3. Will the First Minister make a statement on the contribution of people from outside Great Britain working in the NHS and social care sector in Wales? OQ61358

Yes. I'm very proud to recognise that we greatly value the contribution of our international workforce in Wales today, but also from the very history, from the start of our national health service, which celebrates yet another birthday on 5 July, and I hope it has an early birthday present with a change in Government at a UK level. The vital work that our workforce do in health and social care, whilst recognising any recruitment from overseas, must be ethical and not to the detriment of services in the countries from which we are recruiting.

Diolch. Last week I visited two care homes in Swansea East, where I met carers from Guyana and Trinidad and Tobago. I've also visited schools and met with children of health workers in Morriston Hospital. I want to stress the importance of overseas workers to health and social care. On leaving the EU, we had a large number of southern and eastern European dentists here, but they left. Whilst welcoming the work being done to train more dentists, what can the Welsh Government do to increase the number of EU dentists practicing in the NHS in Wales back to the number we had before we voted to leave?

Well, I'm not sure, entirely, of all of the numbers on European dentists who continue to work in NHS Wales. The positive news in dentistry, though, is that we still recognise the same qualifications. There are other parts of our health and care system where that is not the case and it makes recruitment much more difficult.

I regret the fact that some people did leave after 2016, and I recognise that one of the things we can do to actually encourage people to stay or to come to work in Wales is actually the way in which we talk about the rest of the world, the nature of our relationships. We can't say to people that we regret the fact that we have to talk with and work with their country and then expect people from those countries to come and work and to feel welcomed and included in our country and our society. So, the change in the tone of our conversations with the rest of the world really does matter, as well as, of course, the direct details on how people can come into the country to work in health and social care services, including dentistry. That goes alongside our plans to increase our ability to train people from Wales. And if you think about what we already have done and the statement last week from the health Secretary about the extra investment we're making in health and care professionals, the extra investment we'll make in the future of doctors here in Wales when we open a brand-new medical school in Bangor this autumn—all things that we are doing, all from budgets that Welsh Labour Members have voted for. And if we have a different UK-wide relationship, I believe we'll be in a much better position to recruit and retain people from around the world in a fair and ethical way, just as the Member suggests.

Coming to the ethical issue, First Minister, as someone born outside Great Britain, who spent their career working in the NHS, I can personally attest to the contributions that overseas doctors, nurses, healthcare professionals and carers make to our health and care system. But I'm also acutely aware of the downsides of our reliance on overseas workers, namely we are denying their country of origin of their talent. As a doctor from Kashmir, one of my biggest regrets is the fact that healthcare in my country of birth has continued to decline, with nowhere near enough medics. It is the same across the Indian sub-continent, the Philippines and large parts of Africa. Their best and brightest come here for better wages and working conditions, while healthcare at home struggles to find staff. First Minister, do you agree that our reliance on overseas staff is doing a disservice to many poorer nations? Will you outline the concrete steps you're taking to train and retain British citizens as doctors and nurses?

I thank the Member for his question. I do want to just recognise that I don't welcome his views on politics—we disagree and we're in different parties—but I do recognise and welcome his public service contribution in our health service. It's part of the success story of our NHS. If anyone goes into an operating theatre in any NHS hospital in Wales or across the UK, they'll see that international success story in front of them. It's part of how our health service was created and how it's sustained. In addition, of course, we do continue to invest even more in training record numbers of staff here in Wales. If you look at nursing numbers, midwifery numbers, physiotherapists—a whole range of areas where we've deliberately increased our investment in training, and the health Secretary set that out last week—. That's in addition to what we're doing in the new medical school that will open in Bangor, and in addition to what we've successfully done in the last five-to-six years in sustainably increasing general practitioner trainee numbers as well. 

In addition to that, we do recruit people from other parts of the world, and we do so in a way that is sustainable and ethical. A good example of that is in Kerala, an Indian state where they deliberately overtrain and oversupply health and care professionals. We have an agreement to recruit 250 nurses and doctors from Kerala because we have an ethical partnership with them, and this is a deliberate choice where people want to work in other parts of the world, where they still have family links to go back, and we're proud of the duality in that. I'm someone who was born in a different country as well. I'm here and I'm perfectly capable and able to celebrate my mother's heritage—the place of my birth—and my father's birth in Ogmore-by-Sea. That's who I am and part of the story of our country, and the success of our country, moving forward. So, we'll continue to train and recruit within Wales and the UK. We'll also continue to undertake ethical recruitment from other parts of the world, and the Kerala agreement that the health Secretary signed with the Chief Minister of Kerala is a good example of that.

