2. What is the Welsh Government doing to support mental health provision in Mid and West Wales? OQ59666

Llywydd, we continue to provide significant and sustained support for mental health. In addition to the mental health ring-fenced allocation, Powys and Hywel Dda health boards have received £4.5 million in recurrent funding to improve mental health services over the last two years.

Hywel Dda is strong on mental health. It's the first health board in Wales to roll out the 111 press 2 service, where people can speak to a mental health practitioner 24/7, and it's currently piloting a number of forward-thinking alternatives to admissions, like sanctuaries for children and young people. So, there's a lot of great work that is happening. But, last week, I visited Shadows Depression Support Group in Garnant, which is facing funding cuts. They are doing vital work in the community, and it would be a significant blow to lose that support. So, post COVID, can you assure residents of the Amman and Gwendraeth valleys that mental health provision will remain a priority for your Government?

Llywydd, I thank Joyce Watson for that, and I thank her for what she said about the work that goes on in the Hywel Dda health board. She's absolutely right that the 111 press 2 service has been pioneered in Hywel Dda, and the sanctuary service for young people suffering from mental health conditions—the sanctuary model that we've developed as part of the co-operation agreement—the first practical services opened in Haverfordwest, which will be very well known to Joyce Watson.

As far as the Garnant service is concerned, my understanding is that this is a decision of the local primary care health cluster. So, these are GPs who get together to commission services. They are often time limited. It's the job of the cluster to review the service, to decide whether that investment is giving the greatest return for their local populations. Now, the Minister responsible for mental health services will be in Hywel Dda next month, together with the designated Member, and I'm sure there will be opportunities to discuss the progress that is being made in pan-Hywel Dda services, but also to take up some of the specific points that Joyce Watson has raised this afternoon.

First Minister, residents in my constituency and across Wales are having to leave the country to access specialist eating disorder services. The charity Beat has called on the Welsh Government to ensure there is specialist treatment at the earliest opportunity. A Welsh Government spokesperson said you were working with NHS Wales to scope the feasibility of a specialist eating disorder unit here in Wales. I'd like to associate myself with the comments of your backbench Member Sarah Murphy, who has said that we need timescales of when this is going to be delivered. So, First Minister, can you confirm today what progress you have made on this? And when are we going to have a specialist eating disorder service centre here in Wales to serve those people who need it? 

Well, Llywydd, first of all, let's be clear it's always been the case that, in Wales, we sometimes think it is clinically better for people to access specialist services that are provided across the border. I'm not a nationalist in the way that the Member appears to be. I think it's perfectly possible—. The Member shakes his head. His question to me was that somehow it is preferable for services to be provided in Wales than across the border, and I make the point to him that, sometimes, on a population of 3 million people, a specialist service will be better provided across our border. That has always been the case over 20 years, and, for certain specialisms, it will continue to be the case in the future. And a single eating disorder service for Wales—a single centre—would be far more geographically inconvenient for some parts of Wales than services that can be accessed more readily across the border in England. I have no objection to that because I think that is a better service for patients.

Nevertheless, the Welsh Government provided additional targeted service improvement funding of £2.5 million in the last financial year to recognise the priority of eating disorder services, and health boards have been identifying those local needs and seeing whether they aggregate into a case for a national service for some aspects of eating disorder services. So, that case is being assembled, and it will be for the Welsh Health Specialised Services Committee to decide whether or not that service amounts to something that they would regard as to be funded. But the general point I return to it is where you have very particular needs, and the needs of some people with eating disorders are very particular indeed, a population of 3 million people will not support a service of that sort, and we should not feel hesitant about accessing that service elsewhere where that is in the interest of those patients.

I am meeting the Shadows Depression Support Group in the Amman valley on Friday, and I have to tell the First Minister that the news that this service is due to close in September has caused great concern for the 1,600 people who use the service at the moment. We must also bear in mind the waiting list in the Hywel Dda area for those that need therapy for mental health issues, where over 50 per cent are waiting over six months. So, what can we offer in terms of providing hope and assurance to them? I understand the point the First Minister made, that this was a decision from the local medical cluster, but is there a national framework in terms of assessing the costs and benefits of these decisions, and is there direct funding available for situations where, because of these decisions, there will be gaps in provision for these people? Shouldn't we ensure that there is continuity of support for people who truly need that support in the Amman and Gwendraeth valleys?

I thank Adam Price for that supplementary question. He reflects what Joyce Watson has said already. Of course, I acknowledge the fact that, when services change, that does lead to concerns among some people, particularly those who have accessed the service that is already there.

But the purpose of creating a robust cluster with direct funding that goes straight to them is to provide them with the ability to make decisions. That's the purpose of what we have been developing for a number of years now, and for me, it is important to give that flexibility to local people who are close to the communities that they serve, to use the funding and the budgets that they have in a way that they assess will be effective in future.

I'm sure that the Minister will be able to speak, when she is down in Hywel Dda, with the health board about what is happening in Garnant. It's important to me to adhere to the principle whereby the decisions are made by the people on the ground, with all of the information that they have about local need, and what the most effective way is to respond to those needs.