9. Statement by the Minister for Housing and Regeneration: Integrating Housing, Health and Social Care

Part of the debate – in the Senedd at 6:48 pm on 26 June 2018.

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Photo of David Lloyd David Lloyd Plaid Cymru 6:48, 26 June 2018

Can I welcome this statement from the Minister for Housing and Regeneration? I very much welcome it, and welcome the direction of travel as well. Naturally, we would welcome £105 million capital spend as well. In terms of the background, obviously there's mention of Aneurin Bevan. There will be a lot of mention of Aneurin Bevan over the next couple of weeks, I suggest, and, yes, he was the Minister of housing as well as health, and up to 1951 housing was part of the department of health at Westminster level. Then, for some reason, it got split off, but that link between housing and health is absolutely that intimate, and we should be reinstituting that link, frankly, because bad housing equals bad health. We have homeless people on the streets of Wales today, and their life expectancy is 47 years, while the rest of us are going to live to beyond 80. So, bad housing indeed equals bad health.

In terms of the other situation in terms of people always asking me, 'How are we going to deal with this huge expansion in the number of elderly people and their care requirements and their health requirements?' And I always say, actually, we need to start with their housing. We need a huge expansion of the sheltered accommodation principle, whereby this requires a culture shift amongst our people as well, in terms of planning ahead and thinking, 'How am I going to spend my latter years?' I would suggest in some sort of sheltered accommodation. There are excellent projects dotted around Wales and the United Kingdom—yes, it's a housing solution and people have wardens there looking after them. In the same complex, Scandinavian village-type model, it can get more intensive, then, in terms of—. There's a sort of nurse equivalent—there's a nursing-home-type situation in the same complex, and there are also advanced dementia care beds, again in the same complex, so that people move in, and then if their health deteriorates, they just move to a different part of the same complex—they don't have to leave, so, hence, couples who have been married for 50 to 60 years are not split up like we do now, callously and sometimes without warning. They remain in the same complex, only in a different bit of it. Throw in a bit of a restaurant, hairdressing, bit of bingo—everybody's happy. You know, that's how we should be treating our elderly, not jamming people in residential homes, I would say, or in less-than-adequate private nursing homes, quite often—and I could provide names of less-than-adequate private nursing homes if the Minister insists. But there are some excellent examples. I would mention Cylch Caron, Tregaron—integrated housing, health and social care project. There are still technical issues to overcome, though. I mean, people have been working in their separate little silos for too long, and even when you have some wonderful, innovative thinking, 'Let's start with the housing and build the health and the social care on to it', you still have issues with regard to how that's going to run.

I'm pleased to note that you've mentioned the integrated care fund here as a flagship, and I don't want to embarrass the Llywydd over much, but it's only fair to note that this brilliant idea of the intermediate care fund, as it was then, came as a germ from the brain there of Elin Jones, Assembly Member for Ceredigion, at the time in 2013, which was part of a budget deal between Labour, Plaid, and the Liberal Democrats we had then, in 2014, I think. So, that was the germ of this excellent idea, which has been built upon today. I congratulate Elin all the time, actually, about this innovative thinking, because that's what it's about: it's about breaking out of silos and breaking out of individual portfolios and thinking, 'We have an elderly person here. How are we going to deal with this situation?' We start with, 'Where are they going to live? Can they stay where they are with all the support, or, actually, are we going to have to think a bit broader about this? And let's have these integrated projects.'

So, yes, there's a £105 million. There's a lot of mention about capital funding: capital this, capital that. Lots of projects need revenue support as well. Can I just ask the Minister: is there any revenue funding as part of any of this—not to discount the very considerable sum that you've just announced now—and in terms, obviously, of—? I mean, it is a complex field—that's sometimes why it's difficult to integrate things. There are various other pots of money and lots of other people doing excellent work elsewhere, particularly with certain vulnerable groups. The Supporting People funding, which is continuously under threat of being integrated somewhere else—and lots of people would want to see Supporting People funding safeguarded, maintained, even, developed—how would that work together with this agenda? Because, as you mentioned in your statement, it's not just about elderly people, it's also about people with complex needs as well. Diolch yn fawr.