3. Will the First Minister make a statement on the NHS estate in North Wales? OQ59737

Llywydd, the capital programme in health and social care in Wales exceeds £375 million in the current financial year, and rises again next year. Local health boards must prioritise their own proposals for investment in the NHS estate and then submit business cases to the Welsh Government.

First Minister, it'll come as no surprise to you that I'm going to ask again: where is the investment for the north Denbighshire community hospital? We know that, down the road from the proposed location of the north Denbighshire community hospital in Rhyl, we have a hospital in Bodelwyddan that is really struggling. In fact, it has the worst A&E performance against the eight-hour target and the worst A&E performance against the 12-hour target in Wales, and that is unacceptable. We have one in five people waiting over 12 hours in A&E to be discharged. Now, clearly, there needs to be some action.

One of the solutions that has previously been supported by the Welsh Government has been the establishment of a new north Denbighshire community hospital, with a minor injuries unit, to take pressure off Glan Clwyd, but we're yet to see a spade in the ground, and it's been 10 years since the hospital was promised. When can the people of my Constituency, and people elsewhere in north Wales, who could be served by this hospital, see that work under way?

I thank Darren Millar for the question. Of course, as he says, I'm not surprised to hear him raise the issue, because he has raised it persistently and powerfully on the floor of the Senedd. As I've said to him previously, however, a strategic outline case that came in at £22 million is now a full business case reported at £72 million, and that is such a material change in the proposal that the discussion between the Welsh Government and the board has to continue. Now, the health Minister met the board and said in terms to them that they, with their partners, have to prioritise the many schemes that the Betsi Cadwaladr University Health Board has in the making. And, when we receive that sense of prioritisation, which is yet to be delivered to the Welsh Government, then we will be able to make decisions in relation to the north Denbighshire community hospital. In the meantime, I fully understand why the local Member goes on making the case that he does.

I agree that we desperately need to invest in our NHS estate in Wales—in north Wales in particular. But I also understand that building costs have increased by 40 to 50 per cent, due to inflationary pressures. A lot of it's caused by Liz Truss's mishandling of the economy, of Brexit, as was mentioned earlier, and that capital funding has decreased in real terms from the UK Government. Neither the Welsh Government's borrowing limit, nor the draw-down limit of its reserves, have been operated since 2016, something that the Institute for Fiscal Studies have argued should have happened. And by not doing this, the Welsh Government has been unable to access the necessary funds of this flexibility to address the serious challenges we face in Wales to the extent that it should be able to. Our budget has also decreased in real terms since it was set in 2021 as part of the UK's spending review, compounding the position further.

So, First Minister, do you agree with me that it's the UK Government that is denying Wales the funding that it should be able to call on to invest more in public services and the public estate, such as our hospitals?

Well, Llywydd, a series of Members this afternoon are making the case for additional investment in infrastructure here in Wales. We heard it from the leader of Plaid Cymru in relation to transport, and Carolyn Thomas makes a powerful case for further investment in the infrastructure of our health service. But here are three key facts in all of that, Llywydd: first of all, inflation is eroding the real value of the budgets we currently have—the £375 million available to the NHS will not achieve the impact that we expected it to achieve at the point that that figure was initially set.

Secondly, not only is the value of the Welsh budget being eroded by inflation, but the cash available for capital investment is going down. In 2024-25, there will be a further 11 per cent reduction in the capital available to the Welsh Government for all the purposes that we have to discharge. Indeed, in the spring statement, Members here will remember that the total additional capital investment made available to the Welsh Government for that hospital in Denbigh, for transport in north Wales, for the housing that we need in every part of Wales, as we heard earlier, was £1 million—£1 million for all of those purposes that we have to discharge here in this Senedd. That is the root of the answer to so many of the questions that have been raised here this afternoon. You cannot invest in the way we would want to when we're denied the investment we need.

And my third point, Llywydd, is this, and it was echoed in what Carolyn Thomas said: the borrowing limits available to the Welsh Government were set in 2016. They have not risen by a single penny since then, despite the fact that every single year, the real value of that borrowing goes down. No sensible person that I know of, other than successive Chief Secretaries to the Treasury—I think my colleague the finance Minister is on her seventh or eighth Chief Secretary since she took office—nobody sensible argues that those figures should not be increased at least in line with inflation. And yet, while the case is made time after time to the UK Government, they refuse to take even that small and sensible step to restore our ability to borrow to the level that that Government agreed was necessary for Wales back in 2016.