Mike Hedges is quite right to point out the importance of foreign workers in the care sector. Mike referred to people from Guyana and Trinidad, for example; I am aware of a number of people from Nigeria working in north Wales at the moment and appreciate the work that they do. But, of course, the current Conservative Government brought in a ban on visas for partners and families of many of these people who come to work in our care sector, which, in turn, causes difficulties, not only in the care sector but also in the health sector. Now, very recently—around a month ago, I believe—Wes Streeting from the Labour Party, who is going to be health Minister in Westminster, said that Labour didn't have any intention to scrap that proposal to ban visas for the families of workers in the care sector. Is Wes Streeting right in saying that and do you agree with him? 

I think we need to look at how we recruit people sustainably from other parts of the world, and what that means for them to be recruited here. We also have a wider issue about, actually, having a rational conversation around immigration, which has not taken place in the last 14 years. I believe we need to look at the whole picture when doing that successfully and sustainably. We also need to balance our ability not just to recruit from other parts of the world for the care sector in particular—. If I may, Llywydd, it's worth pointing out that the care sector isn't just there to help the NHS—it's a crucial part of how flow takes place in our NHS and getting people out of an NHS bed when they don't need to be there, but it's also a place of real value of and for itself; I know that in my own family, and other Members here will do as well.

So, what we also need to do, alongside recruiting people from other parts of the world, is to raise the aspirations and the image of people in the care sector. It is too often seen as work that does not count for the same value as others, and it should not be the case. That's why I'm really proud that in the manifesto that is going before people on 4 July, there is a commitment to look at social care, to look at how we fund it properly, and as the first area within the new deal for working people to have a fair pay agreement, it's social care that is being targeted. Having proper pay within the social care sector would make a really big difference for people to go into it, as well as the qualifications alongside it, and that's part of the rational debate around the future to ensure we have the people we need in all aspects—the people that we need—whether that's international recruitment, or, indeed, how we train and sustain a workforce here for ourselves. 

Diolch, Prif Weinidog. I'm sure we've all seen here today the contribution at first-hand that people born outside the UK make to social and healthcare here in Wales. As Mike Hedges indicated, over the past few years, I saw a decrease of workers in care homes from eastern Europe and an increase of workers from the Indian sub-continent—from India and Bangladesh, in particular. And I'll be eternally grateful for the care they have given, often, as Mabon indicated, leaving their own family members, their loved ones, behind. I remember speaking to one individual who was in her tears—an individual from Bangladesh—who couldn't go to her mother's funeral because she was working in a care home here in Cardiff Bay. As you said in your first answer, a change of tone in the conversation is needed, and you'll be more than aware that comments said last week by the leader of the Labour Party were very hurtful indeed to members of the Bangladeshi community—a large section live in your constituency. Will the Prif Weinidog take this opportunity to say that the Bangladeshi community in Cardiff and throughout Wales is valued, and to thank them for their incredible contribution to Wales, to our nation? Diolch yn fawr.

I think it's important to reflect that, following the on-stage question and answer that took place, the leader of the Labour Party quickly reflected on some of the phrasing used in responses, recognising he'd misspoken at one point, and actually reiterating the long-standing relationship we have with Bangladesh and its people, around a whole range of areas of activity, not just in health and social care, but in the economy, too, as well.

I'm very proud to represent Cardiff and Penarth Bangladeshis in this Parliament. I'm very proud of what they have brought to the story of Wales. And if you think about what Wales is today, there are many parts of Wales that just wouldn't be Wales without that international story, from food to art to culture, and how we see ourselves and our place in the world. I'm really keen that Wales continues to be an outward-looking, positive international partner. We've done a great deal more of that in the last decade, and I'm very proud of the fact we've done that. I hope that Britain too can be a much better member of the family of nations in the future, standing up for our interests, but being a genuine partner that wants friendship and partnership with the rest of the world, rather than conflict and deflecting of our own challenges here. I believe we could see that after 4 July.