Welsh government has

had with the health boards to ensure it is supporting patients who need

support with finances towards those transport costs so they can access

treatment. The reality of the situation is that where you have the

Royal College saying the establishment of a particular

service would not be safe, no politician, surely, with then try to

establish that service. It has nothing to do with money. A lot is

to do with the throughput of patients. You cannot increase the

number of patients in a department unless you centralise the service.

The number of patients affected is small. For those affected, it is an

issue, I understand that, but we are talking about between two and three

patients per month. Will the First Minister make a statement on the new

work connections initiative? Supported by ?9 million from the

European social fund, the 17 million new work connections project is

helping people in North Wales to find employment and training

opportunities. It will come to an end at the end of February and it

has been extreme a ported assisting disadvantaged people to find work

but we still don't know what will replace it. Does the First Minister

accept that gap between the programme and whatever replaces it

could be detrimental from the view of finding a deployment for the most

is advantage people and Willie commits to announce plans for a new

scheme as quickly as possible? The authorities themselves are looking

at proposals to make sure that individuals can continue with the

project. We are looking to see how they can put other resources in

place at with this programme. Having said that, we want to ensure that

the plans for the European fund for 2014 /2020 have been considered by

May of this year. You will be aware of the working links programme that

runs concurrently with the new work connections programme. When this

ends, it is possible for people that have been on the new work

connections initiative to seek help from working links. Have you worked

with the UK Government to see how they could assist in that regard

Eschenbach of course, the working links programme has the same

objectives of getting people back into work and providing training for

them and support, particularly where they may have particular needs are

problems which must be addressed. Yes, the Minister has been working

with the UK Government on this. There has been a recent meeting.

Will the First Minister provide an update on the regress of enterprise

ons? We will report further progress in May of this year and on an annual

basis thereafter. Thank you. The Finance committee's report into

enterprise zones published in December last year alluded to what I

can only describe as an air of mystery describing where we are with

regards to those enterprise zones. The report says it is difficult to

be 100% clear about the influence of strategic objectives of enterprise

zones because the Welsh government has hitherto failed to make those

objectives public despite having them in their files. Would you agree

with the finance committee that the first recommendation of that report

should be fulfilled and all non-commercially sensitive

information should be published so scrutiny can run its course? There

is no mystery surrounding the success of our enterprise zones. We

have assisted 60 S N Es. This contrasts with his party's

stewardship of enterprise zones in England. It seems that 11% of those

54,000 jobs promised will be delivered. In order to help keep

track of progress, over the next year we will publish performance

indicators and targets for 2014-15. This will happen in spring of this

year and we are more than happy to be scrutinised on the success of

Welsh enterprise zones. There we are. The clock has beaten

us again and we'll have leave First Minister's Questions there, but

don't forget that you can see more coverage of the National Assembly

online from BBC Wales's Democracy Live page at

bbc.co.uk/walespolitics. That's it for today. We'll be back at the same

time next week with more coverage of First Minister's Questions. For all

the latest news, don't forget to watch Wales Today later at 6:30 on

BBC Resort. Said back and relax as you

get the ball rolling for seven days of live action. -- setback.