8. Debate: The Holtham Report on Paying for Social Care

Part of the debate – in the Senedd at 5:15 pm on 8 January 2019.

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Photo of Vikki Howells Vikki Howells Labour 5:15, 8 January 2019

Now, when the history of the fifth Assembly is written, I think it is our willingness to use our powers over taxation that will mark a clear dividing line, a dividing line that shows the political maturity of this Parliament, a sign of our commitment to use all the tools at our disposal and a promise to the Welsh people to do all we can to create a more prosperous Wales. Nowhere is this clearer than in the ambitious raft of potential new taxes the current First Minister unveiled back in October 2017, and crucial among these is the suggestion of a levy to fund social care. But we must be under no illusion: the challenge to provide the appropriate social care to meet the needs of our society is a considerable one, as I think every speaker in this debate has actually mentioned so far.

Now, around a third of local government spending in Wales is allocated to social care for over-65's, and if you speak to any council leader, they will impress upon you that this is their biggest concern about budgets moving forward. And population trends suggest that this burden is only set to grow. Numbers aged over 65 will increase both absolutely and proportionally over the next decade and the numbers needed in care could increase by a quarter. An ageing population, combined with rising costs and increasingly complex and chronic conditions, will pose economic challenges. The Health Foundation noted in 2015 that Wales spent nearly £400 per person on social care, and that's excluding children and family services. They also estimated that costs would rise by over 4 per cent a year over the next 15 years, and that would mean that by 2030-1 we'd be spending an additional £1 billion on social care in Wales.

Determining a workable solution within the straitjacket of austerity also poses problems. I won't be supporting the first amendment. It misses the very obvious point that our budgets are constrained by the spending decisions taken at Westminster. In turn, this constrains the budgets that can be passed on to local government. If our budget had kept pace with the growth in gross domestic product, Wales would have £4 billion extra to invest in local government, social care and other services, but despite these pressures, the Welsh Government has continued to prioritise social care. For example, the 2019-20 budget contains an extra £50 million to alleviate the frontline pressures on local government.

It is clear that the failed Westminster orthodoxy of austerity is impinging on our ability to provide current and future demands. However, the problem is more deep-rooted than this. Even if our economy and budget grew at a faster rate than the cost of care, we would still face a spending gap that we'd need to bridge. We, therefore, need to seek evidence-based solutions that meet the challenges and Professor Holtham's report provides a critical contribution to this debate and road-maps one solution. Holtham explores the arguments and the various models of determining a sustainable and fairly funded outcome, but his conclusion is clear: raising a specific levy to pay for a specific outcome would meet public concerns, especially if such a levy is age and income dependent and contributory with the social security system stepping in to help those who need it. Holtham also powerfully explains why a funded system would be more efficient than a pay-as-you-go system. Rates could be smoothed and equitable between generations. Hypothecated outcomes would provide cast-iron guarantees for hypothecated input and it could potentially offer wider economic benefits acting as a community fund to promote national growth. As Holtham notes in conclusion, a funded contributory scheme could provide a viable solution to the problem of funding social care in an era of demographic change. Such a scheme would meet shifts in the age profile of Welsh citizens. Again, it would also be self-sustaining.

There will be questions that require further deliberation, of course, but this offers one pragmatic solution to what is the most critical of future needs: ensuring that we meet the care needs of current and future generations and doing so in a way that enshrines dignity and the very best standards. Moreover, Holtham provides a solution that seems to have a certain consensus behind it—in my party, at least. Our recent leadership election certainly generated a range of brilliant ideas from all candidates, but one area where there was a significant amount of agreement was in terms of Holtham and a social care levy. I look forward to these ideas being taken forward.