Nerys Evans

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1. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health cy

   Ddirprwy Lywydd, heddiw dwi'n nodi fy mlaenoriaethau gweinidogol ar gyfer iechyd cyhoeddus ac ataliol dros dymor y Senedd hon. Wrth inni ddathlu 78 mlynedd ers i Aneurin Bevan sefydlu'r NHS ar sail yr egwyddor radical na ddylai amgylchiadau eich genedigaeth fyth benderfynu ansawdd eich gofal, mae'n werth cofio geiriau Bevan ei hun,

   Official English translation

   Dirprwy Lywydd, today I am setting out my ministerial priorities for public and preventative health for this Senedd term. As we celebrate 78 years since Aneurin Bevan established the NHS, built on the radical principle that the circumstances of your birth should never determine the quality of your care, it is worth recalling Bevan's own words,

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2. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health en

   'the victories won by preventive medicine are much the most important for mankind.'

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3. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health cy

   Dros saith degawd wedyn, mae'r neges honno yr un mor berthnasol ag erioed. Ond dyw trin salwch ar ei ben ei hun ddim yn ddigon. Mae iechyd cyhoeddus ac ataliol yn allweddol i sicrhau dyfodol mwy cynaliadwy i'n system iechyd ac i'n poblogaeth ehangach. Mewn cyfnod pan fo'r galw am wasanaethau'n cynyddu, anghenion pobl yn mynd yn fwy cymhleth a phwysau ariannol yn dwysáu, mae'n rhaid inni symud o reoli salwch at fynd i'r afael â'r achosion sylfaenol. Am y tro cyntaf ers datganoli, mae gan Gymru Weinidog sydd â chyfrifoldeb penodol dros iechyd ataliol. Mae hynny'n gam sylweddol ymlaen. Mae e'n ddatganiad clir o fwriad y Prif Weinidog bod atal salwch yn flaenoriaeth genedlaethol. Mae'r dull hwn hefyd yn adlewyrchu'r ymrwymiad maniffesto i symud yn ehangach tuag at wario ar atal ym mhob maes polisi. Dyw'r angen am y newid yma ddim yn newydd. Yr hyn sydd wedi bod ar goll yw'r penderfyniad i'w wireddu. Am gyfnod rhy hir, mae ein modelau, ein prosesau a'n ffyrdd o weithio wedi canolbwyntio ar ymateb i argyfyngau, yn hytrach nag ar eu hatal a helpu pobl i fyw bywydau iachach a hapusach. Mae hynny'n newid nawr. O dan y Llywodraeth hon, fydd llwyddiant ddim yn cael ei fesur yn ôl nifer y derbyniadau i'r ysbyty, ond nifer y bobl sy'n aros yn ddigon iach i osgoi cael eu derbyn yn y lle cyntaf. Nid menter ar ei phen ei hun mo hon. Rŷn ni'n gwreiddio'r gwaith hwn ar draws y Llywodraeth drwy gyfres o gamau strategol er mwyn sicrhau ei fod yn cael ei adlewyrchu ym mhopeth a wnawn. Dwi eisoes wedi cynnal trafodaethau gyda'r holl Weinidogion Cabinet a'r Dirprwy Weinidogion i ystyried sut y gallwn ni wreiddio atal yn fwy effeithiol a chanolbwyntio ar wella iechyd pawb yng Nghymru. Ond mae pob taith yn dechrau gyda'r cam cyntaf, ac mae'r camau cynnar hynny yr un mor bwysig â phen y daith. Mae'r datganiad hwn yn nodi'r sylfeini sydd eisoes ar waith wrth inni fynd ar y trywydd cywir.

   Official English translation

   More than seven decades on, that message remains as relevant as ever. But treating illness is never enough on its own. Preventative and public health are the key to unlocking a more sustainable future for our health system and our wider population. In an age where demands on services are increasing, people's needs are becoming more complex and financial pressures are intensifying, we must shift away from managing sickness to treating the root causes. For the first time since devolution, Wales now has a Minister with specific responsibility for preventative health. That is a significant step forward. It represents a clear statement of intent from the First Minister that preventing ill health is a national priority. This approach also reflects manifesto commitments to a wider shift towards preventative spending across all portfolio areas. The need to make this change is not new. What has been missing is the determination to deliver it. For too long, our models, processes and ways of working have been focused on responding to crises, rather than preventing them and helping people to live healthier and happier lives. This changes now. Under this Government, success will be measured not by the number of hospital admissions, but by the number of people who stay healthy enough to avoid hospital altogether. This isn't a standalone initiative. We are embedding this work across Government through a series of strategic measures to ensure it's reflected in everything that we do. I have already had discussions with all Cabinet Ministers and Deputy Ministers to consider how we embed prevention more effectively and focus on improving the health of everyone in Wales. But every journey begins with a first step, and those early steps matter just as much as the destination. This statement sets out the foundations that have already been laid to put us on the right path.

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4. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health en

