There is one remaining item, which is the short debate, and I call on Sioned Williams to speak to the topic that she has chosen.

Diolch, Dirprwy Lywydd. My debate will be on safer skin, the importance of education in preventing skin cancer. 

And I will be giving a minute of my time to Mabon ap Gwynfor and Siân Gwenllian. 

The warmer weather is finally here—well, I think so, anyway—so more people will have put away their heavy clothes and will be spending more time outdoors, whether relaxing in the garden or having fun on the beach or in the park. Summer gives us all the opportunity to enjoy more of what Wales has to offer in terms of our beautiful outdoor spaces. 

When I was a child, my mother always made sure that I had sunscreen on, and when my children were younger I would annoy them consistently by reminding them to use sunscreen and to wear a hat. When I had sunburn—yes, we've all been there, and I'm sure many of us have burned a bit while we've been out canvassing on the streets of Wales for hours over the last few weeks—I would, like many people I'm sure, dismiss it as just a little annoyance or irritation and just a little warning to be more careful in the sun next time. But, in truth, skin damage from the sun isn't just an annoyance.

Exposure to UV from the sun as well as the use of sunbeds is the primary cause of skin cancer. In 2019, skin cancers accounted for almost half of all cancers in Wales—half. And it is by far the most common cancer affecting Welsh people and, sadly, rates are increasing. Between 2016 and 2019, rates of skin cancer increased by 8 per cent, and the condition now makes up an increasing proportion of the workload of dermatologists. This, of course, not only comes at a considerable cost for our NHS, but has a knock-on on the care for other skin conditions. 

Out of the four UK nations, Wales has the highest rates of skin cancer and we now—all of us—have a one in five chance of developing it during our lives. Common symptoms include a sore or area of skin that doesn't heal within four weeks, looks unusual, hurts, is itchy, bleeds, crusts or scabs for more than four weeks, and anyone displaying these symptoms should go to their GP as a precaution.

Although skin cancer is treatable and the survival rate is very high and improving, over 2,000 people will still die each year across the UK; that’s more than six people every day. It’s essential, therefore, that people try to reduce their risk in the first place, and that is why the Welsh Government really need to have a focus on that preventive approach. As with many health issues we discuss in the Siambr, I would argue that we need a better focus on prevention. Because exposure to the sun is the primary cause, most skin cancers are completely preventable through small behavioural changes and protective measures. Just by spending some time in the shade, especially when the sun is at its highest and hottest, wearing light, baggy clothing, wide brimmed hats, UV-protection sunglasses, as well of course as generously and regularly applying at least SPF 30 sun cream with a four-star or above UVA protection rating, we could significantly reduce the incidence of skin cancer.

And I believe our schools can play a vital role in promoting greater awareness of the dangers of sun exposure and the simple measures like these that can be taken to reduce risk. The World Health Organization recommends sun safety in schools, calling it a cornerstone of skin cancer protection. In England, schools are required to ensure that pupils can, by their final year of primary school, know about safe and unsafe sun exposure, and how to reduce the risk of sun damage. The charity Skcin—which is spelt S-K-C-I-N—offers an accreditation programme that provides primary schools free resources to assist them in their duty of care to safeguard children against UV and prevent skin cancer. There has been limited roll-out in Wales, but the schools that have made use of these resources have praised them for the way they've helped increase awareness amongst pupils and staff.

In terms of what we are doing here, sun safety is recommended as part of Public Health Wales's network for healthy schools scheme, although this is not enforced. ‘A Cancer Improvement Plan for NHS Wales 2023-2026’ states that between 30 per cent to 50 per cent of cancers occur as a result of exposure to avoidable risks, and then prevention will be a key area of focus.

Twelve years ago, following a petition by Tenovus for all children under the age of 11 to be provided with free sunscreen, the Children, Young People and Education Committee of the Senedd conducted an inquiry into school sun protection policy. At the end of the inquiry, they made several recommendations, including that schools should be required to have a document setting out the school's approach to a range of environmental factors that might affect children during the school day, such as including sun protection and shade requirements; consideration should be given to the equipment provided to, and the school requirements for, children in the foundation phase to ensure that they are suitably protected to be outside in a range of weather conditions; the Welsh Government, Welsh Local Government Association, schools and third sector organizations should continue to work together to deliver sun protection education to children.

