Part of 2. Questions to the Cabinet Secretary for Health and Social Services – in the Senedd at 2:50 pm on 31 January 2018.
Thank you, Dai. A couple of things here: one is that, as you know, in stark contrast to what has happened over the border—I don't want to compare with what's happened over the border—what we have done is, in health and social care combined, which is the approach that we're taking, based on the Social Services and Well-being (Wales) Act 2014 and other legislation here, about that idea of integration. Similarly with the funding, there is more going into health and social care here in Wales than there is across the border. But we still know the strains on the system.
In addition to that, I have to say, these ideas of how we make that money go further—well, I've had repeated meetings, and very productive meetings, I have to say, over the last few months that I've been in post with, for example, the regional partnerships. The idea that we should do more joint commissioning—how do we actually make a bigger bang for our buck, so that we can say, 'Well, we've identified what the care accommodation needs are for the elderly'? We could apply this to other areas of thinking as well. How do we collectively say, 'We'll look at what we've got together'? How do we, on a regional footprint, provide for that and get bigger delivery—deliver more care homes and deliver more places and better outcomes for people?
One important thing with that is, I have to say, as tricky as it is, the issue of pooling budgets. This is tricky, because we're all elected Members—we have the mindset of an elected Member as well as sitting here thinking about policy in a highly strategic way. We know how difficult it is for people to say, 'Well, pooling budgets—doesn't that mean that we have to give up a little?' In some ways, yes, but if it delivers the right outcomes in terms of social care then we should be looking at that.
There are things in Wales that we can do more cleverly, more sharply and differently, and we should be doing that. But, ultimately, Dai, I agree with you—there is the bigger challenge going forward, both in health and social care, which is in the thrust of the health and social care review, which is looking at them together. That seamlessness of the pathway for somebody who is a constituent or a patient of yours—that they don't have to think about who's dealing with them or what authority is doing it, but that it feels like a wraparound. I'm convinced, as we look at some of the models with ICF funding, that that is absolutely the way that we should be going.