   I have agreed with the First Minister that Government decision making will be informed by a shared focus on public and preventative health. Official and ministerial-level cross-Government governance arrangements are being established to support this. These arrangements will provide the foundations for a comprehensive new public health strategy and framework for Wales. Embedding prevention and health into decision making will be supported with the guidance and support for public bodies in preparing for when the Health Impact Assessment (Wales) Regulations 2025 come into force next year. Being serious about prevention also means having the budgetary mechanisms to match, and in line with our first 100 days commitments, officials are in the process of exploring better defining preventative spending within the Welsh budget, with the aim of instilling greater coherence in the deployment of resources. I have also held discussions with the Cabinet Minister for Finance and Treasury officials on options for the introduction of a designated preventative departmental expenditure limit—PDEL—within the Welsh Budget. In addition to the strategic cross-Government work, there are immediate priorities that we will be tackling, in addition to rolling out the 100-day commitments. I fully recognise the need for us to provide healthy environments that support people to make healthier choices and maintain a healthy weight, to reduce the risk of severe, life-threatening conditions, including type 2 diabetes, heart disease, stroke and certain cancers. This includes the roll-out of prevention programmes to encourage and support children and adults to be more active in line with the recent changes to the UK Chief Medical Officers' evidence-based physical activity guidelines. I recognise that weight-loss medications have a place for some patients, but we cannot simply medicate our way out of the high levels of obesity that we see across Wales and the UK. It must form part of a blended approach that includes looking at the food systems, regulation, availability and promotion of physical activity, alongside more medicalised interventions. We're getting to work straight away, through our first 100 days commitments. Firstly, on advancing the active mile and the Daily Mile Foundation work across primary schools, with preliminary work well under way with stakeholders to begin the roll-out. Secondly, I have discussed with the Cabinet Minister for Culture and Sport strengthening partnership working between health services and sport organisations, and the wider role both arts and sports can have in health pathways, and have agreed we will embed a workstream for this work within our new cross-Government structures. I will also be working closely with my colleague the Cabinet Secretary for Rural Resilience and Sustainability on the development of the food strategy for Wales. Together, we will consider the fundamental changes needed to strengthen our food systems and the opportunity this presents to improve access to affordable, nutritious food, support locally produced Welsh food, and embed healthy, sustainable food choices, education and awareness within our schools. Alongside this, we will be examining how we create healthier food environments across Wales. This includes considering the levers available to us to support healthier choices in the retail sector, across the out-of-home food settings, and within our communities, helping to make the healthy choice the easy choice. I am firmly committed to addressing the concerning rise in vaping among children and young people. Nearly one in four of our 11 to 16-year-olds has tried vaping, despite these products having been developed as a smoking cessation aid for adult smokers. The unintended consequences of their widespread availability and appeal to young people are deeply concerning, and this Government is determined to take action. The consultation we launched last week marks the first step in delivering the robust measures needed to protect the health of the next generation. Lung cancer disproportionately affects those from the most deprived communities, with a higher incidence rate in these areas. I am committed to improving outcomes with the development of a national lung cancer screening programme with integrated smoking cessation services. Smoking remains one of the leading causes of preventable illness and deaths in Wales and highlights stark inequalities. And through the groundbreaking Tobacco and Vapes Act 2026, we will progress towards the goal of creating the first smoke-free generation in Wales, and this will include work to further reduce smoking rates during pregnancy, which in Wales are the highest amongst the UK nations. My approach to addiction includes tackling substance misuse and is based on the principle of harm reduction, to support and protect families and communities from the problems associated with harmful substance use. I am focused on working across the Welsh Government to do all that we can to tackle the risk factors for substance misuse, alongside work to strengthen support for those that need it, ensuring our work is informed by the voices of those with lived experience. Reducing the equity gap will play a key role in my future vision for preventative services. This includes work to promote vaccinations and screening, which are disproportionately less prevalent amongst our most deprived communities. This will involve better engagement with our underserved communities, better access to services, and digital enablement. I have already taken action to introduce a time-limited meningitis B vaccination programme ahead of the winter peak, and an expansion to the respiratory syncytial virus programme to include those aged 65 to 74 who are immunosuppressed or with chronic respiratory disease. Both these actions will help reduce those affected by serious disease this winter. This national focus on prevention will be informed by and will support local action, working with local government and the community and third sector. I'll be building on the work of the Marmot places under the Health Equity Wales initiative that builds on learning from Torfaen and Blaenau Gwent in taking a more preventative approach with communities to the delivery of services and tackling inequalities. The importance of having a healthier, more resilient population is also clear in the context of the increasing frequency and severity of public health risks. The impacts of climate change on the health of the population have come to the fore with the recent extreme heat, but other linked risks include antimicrobial resistance, environmental hazards, and outbreaks of communicable diseases. A fundamental priority of any Government is to protect its population. This will include work to plan, prepare, and respond to existing and emerging public health risks, working with colleagues and partners to embed a one-health approach across human health, animal health and the environment, and looking internationally to share and learn best practice.

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5. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health cy

   Lywydd, rŷn ni'n credu'n gryf fod adeiladu poblogaeth iachach nid yn unig yn ofyniad moesol, yn enwedig wrth inni fynd i'r afael ag anghydraddoldebau dwfn a hirsefydlog, ond hefyd yn hanfodol i gryfhau ffyniant a gwydnwch ein cenedl. Dyna pam rŷn ni'n gwreiddio'r egwyddor hon ar draws y Llywodraeth, fod gan bob rhan ohoni, nid jest y rhai sydd ag iechyd yn eu portffolio, gyfrifoldeb ar y cyd i gefnogi'r uchelgais hon. Dwi'n edrych ymlaen at roi'r wybodaeth ddiweddaraf i'r Aelodau am gynnydd y gwaith pan fyddwn yn dychwelyd yn yr hydref.

   Official English translation

   Llywydd, we firmly believe that building a healthier population is not only a moral imperative, particularly in tackling deep-rooted inequalities, but is also fundamental to improving the wider prosperity and resilience of our nation. That is why we are embedding this principle across the Government, that every part of Government, not just those with health within their portfolio, have a shared responsibility to support this ambition. I look forward to updating Members on the progress we are making when we return in the autumn.

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6. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health en

   Thank you. You could have had another 10 seconds of pleasantries at the—

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7. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health en

   Thanks for the contribution and for the welcome into the role. In terms of the bilaterals and the shared Government understanding, I think this is the first time we've ever had this discussion across Government level. I think there have been lots of pockets of good practice over a number of years, but nothing embedded, nothing strategic, no discussion about the impact of spend on the population of Wales in other portfolio areas. So, the bilaterals have been really good to kick that process off in terms of just seeing where we can work together. For example, you mentioned food and a discussion with the Cabinet Minister for rural resilience. That's not just a bilateral between me and that Cabinet Minister; we're talking about education, we're talking about our planning system, we're talking about the economy and supporting our food businesses. So, that's what this approach is absolutely about, to make sure we don't miss those opportunities. And if we look at the approach to food during the last Government, it was quite narrowly focused, and this is absolutely building on the work that you mentioned by your previous colleague on the food Bill, to make sure that it is a whole-system approach. I absolutely agree with you in terms of the quality of food in schools, but also teaching our young people about food skills and making sure that we understand where our food comes from, supporting our brilliant agricultural industry, and looking at our procurement rules. So, this is not just something for food; this is absolutely health prevention, looking at the economy. So, those bilaterals have kicked off that discussion while we work out how we make sure that these are embedded discussions early on in every policy development—that we look at preventing ill health and reducing the health inequality that we've got and making sure it's a cross-Government approach. And that's my role—to make sure that we don't miss those opportunities while we work out the mechanics, and that that is replicated on the official level as well. These conversations, potentially, have never happened before in these policy areas, so it's making sure that that's embedded so that it's systematic and strategic that we really do look at health inequality and look at preventative health measures.  In terms of the budgets and the costs, you raise some interesting points there in terms of how that will be developed. You're right in terms of a new budget line. I think the first step that we're grappling with now is the definition of 'prevention', especially if we are committed to increased spend on prevention over this Senedd term. How do we define that is really important—how do we define current activity within health and social care, but also in the other portfolio areas as we move to shift resources towards prevention. Getting that definition of prevention is absolutely key. There are different mechanisms then of identifying that spend. The Scottish Government are currently looking at how you tag some spend as prevention—so, not necessarily creating a budget line but tagging it as 'preventative' and those definitions within preventative spend. We are exploring those options, with the key fundamental principle that transparency is key. Without us knowing what we're spending, how we're spending it, and, ultimately, what the outcomes of that spend are in terms of population health, it's not as impactful as it should be, and that's why I'm in this role.  In terms of the weight loss medication, absolutely—it's creating that system of support around individuals for those lifestyle choices. They are right in some instances: preparing people for treatment in the NHS, for example, or certain body mass indexes. But making sure we've got that whole-system approach around the individual, to make sure there's a sustained improvement, is really important, and we're keeping that under review. Public Health Wales have been successful recently in co-ordinating a Wales-wide bid for funding through the obesity pathway innovation programme. That's £8 million of funding in order to look at these issues, to develop and test approaches that could form part of that delivery model going forward. We want to be looking at treating obesity as a chronic condition, and, obviously, the changes that would mean in terms of how the NHS would respond to that would be key.  I've mentioned the food issue. On substance misuse, absolutely. I'm pleased to hear your approach in terms of the person-centred approach—not just dealing with the substance misuse issue, but, absolutely, mental health and making sure that all the services around that individual are there. Following on from the last Government's harm reduction method, we will absolutely be taking that forward and working closely with the Deputy Minister for mental health. If I've missed anything, as I know time is tight—[Interruption.] I'll come back to you on the COPD screening specifically. Thank you.