Sadly, despite 12 years passing since the committee reported back, and an initially encouraging response from the Welsh Government, a research project at Swansea University has found that several recommendations have not been upheld. That research project, Sunproofed, led by Dr Julie Peconi of the School of Medicine at Swansea University, funded by Health and Care Research Wales, found that only 39 per cent of schools that responded to their survey had a sun safety policy, and that not all schools with policies actually enforced them. Schools with higher percentages of children entitled to free school meals and with lower attendance were less likely to have a policy. Only 29 per cent of schools teach sun safety as a part of the curriculum in every year group. Only 5 per cent of schools had sufficient shade for most active outdoor pursuits. Only 8 per cent of schools include sun-protective hats as part of the school uniform. Welsh-medium schools and schools in north Wales were more likely to have a policy, which I believe demonstrates the fact that sun safety is not being taught in a consistent way across the Welsh education sector and local authority areas.

Schools that did have a formal sun safety policy or procedure were over six times more likely to liaise with school governors regarding sun safety; over five times more likely to include sun awareness guidance in their staff manual; over three times more likely to send out communications to parents regarding sun safety; and over twice more likely to include sun protection as part of the curriculum in every year group than to include it in some year groups only and discuss in an assembly as the need arose only. And also, they were more likely to encourage staff to model sun safe behaviours for students, to have spare hats that pupils could borrow and were more likely to schedule outdoor activities to minimise time outdoors between 10 a.m. and 3 p.m. in the summer term or when the UV index was above 3.

This extremely revealing and important research also included sun safety quizzes with pupils in years 3 to 6 in five primary schools in south Wales. It found that only 5.7 per cent of those pupils were aware that sun protection is needed when the UV index reaches 3, and only 36 per cent knew they could get sunburnt on cloudy days.

I understand that the Cabinet Secretaries for education, climate change, and health, as well as the Chair of the current Children, Young People and Education Committee have received a letter from Dr Peconi regarding the findings of her research. In light of the previous inquiry and this more recent research, I would therefore be keen to learn what steps the Welsh Government are taking to advance sun safety education in our schools.

Education will go a long way towards reducing skin cancer rates, but awareness and understanding are not the only challenges we face, of course. The cost-of-living crisis pushed up the prices of all household essentials, including sun protection. A recent analysis of ONS data has shown that in the last two years, the cost of sunscreen has increased by almost 30 per cent, while recent sales figures suggest that there may be some impact on the number of sun care products purchased.

Dr Bav Shergill of the British Association of Dermatologists said that:

'As sunscreen prices go up there's a distinct possibility that people will use it less, which could put them at great risk of cancer.'

This point is reinforced by a survey from last year, undertaken by Melanoma Focus, which found that nearly half of respondents thought sunscreen was too expensive, and Tenovus Cancer Care raised concerns that sun protection would be left off the list of household priorities. Most worryingly, 10 per cent of respondents said they never wear sunscreen.

Even with those who do purchase sunscreen, concerns over costs may be encouraging them to use less therefore than they should. We know that prior to the cost-of-living crisis most were not applying enough sunscreen, and this situation is unlikely to have got better, of course, as the price has gone up. As a guide, adults should be aiming to apply around two teaspoons of sunscreen if you're just covering your head, arms and neck, or two tablespoons if you're covering your entire body while wearing, for instance, a swimming costume, because if applied too thinly, the amount of protection provided is greatly reduced. And, of course, it should be re-applied every two hours.

Despite its essential role in protecting our health, sunscreen is currently classed as a cosmetic product and subject to the full rate of VAT. Amy Callaghan, who until recently was an MP for East Dunbartonshire, launched a campaign to have VAT removed from sunscreen as it is in many other countries. This campaign is supported by a number of charities and has also received cross-party support in the House of Commons. I know, of course, we don't have the power to vary VAT, but I would be keen to know whether the removal of VAT on sunscreen is something this Government would support and will take up with the next UK Government.

Some foodbanks have even started to include sunscreen as an item that they provide, but only a small number of foodbanks do this at the moment. The Government has, quite rightly, invested in improving access to menstrual products in schools, so I'd like to know whether the Government has considered investigating the feasibility of providing high-quality, effective sunscreen to schools. Also, in terms of the cost element, outdoor activities that can expose children to direct sunlight for long periods, such as going to the beach and parks and so forth, tend to be free and therefore more attractive to those on tighter budgets.

