Item 5 on our agenda this afternoon is a debate on the Finance Committee report 'The cost of caring for an ageing population'. I call on the Chair of the committee to move the motion—Llyr Gruffydd. 

Motion NDM6908 Llyr Gruffydd

To propose that the National Assembly for Wales:

Notes the report of the Finance Committee, 'The cost of caring for an ageing population', which was laid in the Table Office on 12 October 2018.

Motion moved.

Thank you very much, Deputy Presiding Officer. I'm very pleased to speak in this debate today, as Chair of the Finance Committee, on our inquiry into the cost of caring for an ageing population. And although I wasn't a member of the committee during the evidence sessions, I would like to thank everyone who contributed to those sessions, and to the previous Minister for Children, Older People and Social Care for his response to our report, and particularly for accepting our recommendations, either in full or in principle.

One of the six areas we covered in our inquiry, namely the fiscal levers available for funding social care, was debated in Plenary yesterday, of course, and so, I will focus on the five other levers in my contribution today. However, as I noted yesterday, I was disappointed that the Government didn’t feel able to work with the committee on the scheduling of their debate, to provide a more joined-up overview of the social care funding system. We heard stark evidence during the committee's inquiry that there was widespread confusion about the system that we have, and we were told that it would be impossible to create a more complex system even if one tried to do so. But fragmented debate on a fragmented system doesn’t help to bring the clarity that is so important in terms of this issue. So, I've made the point that we've missed an opportunity, and I know that the Trefnydd is here in another capacity and will respond to this debate as the Minister for Finance, but I just wanted to make the point that I'm more than willing to look at any more creative ways of using this place's time more effectively and more efficiently in future. 

Now, the committee heard that although spending on social care has been protected in relative terms, the spending per capita on people over 65 years old had decreased significantly, partly due to the increasing older population. The committee is concerned that, unless action is taken, continuing pressures on social care budgets from increased demand will result in a weaker service and inadequate provision for older people, ultimately.

Concerns over the growing pressures is further compounded by the reliance on the invaluable role played by the 370,000 unpaid or volunteer carers, a contribution that has been valued at over £8 billion per year to the Welsh economy. And I would like to acknowledge the vital role that they play and to reiterate our view that, despite the value of that contribution, depending on unpaid careers is not sustainable in the longer term. 

Our report emphasises our concern around whether the assessments that carers are entitled to under the social services Act are being carried out, and, where they're being carried out, whether needs are being assessed correctly. The support provided to carers is crucial, of course, and the committee was concerned by the approach to assessments. We recommended that the Welsh Government conduct a review of carers’ assessments to evaluate whether the social services and well-being Act is strengthening support to carers. And I’m pleased that this review began in November, and look forward to its conclusions.

The committee heard concerns too around financial and staffing pressures in the care sector. We were concerned to hear that, in some cases, providers of domiciliary care are responding by handing back contracts to local authorities as they are not financially viable on the fee levels paid. As is noted in our report, it is essential therefore that contracts issued by local authorities are realistic to avoid an increase in any unmet need that would in turn lead to increased pressure on the NHS.

We heard of a crisis in the recruitment and retention of social care staff, with low pay and perceived low social status being contributory factors. The social care sector is especially susceptible to additional workforce pressures, as a high proportion of the staff themselves are ageing. And we are also particularly concerned about claims that staff, after being trained by care providers, are being lost to the NHS, or to local authorities, which, of course, have more attractive working conditions and employee packages. We emphasise in our report that addressing workforce issues is fundamental to ensuring the sustainability of the system. People need to see social care as an attractive career option in order to encourage new recruits, and to retain experienced staff. Working conditions in the social care sector must be on a par with those offered to staff in the national health service, in order to demonstrate how valuable these roles are. Therefore, we recommend that the Welsh Government prioritise the process of developing a strategy for the social care workforce, to address these concerns. And this should include taking action to raise the status of those working in the social care sector, in order to ensure that this in an attractive career option, which is appropriately remunerated.

I am pleased that this recommendation has been accepted, and that the Government, in its response, recognises the importance of ensuring a sustainable social care workforce, and I welcome the Government's commitment to delivering improvements. And the committee will look at the effectiveness of the measures implemented recently, as well as those being rolled out later this year, when we undertake our review of the progress made in implementing the recommendations in 2020.