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8. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health en

   Diolch. Thanks for those questions. In terms of the outcomes, we're going to be working on a public health strategy that brings all of this together in terms of what we're trying to achieve across portfolios, and looking at those objectives and those outcomes in the short, medium and longer term. As you mentioned, in terms of the budget, the budget increases transparency on what's actually happening. We don't have that now. Over the last 27 years, we don't know what's been spent on prevention. We don't know the impact. It has not been embedded. So, ensuring that we have transparency in terms of what we're spending does drive activity in terms of being transparent and putting those outcome measures in place to make sure that we are really clear what the expectation is in terms of public and preventative health. In terms of the HPV vaccine, absolutely, and there will be a statement by the Cabinet Minister on the cancer strategy this week, which will include details on that. You're right in terms of working with education, and we've been discussing with the Cabinet Minister for education how we can improve those messages to schools. Schools are under pressure with lots of demands on their time, but making sure that they understand their role in promoting vaccine uptake in schools is really important, and something that we are working on. One of the things that worries me is the differences within our deprived communities in terms of screening and vaccine uptake. The work you mentioned there on inclusion health is really important. There hasn't been a systematic look at this up until now. So, we really need to be making sure that the work that Public Health Wales are doing on screening and vaccinations really understands at that community level what the barriers are for uptake in terms of screening and vaccination. Because we know the benefits of making sure that people undertake screening and vaccination when they're meant to be part of that.  So, there is definitely good work happening, especially on the stigma side as well, but we do need to do more. We do need to better understand it, and we do need to better make sure that the good work that's happening now is better understood across the health service as well.

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9. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health en

   Thank you. On the first point there, in terms of tobacco and vaping, you've referenced the consultation that we launched last week. I mentioned that a key priority is making sure that we tackle the increasing number of children and young people who are vaping. Vaping is seen as a cessation tool for adults who smoke, it was never intended—. These are unintended consequences with dire impacts. Talking to parents and teachers, they really want us to step up and support tackling this issue. So, I'd urge people to respond to the consultation, which looked at changing the packaging of vaping products, making them plain packaging, similar to tobacco, removing the ability of companies to call them flavours that would be attractive to young people, and also the design of them, making them less appealing to young people, and also restricting where they're sold in shops so that they're under the counter. That's the first step, and I've asked officials to give us an outline of the other powers that we have in order to tackle tobacco and vaping, and making sure that we really do tackle these issues. On obesity and green spaces, absolutely, I think social prescribing, where it happens, is fantastic, and it's making sure that we embed that, share the best practice and make sure that people understand the benefits of linking to their local communities, not just in terms of green spaces, but physical activity and community groups, making sure that that is seen as a central part of the prescribing tool that our GPs have. On the food strategy, we are working at pace on this and we will be sharing information on it. It is going to be comprehensive, as I mentioned in the answer to James. It's not just looking at food in terms of what we produce, but also looking systematically at healthy food, supporting our rural industries, looking at production, and also, in terms of healthy foods, looking at schools and our young people. I think also, going further than that, I'm keen to look at healthy food environments and making sure that we talk to food producers and manufacturers about what more they can be doing and what more we can be asking them to do in terms of reformulation, product placement, and really looking at retail spaces and out-of-home food outlets to make sure that we are really committed in terms of tackling this, making sure that the healthy choice is the easy choice. We know that we are not eating as much fresh fruit and veg as we should be doing. We know we've got a fantastic agricultural industry, and we should be looking at procurement rules as well, which will be part of that. In terms of COVID, you mentioned our manifesto call. We made a clear manifesto call to establish a Wales-specific review of the COVID response, focused on matters not fully addressed by the UK-wide inquiry. With the report out today, of course, we'll be studying the report's findings and the recommendations in depth and publishing a response to that within six months. Responsibility lies with my Cabinet colleague. And in terms of children's public health, in terms of the demographics, in terms of the outlook for children's public health, this is an absolute area we need to be focusing on, and that's why, as part of the public health strategy, there'll be a specific public health strategy for children that we'll be developing in the months ahead.

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10. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health en

    Diolch. As you will well know—and thank you for your work in this area—everyone aged 12 and over diagnosed with diabetes and registered with a GP in Wales is invited for screening through the Diabetic Eye Screening Wales service. The OCT you mentioned, delivered with the diabetic eye screening programme, may reduce referrals for inadequate images to hospital eye services, which would improve participant experience. However, the introduction of OCT would need a new service delivery model, which would require additional specialist workforce and equipment. Scoping of the introduction of OCT is part of the wider Diabetic Eye Screening Wales transformation plan, which is planned for future years, and would determine the potential benefits of introduction and requirements in relation to resource and funding. So, the focus at the moment is currently on improving the stability of the diabetic eye screening for existing screening pathways. As you will know, Diabetic Eye Screening Wales is delivered in accordance with the recommendations of the UK National Screening Committee, and that committee is currently consulting on the use of digital imaging within the screening programme, and we will consider the advice of the committee when that is received.

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11. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health en

    Thank you. You're right to point out the cancer inequalities. I think that's one of the clearest examples of the wider health inequalities that we face in Wales, especially in some of the communities in south Wales. Evidence shows that people living in more deprived communities are more likely to develop cancer, more likely to die from cancer, and less likely to survive cancer than those living in the least deprived communities. So, it's an absolute imperative that we tackle that issue, and tackle the issue you mentioned there in terms of screening as well. These inequalities are driven by many of the same factors that underpin health inequalities, including poverty, smoking, obesity, housing, employment and access to services. That's why this is a cross-governmental approach, and that's why this Government is taking a very, very different approach to previous Governments by having a designated Minister with responsibility for looking at these issues across Government. The Cabinet Minister for health will be setting out a statement on the plans for cancer this week, with the aim of developing a cancer plan, as we set out ahead of the election.

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12. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health cy

    Diolch yn fawr. Mae yna bryderon sylweddol ynglŷn â'r defnydd o cetamin a'r cynnydd yn y defnydd o cetamin, wrth gwrs, yn enwedig ymysg pobl ifanc, a'r niwed y gall hwnna beri. Diolch i chi am eich gwaith yn ystod y Senedd ddiwethaf yn y maes yma. Dwi'n edrych ymlaen at gysylltu gyda chi yn y grŵp trawsbleidiol pan fydd wedi cael ei sefydlu. Byddwn i'n hapus iawn i wneud hynny.

    Official English translation

    Thank you very much. There are serious concerns about the use of ketamine and the increase in the use of ketamine, of course, particularly among young people, and the harm that that can cause. Thank you for your work during the last Senedd in this area. I look forward to engaging with you in the cross-party group when it is established. I'd be more than happy to do that.

