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

Part of the debate – in the Senedd at 5:21 pm on 8 January 2019.

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Photo of Vaughan Gething Vaughan Gething Labour 5:21, 8 January 2019

Thank you, Llywydd, and I'd like to start by thanking Members for their contributions this afternoon. Today's discussion has helped to continue, if not open, a debate that we do need to have on paying for social care. And our aim in bringing this debate today is twofold: to continue to identify the issues and implications in respect of options for the long-term financing of social care costs and to start to develop a platform from which we can build a wider consensus around a potential solution or solutions. And as I've said, there are no easy answers and there are no quick wins, but I'm heartened today that a number of the views expressed in the debate converge on a consistent drive to address this agenda, because there is a clear need for a nationwide debate on what a high-quality and sustainable social care sector in Wales looks like. And that, of course, means continuing to progress our agenda to integrate health and social care to deliver improved outcomes and experience. All parties in this place were, of course, involved in helping to commission the parliamentary view that we then accepted and built upon, and is central to our 'A Healthier Wales' agenda—the joint long-term plan for health and social care here in Wales.

But the debate, moving forward, about social care should rightly include options on finance, including taxation, and we will consider existing research and previous work. And as I said earlier, the debate has to acknowledge the role that local government have because they provide and commission much of the care that we have discussed today. Other providers and people across different parties will also need to be involved, and I do want to highlight that in that conversation with local government, it is taking place across different political leaderships: Conservative-led, Plaid Cymru-led, Independent-led and Welsh Labour-led councils are all part of the discussion that we wish to have, and are having, including with the Association of Directors of Social Services. It takes on board the point that Vikki Howells made—that when you talk to local authority cabinet members and leaders, their No. 1 concern about the future finance is actually about social care and education, the two big blocks of spending, and how they'll manage to maintain spending in this area, not just from a financial point of view but, actually, for the quality of care that they wish to see provided in their local communities. So, we are committed to taking account of new thinking and any creative approaches that exist, particularly as we do develop new models of care—to continue to promote a preventative approach, to make full use of new and existing technology to help people remain as independent and supported in their own communities as possible.

And there will of course be questions about how much we expect to raise in new revenue. So, not simply how we use the revenue that we have now but how to raise new revenue and what that would, or should, provide. And there are questions raised and a number of comments about what we are seeking to do. To replace revenue or to raise new revenue? We want more revenue to be available. I'll turn to some of the comments made—I won't be able to address each and every one—but we do have this debate about whether we get stuck into just talking about underfunding vital services. So, I say a £1.2 billion cost is the minimum cost of austerity—just keeping pace with inflation, not keeping up with GDP. We are then blamed by other parties. We respond by saying that in three successive general elections of championing austerity, we won't actually get to address the challenges that we have, either within Wales or the rest of the United Kingdom. There are choices to be made within our budget, and we have made choices, because there is no consequence-free choice to be made. We chose, within a diminishing overall budget, to invest more into our NHS, and that has consequences on every other budget line that we fund. There's no point pretending that that hasn't happened. But for social care, if we cannot generate extra revenue, then we accept that we'll have a diminishing amount and quality of care. So, this isn't simply about raising extra revenue to maintain a service; we want to raise extra revenue to maintain but also to improve a service. So, it's not just about keeping pace with demographic challenge. And our biggest concern, of course, is that social care has always been means-tested, where the NHS, since its creation, has not. And many of our citizens whom we represent are surprised that social care is means-tested—at the point at which they need that social care, they're surprised that they have to go through a form of means test.

Now, I recognise what Dai Lloyd said about wanting to have a national care service and the broader point about improving services for the citizen—the citizen who requires dignity in the care that they take part in and receive, but also dignity for the member of staff delivering that care. I was very pleased that, within the debate, a number of Members made the point that they have seen social care taking place, they've visited people and had their own personal experiences, and they're impressed with the quality of care that our staff are providing, and often staff who are not very well paid. For the challenge, I agree, is not simply a question of finance, but we do need to move ahead with new funding models if we are going to meet demographic and quality challenges for the future.

As I stated earlier, Llywydd, we will oppose the first Conservative amendment, but support the second. I thank Members for their contributions today and look forward to carrying on this conversation to inform our options to develop the financing of the future costs of social care here in Wales and I genuinely do look forward to being able to do that within my own party, but across different parties and different partners within and outside this place.