During the pandemic, Governments around the world took unprecedented measures to protect public health. We are currently facing increasing rates of skin cancer, more people being diagnosed with cancer and receiving treatment, as well as those costs, the increasing costs to the NHS. We saw during the pandemic how hand sanitiser, for example, became regularly and freely available to the public. I wonder whether sunscreen could be made available in similar dispensers in public sector workplaces, schools and hospitals. Most skin cancers are preventable, but they can be deadly. So, what are we going to do to ensure that they are prevented effectively?

This is a matter of the utmost importance. We know that climate change is affecting skin cancer rates, and will continue to have an effect as temperatures continue to rise. By implementing sound public health policies now, we can mitigate this growing health crisis, which will be exacerbated by climate change. We must see this through the lens of the well-being of future generations, and we must give this issue the serious attention it deserves. I look forward to hearing how the Government intends to act to ensure this. Thank you.

Cancer does or has touched almost every family in Wales. Twenty five years ago, my husband, Dafydd, died having been diagnosed with skin cancer, melanoma. He was 47 years old and he was the father of four young children, with the youngest just three years old. At that time, there wasn't must talk of melanoma or much discussion of it, but, now, it's well known that skin cancer is one of the most common cancers in Wales, and cases are increasing. But there still isn't enough discussion of the issue and the practical steps that everyone can take aren't given enough coverage either—practical steps to protect the skin from the dangerous rays of the sun. And I agree, therefore, that we need a focus on educating children and adults on the practical preventive steps they can take to mitigate risks.

Melanoma does steal loved ones away from us, but there are ways of helping, there are ways of mitigating the risks, and we must draw the attention of the people of Wales to those, and I think that the state here in Wales is duty bound to lead on that work.

Thank you very much, Sioned, for bringing this debate forward. It was very interesting to hear the recommendations on how much sunscreen to apply. My children will be very pleased to hear that, because we tend to lather them with too much and they look like zombies by the time we've finished. [Laughter.]

But it is important when you consider that cases of skin cancer in Wales are increasing, as you've said, and that we have more cases here in Wales than in any other nation of the UK. And it can happen so easily without us even knowing, which is why Sioned's debate is so important, and she's right, therefore, in calling for education for children about the condition within our schools and at a young age. And in understanding that only one in three children in Wales are educated does show that deficiency in the system.

Given, therefore, that cases are increasing, this does show the need for us to develop a comprehensive cancer plan in Wales, such as the cancer plan that Plaid Cymru is putting forward, which will lead to identifying patients earlier and better diagnostics for other cancers too. So, I look forward to hearing the Minister's response and, specifically, how the Minister believes that we can tackle that issue of how we educate children and young people on the dangers of skin cancer. Thank you very much, Sioned.

I call on the Cabinet Secretary for Education to reply to the debate. Lynne Neagle.

Thank you, Dirprwy Lywydd. And can I thank Sioned for bringing forward this debate, which has been really informative and very thought provoking? As Sioned highlighted, skin cancer is by far the most common cancer in Wales. There were around 15,000 recorded cases of non-melanoma skin cancer and 1,000 cases of melanoma in 2019. And, as Sioned highlighted, the cases are rising. Siân, I wasn't aware that your husband had died of melanoma, I'm really sorry to hear that, and thank you for sharing that experience with us today.

We remain, as a Government, committed to improving the qualify of life for everyone in Wales, and this, of course, includes a focus on cancer prevention and education that supports health and well-being more broadly. Sun safety is a key part of skin cancer prevention, and education in this area is key. This is currently, as Sioned highlighted, supported by the Welsh network of health and well-being promoting schools, supported by Public Health Wales. The network is responsible for maintaining and promoting the well-being of all learners. Local co-ordinators signpost and share information and resources with schools to support sun safety across Wales.

Public Health Wales also provides a range of workforce development opportunities for local health and well-being promoting schools co-ordinators to remain up to date with current issues relating to sun safety, which they can share directly with schools, so they address issues with learners and parents. The network's proposed minimum standards describe the core components of a whole-school approach, and while these are not topic specific, a number of these standards support the development of appropriate policies and practices around sun safety, including learning through the curriculum.