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13. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health en

    Across Wales, the area planning boards have developed a range of information about ketamine, mainly focused on awareness raising, harm reduction, reducing risks and ensuring information is being disseminated widely. Areas are also adapting services to address these issues and these developing needs, with treatment pathways specifically for those using ketamine, with some areas implementing joint assessments for those using the drug. This allows access to clinical support and consultation from the substance misuse service, and quicker access to GP support and community mental health referral teams where appropriate. Given the concerns, and the rise of the concerns, on the use of ketamine in our communities, we've established a ketamine working group with key stakeholders and clinical leads to take this work forward. The aim of the group is to share best practice and to inform a co-ordinated approach across Wales. This includes informing treatment pathways and prevention, but also how we raise awareness of the harms, building on the local work already being led by the boards. The first meeting of the working group took place on 13 July. I'd like to reiterate I'm more than happy to work with the cross-party group to share information about that working group and how we can work together to raise awareness of this really important issue and the harms associated with it.

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14. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health en

    Well, I'm glad you agree with the priority that we've put on tackling waiting lists and the investment that we've set out in the supplementary budget in order to do that. I hope, indeed, that Members would reflect on what voting against that supplementary budget would mean in terms of the investment that we need in our NHS and across other preventative health measures. There's investment in the supplementary budget on the swimming initiative for schools as well. So, voting against the supplementary budget this afternoon does have serious consequences in terms of the ability of our NHS to respond to the demands it's facing now and the backlog that we have inherited from the previous Government, which absolutely impacts on the issues that you mentioned about the provision of health services in our rural communities. I am also from rural west Wales and know the challenges. As the First Minister set out earlier this afternoon, our ambition is to make sure that we look at rural-proofing, to make sure that the cost of delivery of services really does adequately reflect the actual costs in terms of what's being funded, and that is a key central part. But I'd urge Members across this Chamber to make sure that they support the supplementary budget, to make sure of exactly what you mentioned, in terms of tackling the waiting lists and making sure our health and social care system is on a sustainable footing.

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15. 6. Statement by the Deputy Minister for Public and Preventative Health: Priorities for Public and Preventative Health en

    Diolch. The NHS dental contract arrangements that came into force on 1 April this year represent the most significant changes to NHS dentistry in two decades. Health needs and prevention are at the heart of the new system, creating an opportunity to improve access to care and to ensure resources are targeted towards those with the greatest need. We are, as you would expect, keeping the new contract under continual review to assess its impact on patients, practitioners and access to services, but we do need to give it some time to bed in. As evidence emerges, we will work with stakeholders to identify where further refinements may be required to ensure that the system is delivering the intended improvements and remains an attractive place to provide NHS dental care.

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1. 9. Short Debate: Health inequalities in the south Wales coalfield cy

   Diolch, Lywydd. Dwi'n croesawu'r cyfle yn fawr i ymateb i'r ddadl yma er mwyn dangos pwysigrwydd y cymunedau glofaol i'r Llywodraeth yma, ein dealltwriaeth, fel Llywodraeth newydd, o'u hanghenion arbennig nhw, ac i amlinellu sut fyddwn ni'n cydnabod hynny ac yn gweithredu yn ystod y tymor yma. Dwi'n gwybod bod y materion yma'n bwysig iawn i'r Aelod, fel rŷn ni wedi clywed y prynhawn yma, a dwi'n diolch i'r Aelod am gyflwyno'r materion yma. Dwi'n edrych ymlaen at weithio gyda fe yn ystod y tymor i dynnu sylw at y materion sy'n wynebu ein cymunedau glofaol ac i weithredu i gau'r bwlch iechyd annerbyniol sy'n bodoli. Mae'n nodweddiadol hefyd mai dyma'r ail waith mewn pythefnos i ni drafod anghydraddoldebau iechyd. Mae hyn yn adlewyrchu'r pwysigrwydd mae'r Senedd newydd yma a'r Aelodau newydd yn rhoi i'r pwnc, sy'n galonogol iawn, ac mae'r pwysigrwydd hynny, wrth gwrs, wedi'i rannu gan y Llywodraeth ac rŷn ni'n ymfalchïo yn hynny. Dyma'r tro cyntaf i ni gael ffocws gwirioneddol ar iechyd ataliol mewn Llywodraeth. Ac fel rŷn ni wedi clywed gan Matthew, mae'r elfennau amrywiol yma sy'n plethu ar draws pob un maes portffolio yn sicrhau ein bod ni'n mynd i gael lens ataliol yn y penderfyniadau rŷn ni'n eu cymryd. Mae'n ffaith anghyfforddus, ond mae'n rhaid i ni dderbyn, yng Nghymru heddiw, fod lle mae person yn cael ei eni, ei fagu ac yn byw yn cael dylanwad dwfn ar ei iechyd, pa mor hir y gallan nhw ddisgwyl byw a faint o flynyddoedd o fyw mewn iechyd da. A does yna unman yn dangos y problemau yma sy'n cael eu hwynebu yn fwy na'n cymunedau ôl-lofaol.

   Official English translation

   Thank you, Llywydd. I very much welcome the opportunity to respond to this debate, to emphasise how important our coalfield communities are to this Government, and the need for us, as a new Government, to understand their specific needs, as well as to outline how we will acknowledge this and act accordingly during this Senedd term. I know that these issues are very important to the Member, as we've heard this afternoon, and I thank him for presenting them today. And I look forward to working with him during this term to highlight the issues that our coalfield communities face and to act to bridge the unacceptable health gap that exists. It's also notable that this is the second time in a fortnight that we've discussed health inequalities. This reflects this subject's importance to the new Senedd and Members of the Senedd, which is hugely encouraging, and the importance of that is shared by this Government, and we take pride in that. This is the first time that we've truly focused on preventative healthcare in Government. And as we've heard from Matthew, these diverse elements that dovetail across every portfolio area ensure that we're going to have that preventative lens on the decisions that we make. It's an uncomfortable fact but one that we must accept that, in Wales today, where a person is born, where they're brought up and where they live has a deep influence on their health, on their life expectancy and how many years they can expect to live in good health. And nowhere demonstrates these health inequalities that we face more than our former mining communities.

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2. 9. Short Debate: Health inequalities in the south Wales coalfield en

   From Blaenau Gwent, Torfaen and through to Merthyr, Rhondda Cynon Taf, Caerphilly, Neath Port Talbot, Swansea and part of Carmarthenshire, we see that families and communities that helped build modern Wales now experience social, economic, environmental and health challenges. These communities powered the industrial revolution and fuelled the prosperity of Wales and far beyond. They produced the coal and steel that helped shape modern Britain, and they built strong traditions of solidarity, resilience and community that remain a source of pride today. But our industrial heritage has left a legacy. The health inequalities that we see today are the result of long-term social and economic change. They have been shaped by our industrial past and by the decline of the industries on which many families and communities depended. The economic hardship, unemployment and underinvestment that followed are responsible for that legacy, affecting opportunities, well-being and health outcomes across generations. The inequalities we see today did not happen by chance; they are a result of political choices made over many years by previous Welsh Governments and successive Westminster Governments that failed to give enough priority to closing the gaps that our communities continue to face—gaps in wealth, gaps in opportunity and ultimately in health. Too many people have been held back by circumstances beyond their control, and those inequalities have been allowed to persist for far too long. This Government is determined to change that. We are committed to understanding the challenges that people face, tackling inequality wherever it exists and making fairness the foundation of everything we do. Ensuring that reducing health inequalities is embedded across every part of Government is my responsibility, because, as we've heard, improving health cannot be the job of the health service alone; it must be at the heart of every decision that we make.

