Part of the debate – in the Senedd at 5:05 pm on 8 January 2019.
Before making some remarks or comments about the report by Professor Holtham itself, I'd like to make a few remarks about my experience and my impressions of the care that's provided at present. In my constituency, before Christmas, and at other times of the year, I've seen great care being provided to people in care homes in my constituency by people who are on very low wages, but they do it because they see that role as a calling for them, or a vocation for them. I see a lack of beds locally for people who can't afford to pay for their own care. I see departments of social care in local authorities not being able to pay for the kind of care that they'd like to provide for people across Wales. Somehow we have to aim for the kind of sustainable system that all of us want to see.
Yes, the demographics are changing, and the costs are going to rise as we have an older population, but the basic question here is: how can we share that cost across society and ensure that everyone contributes towards that additional cost, rather than leaving the people who can afford to pay for their own care—people who are very fortunate, like the majority of us here in the Assembly—leaving us to pay while leaving other people who can't afford it to hope that a new system is introduced? We have to have a new system, and I'd like to see a different culture. I agree greatly with Jenny Rathbone that we need more of a community flavour to the care that we provide for people, and introduce much more co-operative systems for providing that care in our communities. So, we need a cultural shift, but we also need a policy change as well.
I'm very grateful to Professor Holtham for providing his ideas about one model that we could be looking at. We need to think outside the box, because the challenges are going to grow so much in the years to come. I have a number of doubts about the model that he recommends. It's not clear to me whether it's a levy being recommended here to take the place of the costs that people pay for social care at present, or an additional source of funding. If we're talking about introducing a levy and asking people to keep on paying for their own care, well, obviously that's something that we have to realise is a political challenge to have to sell to people. On the other hand, if what we have here is a levy that's supposed to pay for all the costs emanating from the public purse at present, I think possibly there is a lack of clarity regarding the financial figures that are mentioned in the report. He's talking about £550 million as the social care cost—that cost in truth is £750 million, but it just happens that £200 million of that comes in costs from people. So, the figure that is central to this proposal from Professor Holtham is rather unclear. Maybe the Government could explain whether they understand that this is a levy to replace costs or to create an additional fund. Is that what it is?
And, the figures relate to social care for people under 65 in this report. There is a lot of demand for care for those who are under 65—sorry, this report deals with over-65s. There is the issue also of the years that we will be waiting for that fund to pay out. What is the Government's view in terms of how we would pay for care now while we're waiting for that fund to reach the point where it would be able to pay out?
Finally, returning to the comments made by Dai Lloyd, it says a lot, I think, that it has taken us decades since we established the NHS for us to reach this point where we think, 'Well, how can we have a care service as well?' And maybe, in all seriousness, what we should be doing is not talking about how we're going to create £400 million annually for social care, but how we can look forward and look ahead to creating billions more for a health and social care service. And the fact that we are discussing the social care element in isolation here shows me that we are much further than we should be away from thinking of an integrated service for the years to come.
But, as I said, I'm grateful to have this paper and I'm looking forward to a broader discussion tomorrow in the wake of the Finance Committee's report.