Now, the committee welcomes the increase in the capital threshold for contributions to non-residential care from assets, but is concerned as to whether Welsh Government has provided sufficient funding to cover revenue lost by local authorities. We welcome the recent announcement, of course, on the final increase to a £50,000 threshold, as well as the additional £7 million to fund this, but, most importantly, we welcome the commitment to monitor and also to adjust this funding, should that prove to be inadequate.

Although we welcome the inter-ministerial group on paying for social care’s plans for public engagement to better inform the public of the charging framework in the coming year, the committee is concerned by the general lack of awareness around paying for adult social care, and particularly the fact that the complexity related to the current arrangements can lead to unfairness in respect of those eligible to receive publicly funded formal support.

As part of our inquiry, the committee considered options for fiscal reform, including the proposal made by Professor Gerry Holtham for a contributory scheme of compulsory insurance. Now, we welcome the work commissioned by the Welsh Government in developing this proposal as a positive step in acknowledging that the existing system will need to change to meet future demand.

The committee endorses calls made by stakeholders for a national conversation about the standard of the care that the public wants, before decisions about future funding are made. We therefore recommended that the Government should engage with the public about the future funding of social care, in order to discuss what the public would expect to receive in return for any additional contributions in the future. In particular, we recommended that, before introducing a levy to raise additional funding for social care, the Welsh Government will need to be able to justify how any funds raised will be used, and to demonstrate that this funding will make a difference. Now, this process should include explaining the level of care that the public should expect, since it's unlikely, of course, that the public will support this if the care provided remains as its current level. And listening to the comments of the health Minister about this national conversation yesterday, of course, was encouraging.

I welcome the Government’s acceptance of recommendations 7 and 8, and particularly its commitment to develop innovative funding models, to ensure resources are available to meet future social care needs, as well as its recognition that significant public engagement will be needed before decisions are made.

Finally, the committee is aware of the conclusions of the parliamentary review of health and social care in Wales. Now, the committee heard that the proposal for a single system of seamless health and care was broadly welcomed, but we're also aware, of course, of the concerns that exist that social care can sometimes be seen as a cinderella service. Now, the committee recommended that the Welsh Government explores how the proposal of a seamless health and care system, advocated in the review, could combine a fund for social care as well as the national health service, which would be free at the point of contact. This recommendation was accepted in principle only; therefore, we would be grateful for more information from the Minister as to how the Welsh Government envisages this idea developing. 

The cost of caring for an ageing population is one of the biggest and most important issues facing Wales today, and it is reassuring that the Government accepts all the recommendations, bar one, in full. The Government’s response refers to a variety of activity on the subject, including the creation of inter-ministerial groups, the multiple long-term strategies being developed, the consultations and awareness raising, all of which, of course, is encouraging, and we do hope to see positive outcomes from these initiatives when we review all of these recommendations in the year 2020.

However, it is vital that changes are made. Firm and urgent action is needed, in order to find the best solutions for Wales and in order to ensure that the people of Wales can see progress. The cost of caring for an ageing population is an issue that should never be far from our thoughts, and it's a problem that directly or indirectly affects us all. Thank you. 

I'm pleased to contribute to this debate and, indeed, to have been a member of the Finance Committee and to have taken part in the report of the Finance Committee review. It was a thought-provoking inquiry about an issue that, as the Chair of the committee has said, is of growing concern and should be of growing concern to all of us. As we've heard, the proportion of older people in Wales has been increasing over the last decade, and projections show that this trend will only continue. There are serious questions to be addressed with regard to the level of resources available to maintain services and the pressures upon them.

So, where do we go from here? This is what we tried to address in the report. Well, as has been said, Professor Gerry Holtham has suggested a common insurance fund to cover future costs of adult social care, and the committee looked at this, as well as other possible solutions, and I'll come on to those in a moment. 

First of all, if I can turn to some of our key recommendations, recommendation 1 calls on the Welsh Government to develop more targeted research, so that we have access to the most up-to-date and accurate data to base future projections on, and, as we know from experience, some of the limitations of Welsh-only data to date has been an issue for this Assembly. Recommendation 2 calls for a full review of carers' assessments and whether the Act has actually delivered stronger support for carers on the ground—its whole intention.