I am aware of the Swansea University-led project, which is currently working with schools to help explore the current perceptions of tanning in children, parents, carers and educators, and the results of this project will support the development of new educational resources aligned to the Curriculum for Wales. I haven't received—at least, I haven't seen—a letter yet from the researcher, but I will make sure that I follow that up and ask for a copy of her research. Public Health Wales has arranged for the academic leading on this project to present at its Welsh network of health and well-being promoting schools meetings, which are taking place this week in north and south Wales.

In addition to this vital public health work, the Welsh Government provides advice and guidance for all schools and settings to support them to keep children and young people safe on extremely hot days. This, of course, includes practical advice on the importance of maximising shade, restricting time in the sun during outdoor activities and the use of sun covers. Within the guidance, there are different risk assessments that schools can draw upon to implement additional safety measures for their children and young people as necessary.

Education, of course, is crucial to support learners to develop health-promoting behaviours, and at the heart of the Curriculum for Wales framework are four purposes that are central to every decision made about the new curriculum. One of those four purposes is to support children and young people to become healthy, confident individuals. The Curriculum for Wales makes health and well-being a mandatory area of learning and experience for the first time, underlining our commitment to the health and well-being of learners. For the first time, health and well-being have equal status in law to other important areas of the school curriculum, and schools are expected to deliver teaching as part of their curriculum from early years through to 16. Since the roll-out of the Curriculum for Wales, we've worked closely with our partners, including Public Health Wales, to support teachers to deliver this.

This area of the curriculum provides a holistic structure for understanding health and well-being. The mandatory statements of 'what matters' code specifies that developing physical health and well-being has lifelong benefits. This aims to help learners to understand the factors that affect physical health and well-being, including health conditions, physical activity, nutrition and the importance of a balanced diet. As learners progress, other statements of 'what matters' that are relevant to this topic consider the assessment of risk, the importance of good decision making and the role of social influencers in their lives. This new focus will help children and young people to foster healthier and safer lifestyle choices throughout their lives and support them to understand the risks and dangers on a range of challenges and issues. Exposure to the sun or sunbed use, which is banned for under-18s in Wales, are obvious examples where learning in the Curriculum for Wales can support learners to make healthier choices informed by the evidence.

Innovative work and learning on cancer awareness and prevention is happening in schools in Wales. A project co-ordinated by several secondary schools across Rhondda Cynon Taf developed a learning programme aiming to raise awareness of bowel cancer. This was implemented through Pontypridd High School's work with the Moondance Cancer Initiative. Through a partnership approach, which included the council and Cwm Taf Morgannwg University Health Board, the programme produced learning resources and experiences for their learners. This includes understanding cancer screening, how to use a test kit, and developing materials to engage parents, carers and the wider community, which promoted key messages around prevention, screening and early symptoms. The programme helped improve the learners' understanding of cancer, and, in particular, bowel cancer, from causes to screening and recovery rates. The importance of screening as a part of this learning was crucial, because early diagnosis and treatment brings much higher survival rates. This was an effective programme that innovatively and creatively tackled a sensitive yet important topic. This is a great example of how schools have collaborated with learners and their families, with an aim to improve outcomes for their community, with the Curriculum for Wales values at its heart.

Although the focus of the project was bowel cancer in particular, a similar approach could be taken to support to skin cancer prevention and other conditions. These are the sorts of opportunities that the Curriculum for Wales provides for schools, and I am keen to see more of these types of innovative learning experiences that are so relevant to learners and their communities. That is the role that schools can play in issues like this, providing learning that helps learners understand health-related issues, builds their confidence in grappling with these topics and to make informed decisions that support their own health and well-being. But we also cannot forget that cancer prevention is an issue for the whole of society, not something that we can place entirely on the shoulders of schools. 

Can I just conclude by thanking Sioned Williams for bringing forward that debate? Eluned Morgan has also heard the debate today. I give her my assurance that I will look at the research and also the links with the previous recommendations of the Children, Young People and Education Committee, which, for some reason I can't understand, I don't think I was part of. I will make sure that I see what has happened with those recommendations. Diolch.

Thank you, all. That brings today's proceedings to a close.

The meeting ended at 17:47.