Diolch, Ddirprwy Lywydd. I welcome this debate and move our amendments. Perhaps I might also mention that Members will have the opportunity to develop the positions put forward today in a debate that the Welsh Conservatives will be tabling in the next few weeks. I think we should really keep this in our line of sight. It is something we should be discussing often, particularly with the Cabinet Secretary’s parliamentary review ongoing.

Good social care is affected by a number of complex concerns because our constituents have complex needs. It isn’t open to a homogenous solution because we’re not a homogenous Wales. Labels like ‘integration’ can’t be seen as a silver bullet any more than Welsh Government can be seen as a golden goose. Integrating systems that are themselves imperfect and unequal in status presents its own dangers as well as some really, really exciting and good examples. But, why so narrow a path to a fundamental systemic change, which is what we may actually need?

I certainly don’t want you to think that I don’t believe that integration is the wrong way to go—isn’t the wrong way to go—but how far and how broad? Do we really want everything co-located in hospitals? Are we talking about a national care service that effectively disconnects the district general hospital space from a new leviathan responsible for primary, secondary and social care, maybe even removing strategic responsibility from local authorities altogether? Do we want a network of Builth models or Prestatyn models? Do we transfer all social workers into the NHS or all occupational therapists out into local authorities? How much responsibility do we place on the individual or their family or their bank account or the public purse?

I don’t think that the Government’s parliamentary review can blink when faced with transformational visionary change, and I hope that it really uses this period of experimentation, if you like, with the intermediate care fund as evidential but not the final answer. Revolution or evolution—I’m actually quite open-minded to either course there, as long as there is resolution in both senses of the word, but we won’t get that unless we look beyond the NHS and social services.

To the motion—points 3 and 4 first. Opposition of all colours, or parties of all colours, made the case in the last Assembly, as they already have in this Assembly, that the closure of community hospitals has gone too far—manifesto commitments all round. Yes, some buildings needed modernising or replacing, but what we really mourn is not the buildings but the beds. It is the closure of community hospitals and the loss of their beds that the Welsh NHS Confederation, in their meeting with me last week, called the ‘turning point’.

Every one of us will say that an individual’s better off at home with an appropriate enabling or reabling care package, but there’s no plan B, is there? Keeping people in acute beds or commissioning step-down places in residential homes is not the flexible or wide range of settings referred to in the Government amendment. We now need the community beds to protect people from a new institutionalisation in acute beds created by delayed transfers of care. These community beds are no longer the cause of institutionalisation.

Allied healthcare professionals are likely to get a more accurate assessment of someone’s ongoing support needs from a community bed—obviously, maybe not as accurate as in an individual’s home, but that still has its risks where assessment is not met by immediate provision. Until we can fully satisfy patient need by opening new community beds as part of their respite and reablement, perhaps in new settings, then Government should listen. In this and the last Assembly, which was also in balance, let me say, all opposition parties representing their constituents have been telling you to stop closing community hospitals.

We’ll be supporting point 1 of the motion, and our amendment to that just emphasises what’s now axiomatic: reabling care or delaying the need for hospital admission in the first place—that’s what we want for our constituents and that’s what we want for the NHS. You can’t get that contribution to sustainability without these guys, not just with physical care but psychologically too, because if you feel in control of your medical and personal needs—feel that they’re being met—you may also feel confident enough to ask for help with your social needs, and loneliness is the example that we’ve all been talking about recently.

Finally, point 2 of the motion and our second amendment—well, yes, of course, unpaid carers make this contribution to sustainability, and meeting their needs is part of meeting the needs of the cared-for, which is why I’ve used section 35 of the Social Services and Well-being (Wales) Act 2014, rather than section 40, in the amendment. I hope it won’t be rejected simply because I didn’t list nine separate sections from that Act. This is my clumsy attempt to say that social care is about a group of people of all ages, however it’s chopped up in legislation—the cared-for, first and foremost, but also carers, care workers, health workers, housing providers, house builders, families, charities, neighbourhoods, energy companies and, yes, even managers and politicians. We need to lift our heads a little on this, and looking at the NHS integration agenda means that we’re just looking for half a solution. Thank you.