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3. 9. Short Debate: Health inequalities in the south Wales coalfield en

   Too many people in Wales can expect to spend far fewer years in good health than they should. In just a few years, healthy life expectancy has dropped by over two years for men, and two and a half years for women in Wales. This isn't a gradual change; it's a clear warning that the nation's health is getting worse. The challenge is particularly acute in the south Wales coalfields, where healthy life expectancy is below the Welsh average for both men and women. In Cwm Taf Morgannwg, girls can expect just 55 years of good health, and boys 56 years, which are the lowest figures in Wales. This is just simply not fair. It's about people spending longer periods of their lives living with illness, people losing their independence, families facing hardships and more pressures on our public services. In some of our most deprived communities, men live 18 years less in good health than those in the most affluent communities—18 years less in good health—and, for women, the gap is 19 years. That is the legacy that we are dealing with. The gaps that we see in healthy life expectancy are much more than about health alone. They tell a story about opportunity, economic security and whether people have access to the things that help prevent ill health and support healthy lives. That is why this Government speaks as one in our focus on prevention and promoting people's physical and mental health and well-being across everything the Welsh Government does, and why my role, the first of its kind in devolution, was created. If we want healthier populations, we must look beyond hospitals and GP surgeries. Health is fundamentally shaped by our homes, our schools, our workplaces and the strength of our communities. Action on poverty, housing, education and employment is also action on health. Tackling the root causes is essential if you want to reduce inequalities and help people live healthier lives for longer. We need to help individuals, families and communities across Wales to be their best. Our communities are strong and resilient. They are best placed to shape their futures. That is why this Government's commitment to prevention is also a commitment to fairness and empowering communities to build on their strengths, support local leadership and create a healthier, more prosperous future for generations to come. There are encouraging signs of change across the coalfields areas that we can learn from and we will build on. The Coalfields Regeneration Trust—about which I must declare an interest, as I used to work with them last year—who my colleague talked about earlier, provides a strong example of community-led change, supporting jobs, skills and community development in former mining areas, and helping communities build healthier and more prosperous futures. Their work in tackling health inequality is to be championed and built on. In Gwent, Wales's first Marmot region is bringing partners together to tackle the root causes of poor health through action on poverty, housing, employment and community well-being. This involves adopting public health expert Sir Michael Marmot's eight principles, which aim to eliminate unfair and avoidable differences in health, which can be caused by where people live, what kind of job they do and how they're treated in society. Places such as Torfaen have been at the forefront of this work, demonstrating how co-ordinated action across public services and communities can reduce inequalities and improve health outcomes. The Torfaen deal provides a clear example. Built around shared ambition for a fairer, healthier and more resilient borough, it brings together residents, public services and community partners to co-design solutions to local challenges, focusing on the things that most shape health. I've been lucky enough to meet the chief exec of Torfaen local authority, Stephen Vickers, who is a leader in this field, and I would urge everybody interested in the Marmot principles to meet him and to see the brilliant work that they're doing to embed reducing health inequalities across all decision making across that local authority, from planning to delivering of services to building resilient communities. Torfaen has recognised that health is created in our homes, in our schools, workplaces, neighbourhoods, and not just in our hospitals. It is exactly the kind of preventative, community-led approach that can help narrow inequalities and improve health outcomes for future generations. The Health Equity Wales initiative is helping accelerate this change, working in partnership with and learning lessons from local authorities, health boards and communities from across Cardiff, Denbighshire, Merthyr, Neath Port Talbot, Torfaen, Blaenau Gwent and RCT. Together, this growing number of partner organisations are committed to strengthening the ability of all places in Wales to act on health inequalities. Last month, I visited the Happy Healthy Blaenau Gwent initiative, where I saw first-hand the impact of a preventative approach through social prescribing. It was a powerful reminder that improving health is more than just treating illness. Initiatives like this can improve well-being, strengthening community connections, and, for some people, provide the first step towards building confidence and moving closer to employment. By listening to local people and building on local strengths, we can create healthier and fairer communities. Ultimately, our ambition is simple: to ensure that no community's future is determined by its past, and that places that contributed so much to Wales's prosperity are given every opportunity to share in Wales's future prosperity. The debate that we held two weeks ago about health inequalities in Cardiff was important because it reminded us that health inequalities remain a reality in modern Wales. Yet we can see something else: communities with enormous strength, deep resilience and a determination to build a better future. We owe it to those communities to untap the potential and build on our strength to spread prosperity to our coalfield communities and to all parts of Wales. Next week in the Siambr, I'll be setting out my priorities for public and preventative health in Wales. The challenge before us is not simply to treat illness more effectively, it is to create the conditions across Government for better health for all. Because good health should never depend on wealth. Because where someone is born should not determine how long they live. And because the gap between the healthiest and the least healthy communities in Wales is not inevitable.

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4. 9. Short Debate: Health inequalities in the south Wales coalfield cy

   Mae'r Llywodraeth hon wedi ymrwymo i fynd i'r afael â'r pethau sylfaenol sy'n achosi iechyd gwael, mynd i'r afael ag anghydraddoldebau ble bynnag maen nhw'n codi, a gwneud yn siŵr bod ein gwaith atal yn ganolog i'r gwaith yna mewn Llywodraeth, fel y gallwn ni adeiladu Cymru lle mae pawb yn ein cymunedau glofaol neu unrhyw le arall yng Nghymru yn cael cyfle i fyw yn hirach ac yn iachach. Hoffwn ddiolch i'r Aelod am ddod â'r ddadl yma heddiw. Does dim dowt dy fod ti'n mynd i fod yn gynrychiolydd cryf ac angerddol i dy gymunedau. Mi fyddwn i'n hapus iawn i ymweld â'r prosiectau rwyt ti wedi sôn amdanynt. Dyna yw ein huchelgais ni fel Llywodraeth, a dyma'r gwaith rŷn ni'n benderfynol o'i wneud. Diolch yn fawr.

   Official English translation

   This Government is committed to tackling the fundamental causes of ill health, to tackling inequalities wherever they arise, and to ensuring that the preventative approach is central to the Government's work, so that we can build a Wales where everyone in our communities or anywhere else in Wales can have the opportunity to live a longer and healthier life. I'd like to thank the Member for bringing forward this debate today. There's no doubt that you're going to be a strong and passionate representative of your communities. I would be very happy to visit the projects that you've mentioned. That is our ambition as a Government, and that's the task that we are determined to accomplish. Thank you.

