Part of the debate – in the Senedd at 4:48 pm on 8 January 2019.
I'm pleased to take part in this very important debate. Social care provision—surely, as has been announced, the challenge is great and it demands priority, and the Holtham report is a valuable contribution to that debate.
I don't know if I mentioned in the past that I've been a GP for about 35 years, but I've also been a past trustee of Crossroads Caring for Carers as well, so, exposure to the demands of my patients requiring social care has been great and continues. Now, obviously, people are living longer, largely due to the success of the NHS, despite some vilification from some corners. Okay, we've got clean water and some better housing as well, but the recent increases in life expectancy have come about because of the NHS. Two hundred and fifty people in the UK in 1950 celebrated 100 years of age, 2,500 celebrated 100 years of age in 1990, 13,700 celebrated 100 years of age two years ago. Yet, just focusing on financing the current, stretched social care system would betray our elderly population too, and is a very limited response to the challenge that we do face.
One of the reasons why I'm a fan of a Labour politician, Aneurin Bevan, is that he managed to create a coherent national health service with salaried nurses, doctors, physios; contracts; terms of employment; training; and all the rest when faced with the mishmash of health delivery in the 1930s, which was part public provision, part private provision, part charitable provision, with nobody really in overall charge and people missing out on healthcare in droves. He overcame huge vested interests and brought the NHS into being as a coherent stand-alone service, despite opposition from doctors.
Fast forward over 70 years and when you look at the social care system, it's like health was in the 1930s, with part public provision, part private provision, part charitable provision. We need to create a national care service in the same way that Aneurin Bevan faced down opponents who were saying, 'It's going to be too expensive, it's going to be far too complicated, doctors don't want to lose their private practice, local authorities losing their role.' Huge political will brought about a truly national health service, free at the point of delivery, from general taxation, with all our health risks pooled together. We need to take Aneurin Bevan's inspiration and vision and create a national care service in this twenty-first century.
Just talking about finance is limited and cold because we're dealing with people here—frail, elderly, vulnerable people. Shouldn't we make care better? Pay care staff more, employ them in a national service with terms and conditions, train them and register them, exactly like the NHS. A national care service with parity of esteem with the national health service. A national care service financed out of general taxation, just like the NHS. Care free at the point of delivery, just like the NHS. No distinction between free nursing care and, in the future, free personal care. There is a distinction now, personal care is means tested and charged for. Imagine such a revolutionary scenario with no division between nursing and social care. 'But we could never afford it,' people will say, forgetting that 80 per cent of social care costs today are paid for by Government, are publicly funded now—80 per cent is already paid for.
Imagine the uproar if you attended your GP today and you were told that you would need complex, expensive healthcare and that you would need to sell your house to fund it. Imagine the uproar, people on the streets protesting, topical questions in the Senedd, no doubt, but we accept people having to sell their homes to fund long-term social care with hardly a whimper. A social care levy would not reorganise the care service or stop you having to sell your home to fund care either.
Let's just stop—my final point—looking at social care as just a cost. We've had several speeches over recent months from Labour benches about the foundation economy, and social care is right there in the foundation economy. It's recognised with the NHS as a driver of economic development, especially in rural Wales, with 80,000 jobs in the NHS and a similar number in social care. The NHS is recognised as an important economic driver in terms of employment and higher than average salaries in areas where job prospects are often bleak. The same would apply with a national care service employing carers in a national service all over Wales, guaranteeing employment and decent salaries in areas of Wales with little alternative employment options and with care support workers no longer on zero-hours contracts, poor pay and little training. So, any discussion, to close, about social care should not just be about costs. There's an economic development opportunity here as well, and an economic gain, indeed, potentially outweighing those costs. Diolch yn fawr.