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Open this sitting on the stage

1. 3. Topical Questions cy

   Rydym wedi gweithredu ein trefniadau cydlynu ymateb i fonitro a rheoli effeithiau gwres eithafol ar draws y meysydd yr ydym yn gyfrifol amdanynt, gan weithio gyda phartneriaid, fforymau gwydnwch lleol a Llywodraeth y Deyrnas Unedig. Rwy'n annog pawb i ddilyn y cyngor iechyd cyhoeddus, yfed digon o ddŵr a chadw mas o'r haul yn ystod y rhan boethaf o'r dydd.

   Official English translation

   We have implemented our response co-ordination arrangements in order to monitor the impacts of extreme heat across the areas that we are responsible for, working with partners, local resilience forums and the UK Government. I encourage everyone to follow public health advice, to drink plenty of water, and to stay out of the sun during the hottest part of the day.

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2. 3. Topical Questions cy

   Diolch. Rwy'n cytuno gyda'r sylwadau ynglŷn â difrifoldeb y tywydd eithafol yma rŷn ni'n ei weld heddiw, yfory a dros y dyddiau nesaf. Fel gwnes i sôn, rydym ni wedi cydlynu gweithgaredd yn genedlaethol er mwyn rheoli a monitro'r sefyllfa bob dydd. Mae'r adran diogelwch gwladol a gwydnwch yn cydlynu'r gwaith yna ac yn gweithio gyda swyddogion ar lawr gwlad a swyddogion iechyd cyhoeddus hefyd er mwyn inni gael yr ymateb trawslywodraeth yna, fel gwnaethoch chi sôn. Gwnaeth yr ymateb cenedlaethol gynyddu i lefel 1 ar fore 22 Mehefin, bore dydd Llun, wrth i ni fonitro'r sefyllfa. Gwnaethon ni ddod â'r gweision sifil polisi at ei gilydd mewn modd ymarferol iawn i edrych ar yr elfennau gweithredol yna er mwyn ein bod ni'n ymateb. Rydym ni'n cydnabod y risgiau, rydym ni'n cydlynu gweithgaredd, ac fel gwnaethoch chi sôn, mae'r risg i fywyd yn un difrifol iawn mae'n rhaid i ni ei gymryd o ddifrif. Ar y meysydd iechyd, wrth gwrs, rŷn ni'n gwybod bod Iechyd Cyhoeddus Cymru wedi rhoi cyngor mas i'r sector iechyd. Roedd y prif gynghorydd meddygol wedi cysylltu gyda phartneriaid nôl ym mis Mai i wneud yn siŵr bod y cynlluniau mewn lle ar gyfer fel achosion fel hyn, sy'n debygol o ddod yn fwy aml nawr oherwydd newid hinsawdd. Yn sicr mae hwnna'n flaenoriaeth i ni fel Llywodraeth: gwneud yn siŵr ein bod ni'n cydnabod y ffaith bod newid hinsawdd yn bodoli, gan gydnabod bod angen i ni weithio ar draws y Llywodraeth er mwyn paratoi am achosion fel hyn yn fwyfwy aml, yn anffodus.

   Official English translation

   Thank you. I agree with the comments made about the severity of the extreme weather that we see today, and over the coming days. As I mentioned, we've co-ordinated activities nationally in order to try and manage and monitor the situation every day. The national security and resilience department is co-ordinating that work and working with officials on the ground and public health officials as well so that we can have that cross-government response, as you mentioned. The national response increased to level 1 on the morning of 22 June, Monday morning, as we monitored the situation. We brought policy civil servants together in a practical way to look at the operational elements so that we could respond. We recognise the risk in terms of co-ordinating activities, and, as you said, the risk to life is very severe and we have to take that seriously. In terms of the health areas, we know that Public Health Wales has given out advice to the health sector. The chief medical officer contacted partners back in May to ensure that plans were in place for these kinds of events, which are likely to become more frequent now because of climate change. Certainly, that's a priority for us as a Government: to ensure that we recognise the fact that climate change does exist, recognising that we will need to work across the Government to prepare for these incidents more frequently, unfortunately.

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3. 3. Topical Questions cy

   Diolch. Rwy'n rhannu'r pryderon yna ac yn rhannu'r sylwadau ynglŷn â'r effaith ar deuluoedd wrth i ysgolion a llefydd gwarchod plant gau. Ond nid ar chwarae bach ŷn ni'n gwneud hyn, wrth gwrs, o ran y rhybudd coch. Dydyn ni erioed wedi cael rhybudd coch fel hyn yng Nghymru o'r blaen oherwydd tywydd. Mae cau ysgolion a chau llefydd gwarchod plant yn rhywbeth i'r penaethiaid lleol neu'r awdurdodau lleol. Yn amlwg, fel y byddwch chi'n ymwybodol, mae pob un adeilad yn wahanol o ran maint a'r gallu i ymgymryd â thymheredd fel yma, felly mae'n iawn ac yn briodol bod y penderfyniadau yna yn cael eu gwneud ar sail risg leol, ar sail yr amodau penodol, er mwyn ein bod ni'n cadw pobl ifanc a'n plant yn ddiogel. Rŷn ni'n gwybod bod plant a phobl ifanc, yn enwedig, yn fwy bregus, yn methu controlio tymheredd y corff, felly mae'n ddyletswydd arnon ni i gyd i wneud yn siŵr ein bod ni'n gofalu am blant a phobl ifanc, a phobl hŷn a phobl â chyflyrau iechyd penodol yn ystod y cyfnod yma. Felly, dyna'r rheswm, wrth gwrs, pam mae angen i ysgolion ystyried cau yn y meysydd yma. Ac, wrth gwrs, rŷn ni'n monitro'r sefyllfa yn ddyddiol ac yn gwneud yn siŵr bod y gefnogaeth yna mewn lle.

   Official English translation

   Thank you, and I do share those concerns and those comments on the impact on families as schools and childcare facilities close. But we don't take these decisions lightly in terms of the red weather warning. We've never had such a red warning in Wales because of hot weather. School closures and the closure of childcare facilities is something for headteachers or local authorities. Clearly, as you'll be aware, every building is different in terms of size and the ability to cope with high temperatures, so it's right and appropriate that those decisions are made based on local risk basis, and particular conditions locally, in order to keep our children and young people safe. We know that children and young people, in particular, are more vulnerable, more susceptible to hot temperatures and can't control body temperature, so we are all duty-bound to ensure that we look after children, young people and older people and people with particular health conditions during these times. So, that is why, of course, we do need to consider school closures in these areas. And, of course, we are monitoring the situation on a daily basis and ensuring that that support is in place.

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4. 3. Topical Questions cy

   Wel, dwi'n falch iawn i glywed y sylwadau yna, a'r ddealltwriaeth bod hyn yn rhywbeth mae angen inni ei daclo, a bod newid hinsawdd yn flaenoriaeth. Wrth gwrs, mae'n flaenoriaeth i'r Llywodraeth newydd yma, a byddwn ni'n falch iawn i weld y gefnogaeth i'r ffaith ein bod ni yn blaenoriaethu mesurau i ddelio ag effaith newid hinsawdd, ac, fel y gwnaethoch chi sôn, yr effaith real sy'n digwydd ar hyn o bryd i'r system trafnidiaeth, yn ogystal ag ysgolion ac yn y blaen. Felly, mae hyn yn flaenoriaeth i'r Llywodraeth. Mae'n rhywbeth rŷn ni'n mynd i'w wreiddio drwy bob un portffolio—yr angen inni ddim jest edrych ar y mesurau newid hinsawdd, ond hefyd fel rŷn ni'n paratoi fel gwasanaethau, yn enwedig yn y gwasanaeth iechyd a gofal cymdeithasol, wrth gwrs, a gwneud yn siŵr bod cynlluniau mewn lle, fel rŷn ni wedi dros y misoedd diwethaf. A rhaid gwneud yn siŵr bod y cynlluniau mewn lle pan mae yna issues fel y rhybudd coch yma yn codi, a bod yna gefnogaeth a dealltwriaeth bod angen gweithredu ar y cynlluniau yna ar fyrder, a'n bod ni'n monitro ac yn rhoi'r gefnogaeth yna yn ôl yr angen.

   Official English translation

   Well, I'm pleased to hear those comments, and the understanding that this is something that we need to tackle, and that climate change is a priority. Of course, it's a priority for this new Government, and we'll be very pleased to see the support for the fact that we are prioritising measures to deal with climate change impacts, and, as you mentioned, the real impact that is happening now in terms of the transport system, as well as schools and so forth. So, this is a priority for the Government. It's something that we are going to embed throughout all portfolios—the need for us to look not just at climate change measures, but also at how we prepare our services, particularly the health and social care services, to ensure that plans are in place, as we have done over recent months. And we must ensure that when issues such as the red warning do arise, there is support and an understanding that we need to implement those plans urgently, and that we do monitor them and that the support is in place to do that as necessary.

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5. 9. Short Debate: Life expectancy inequalities in Cardiff’s southern arc cy

   Diolch yn fawr, Dirprwy Lywydd. A diolch yn fawr i'r Aelod am gyflwyno'r ddadl mor bwysig hon heddiw ar ei phen-blwydd, a phen-blwydd hapus. Tu ôl pob ystadegyn rŷn ni wedi clywed amdano yn ystod y trafodaethau heddiw, mae yna berson, mae yna deulu a chymuned, pobl yn byw gyda phoen neu salwch y gellir eu hatal. Mae plant ledled Caerdydd a Chymru yn tyfu i fyny gyda rhagolygon iechyd gwahanol iawn, nid oherwydd eu dewisiadau eu hunain, ond oherwydd amgylchiadau eu bywyd. Dyna pam mae'r ddadl yma mor bwysig. Mae nifer y blynyddoedd iach y gallwn ni ddisgwyl eu byw yng Nghymru yn is na mewn gwledydd eraill ar draws y Deyrnas Unedig, ac mae'r sefyllfa yn gwaethygu. Gall babi a anwyd rhwng 2022 a 2024 ddisgwyl byw dim ond 59 mlynedd mewn iechyd da. Mae hynny'n is na Lloegr ar gyfer dynion a menywod, ac yn waeth nag unrhyw ran arall o'r Deyrnas Unedig ar gyfer menywod. Mae Caerdydd, wrth gwrs, yn ficrocosm o beth ydyn ni'n ei weld dros Gymru gyfan. Ond nid y ffigurau eu hunain sy'n peri'r pryder mwyaf. Yr hyn maent yn ei olygu yw bod mwy o bobl yn treulio mwy o'u bywydau yn byw gyda salwch, cyfyngiadau a heriau iechyd, mwy o amser yn dibynnu ar ein gwasanaethau iechyd a gofal, mwy o amser i ffwrdd o'r gwaith, oddi wrth deuluoedd ac oddi wrth y pethau sy'n rhoi ansawdd a phwrpas i fywyd. Ac mae'r duedd yn mynd i'r cyfeiriad anghywir. Ers 2017-19, mae disgwyliad oes iach wedi gostwng dros ddwy flynedd ar gyfer dynion a bron i dair blynedd a hanner ar gyfer menywod yng Nghymru. Nid newid graddol mo hwn; mae'n rhybudd clir fod iechyd y genedl yn dirywio. Ac mae'r dirywiad hwnnw'n taro rhai cymunedau yn llawer caletach nag eraill, fel ŷn ni wedi clywed. Mewn rhai o'n cymunedau mwyaf difreintiedig, mae dynion yn byw 18 mlynedd yn llai mewn iechyd da na rhai o'n cymunedau mwyaf cefnog. Ar gyfer menywod, mae'r bwlch yn 19 mlynedd. Dylai hynna beri pryder i bob un ohonom ni, oherwydd nid jest anghydraddoldeb iechyd yw hwn, ond anghydraddoldeb mewn cyfleoedd ac mewn ansawdd bywyd.

   Official English translation

   Thank you very much, Dirprwy Lywydd, and thank you very much to the Member for bringing such an important debate forward on her birthday, and happy birthday. Behind every statistic we've heard mentioned during this debate today, there is an individual, a family and a community, people living with pain or illness that could be prevented. Children across Cardiff and Wales are growing up with health prospects that are very different, not because of their own choices, but because of their life circumstances. That's why this debate is so important. The number of healthy years we can expect to live in Wales is lower than in other nations across the UK, and the situation is deteriorating. A baby born between 2022 and 2024 can expect to live just 59 years in good health. That is lower than England for men and women, and is worse than any other part of the UK for women. Cardiff, of course, is a microcosm of what we see across Wales. But the figures themselves aren't the greatest concern. What they mean is that more people are spending more of their lives living with illnesses, health challenges and limitations, more time dependent on our health and care services, more time away from work, from families and from those things that provide purpose and quality of life. And the trend is moving in the wrong direction. Since 2017-19, healthy life expectancy has declined by over two years for men and almost three and a half years for women in Wales. That's not a gradual change; it's a clear warning that the nation's health is in decline. And that decline is hitting some communities far harder than others, as we've heard. In some of our most deprived communities, men live 18 years less in good health than in some of our most prosperous communities. For women, the gap is 19 years. That should cause concern to each and every one of us, because this is not just health inequality, but inequality in opportunity and quality of life.

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6. 9. Short Debate: Life expectancy inequalities in Cardiff’s southern arc en

   Much of the ill health that blights lives across Wales is neither inevitable nor unavoidable. In many cases, it's predictable. In many cases, it is preventable. That is why it is so troubling that healthy life expectancy is falling and health inequalities are widening. When we talk about avoidable deaths, we're not talking about statistics on a page. We're talking about parents, partners, friends and neighbours whose lives could have been longer and healthier. We're talking about people spending years living with illness that could have been prevented, years that should have been spent working, caring for loved ones, pursuing opportunities or simply enjoying life. We know that around 23 per cent of deaths are considered avoidable. We know that around 40 per cent of cancers could be prevented. And we know that without action, the number of people living with four or more long-term conditions could almost double by 2035. The question before us is not whether we can afford to act, it is whether we can afford not to. That is why this new Government is taking a different approach. Ensuring that people across Wales have the means, the opportunity and the support to live healthier lives is at the heart of the work in this new Government. Prevention is no longer something that sits at the margins of policy; it is at the centre of everything we do. For the first time since devolution, Wales now has a Minister with specific responsibility for preventative health, which is a significant step forward and a clear statement of intent from the First Minister that preventing ill health is a priority. But this role extends far beyond the boundaries of the health service, because, as you mentioned, health does not begin in a hospital, a GP surgery or through a prescription. Health begins in the homes that people live in, the jobs that they do, the food they can afford, the schools their children attend and the communities they are part of. My responsibilities reflect this Government's understanding that improving health means tackling the factors that shape people's lives. It means creating healthier food systems. It means giving young people the knowledge and skills to make healthy choices. It means designing places that support active lives. It means reducing poverty, improving housing and creating the conditions for secure and rewarding work. For too long, we've accepted a false economy in the way we manage and fund our health services. Previous Governments have prioritised responding to illness rather than preventing it. Too little has been invested in keeping people healthy, and then we have paid a far greater price when people become unwell, require treatment or are forced out of work. That approach is neither sustainable nor fair. We are determined to correct that imbalance by placing greater emphasis on prevention and by ensuring that policy making across Government addresses the social determinants of health, including housing, education, employment and poverty reduction. Because the greatest opportunity before us lies not simply in treating illness, but in preventing it from occurring in the first place. The benefits are profound: better health, greater independence, stronger communities, reduced pressure on public services and a fairer Wales where a person's health is not determined by the circumstances of their birth. But achieving that requires more than just good intentions. It requires sustained commitment from across Government and across society. So, what does that mean in practice? Well, within health and care, we recognise the need to shift services toward prevention, earlier intervention, and care close to home, which is essential if our health and care services are to remain sustainable in the face of demographic change. As Members will know, the First Minister convened a primary care summit last week to build understanding and support for this shift towards community-based care, and I will continue to work closely with the Cabinet Minister for Health and Care to drive this forward. But prevention does not stop at the NHS. We are working across Government on a comprehensive food strategy. Our aim is simple: to make healthy food easier to access, more affordable and better understood. That means improving food literacy, supporting local food production, and ensuring that every child leaves school with the knowledge and confidence to prepare healthy meals, because good health starts early. The experiences and opportunities available to children shape health outcomes for a lifetime, and that is why tackling poverty remains one of the key priorities of this Government. We are expanding access to childcare, helping families with household costs, and creating new opportunities for parents to enter or to return to work. We know that good jobs are good for health. Secure employment, fair wages and opportunities to develop skills support both physical and mental well-being. That is why this Government is committed to building a stronger economy that delivers prosperity and opportunity in every part of Wales. At the same time, we recognise that warm, safe and affordable homes are not a luxury; they're one of the foundations of good health. Yet too many people in Wales continue to live in homes that are cold, damp and expensive to heat. At a time when around a quarter of households in Wales experience fuel poverty, that is unacceptable. We are committed to reducing energy costs, improving the quality and energy efficiency of homes, protecting support for those facing acute fuel poverty, and reviewing the Warm Homes programme to ensure it delivers the support that people need, because no-one should have to choose between heating their home and protecting their health. We also recognise the vital role that culture, sport and the natural environment play in helping people live healthy and fulfilling lives. Participation in sport, creativity, culture and nature-based activities can improve mental well-being, reduce stress, strengthen social connections and support healthier lifestyles. These are not optional extras, as we've heard from the Cabinet Secretary for Culture and Sport. They are part of the fabric of healthy communities. Taken together, these examples demonstrate that prevention is not a single programme or a single intervention; it's a whole Government commitment to fairness. It's about creating the conditions that allow people to live healthier lives, wherever they live and whatever their circumstances. Alongside this work, we will develop a new public health strategy and framework for Wales, informed by a comprehensive review of current and future public health challenges. We will also introduce targeted plans for children and older people, and roll out preventative programmes that help children become more active, including expanding access to initiatives such as the Daily Mile and school swimming within our 100-day programme. But Government cannot do this alone. Communities understand better than anyone else the barriers they face and the changes that are needed, and there is good work happening across Cardiff that must be built on. We must listen to people's experiences, learn from their expertise, and work alongside them to design solutions. That's why partnership matters. Through Health Equity Wales, we're already working alongside local authorities such as Cardiff on this, and we will continue to put the internationally recognised Marmot principles into practice, strengthening partnerships, listening to communities, sharing learning and driving the long-term cultural and systematic changes needed to reduce health inequalities, because ultimately, as you eloquently mentioned, health inequalities are not inevitable. They are a result of choices, systems and circumstances, and if they've been created, then they can be changed. And that is the work we are committed to delivering.

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7. 9. Short Debate: Life expectancy inequalities in Cardiff’s southern arc cy

   Am rhy hir, rŷn ni wedi adeiladu system sy'n ymateb pan fydd pobl yn mynd yn sâl, yn hytrach na gwneud popeth o fewn ein gallu i helpu pobl i aros yn iach, ac mae'n rhaid i hynny newid. Ni allwn dderbyn Cymru lle mae dau blentyn yn cael eu geni ychydig filltiroedd oddi wrth ei gilydd yng Nghaerdydd, ac mewn mannau eraill o Gymru, ac yn wynebu dyfodol hollol wahanol o ran iechyd, hapusrwydd a chyfle. Ni ddylai iechyd da fod yn fraint. A'r gwir syml yw hwn: ni fyddwn yn cau'r bwlch mewn disgwyliad oes oni bai ein bod hefyd yn cau'r bylchau mewn tlodi, mewn tai, addysg a chyfle. Dyna pam mae atal salwch yn fwy na pholisi iechyd; mae'n fater o gyfiawnder cymdeithasol. Mae'r her yn fawr, ond mae'r achosion yn hysbys, ac os ydym yn ddigon dewr i fynd i'r afael â'r achosion hynny, yn hytrach na dim ond trin y canlyniadau, gallwn adeiladu Cymru lle mae pawb ym mhob cymuned yn cael y cyfle i fyw bywyd hirach, iachach a gwell, a dyna fwriad y Llywodraeth newydd yma. Diolch yn fawr.

   Official English translation

   For too long, we have built a system that responds when people fall ill, rather than doing everything within our ability to help people to remain healthy, and that must change. We cannot accept a Wales where two children are born just a few miles apart in Cardiff, and in other parts of Wales, and face entirely different futures in terms of their health, happiness and opportunities. Good health should not be a privilege. And the simple truth is this: we will not close the gap in life expectancy unless we also close the gaps in poverty, housing, education and opportunity. That's why preventing illness is more than a health policy; it's an issue of social justice. The challenge is great, but the cases are well-known, and if we are brave enough to address those, rather than just treating their consequences, we can build a Wales where everyone in every community gets the opportunity to live longer, healthier and better lives, and that is this new Government's intention. Thank you.

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