Now, our inquiry looked at the fragility of the provider market, and the evidence provided to us suggested that the market has been fragile for some considerable time, and this is leading to increasing in-sourcing by local authorities to try and reduce the risk exposure for the independent sector. Public Policy Institute for Wales highlighted to us how some providers are returning their contracts to local authorities, because they can't provide at the set fee level. So, whichever way you look at it, this is—over the longer term—an unsustainable situation. 

If I can just say a little bit about the workforce pressures and retention, the committee received a great deal of evidence that pointed to the difficulties in recruiting staff to the social care sector in the first place, and indeed subsequently retaining those staff. Care Forum Wales said that care workers can often earn more stacking shelves, unbelievably, than working in the sector, or that's the perception, at least, and that cannot be right. I'm pleased the Minister has committed to raising the profile of social care workers so that it can be seen as a more positive career choice, because that was certainly lacking from the evidence that we took from the sector. But we need to do more than that; it's more than just perception. We do need to retain those employees once they're recruited. 

Just moving on to the proposed social care levy that the Chair has mentioned and Professor Gerry Holtham's favoured solution and its key tenets. Those are contributions made as a proportion of income, with rates remaining constant throughout a person's life, although they would be higher the older a person is when they enter the scheme. Professor Holtham was quite honest and said that more work would need to be done on whether you would have a sliding scale, for instance, of contribution or a flat rate of, he suggested, 1.5 per cent. So, there are many variables.

Professor Holtham also admitted his suggestion that reversing the 20 per cent decline in spend per head of population, which he identified, may or may not be sufficient to tackle the problems that we face. He said that it might be better to talk in the region of 23 per cent at the higher end or 17 per cent at the lower end and that either of these may work, or they may not, and that a great deal more work would need to be done to find out exactly what level that would need to be set at.

There's also, of course the important issue of how you sell all this to the public. Do you refer to the new scheme as a levy—effectively a tax—or do you label it as compulsory insurance? Of course, even if you do the latter, it may come to be regarded as a tax anyway, so you may as well, in some cases, bite the bullet on that, but the public must know that there is a big problem here and they must be on our side in finding a way to tackle it.

Crucially, I think, this has to have cross-party support and be supported for the longer term. That's the only way that this will work and be accepted. You also have to have agreement on how to cover the costs for those who may not have made any significant contributions throughout their lives through illness or through not working for other reasons.

So, do we have a separate levy or incorporate it into the Welsh rate of income tax? That option will soon be open to the Welsh Government. The latter is a simpler, as the former finance Minister said, way of doing things and the structure is in place, but, again, the public may need to see clearly that the amount being collected is going towards their social care.

So, finally, the Minister said—or the former Cabinet Secretary, as he was—that a UK-wide solution would probably be the best solution and I can see his reasons for saying that. The costs are so great that spreading this across the UK would probably be beneficial. But that said, if this does ultimately fall to Wales to make headway on this issue, then so be it. This is an issue that cannot be ignored for any longer. It was a pretty bleak picture that the report painted, but there were also a number of solutions in there and I think we all have to look at that across parties to find a way to move forward that's acceptable to all of us here and also to the public at large.

I'm delighted to participate in this debate, although I am not a member of the Finance Committee, but I welcome the report and the background work underpinning it, and we heard the arguments in the Government’s debate yesterday.

The funding system for social care—as the Chair has already outlined—is very complex indeed and it wouldn't be possible to come up with a more complex system even if you tried, as the Chair said. Having said that, it's not just a matter of money. As I said yesterday, we need to look in the round at the significant challenge of providing elder care and to try and view it from a positive perspective. We have an opportunity to create a national care system here, because I do think we need to change the structure. We need to be radical because it is going to take funding and we have to convince the public that there is a valuable system, based on a similar system to the health service. Everyone loves the health service of course, well, why not structure our care service so that it becomes more similar to our health service? Because there will be economic gains from that too, in providing jobs, salaries, training and so on and so forth, just like the workers in the health service, in those areas of Wales that find it difficult to provide jobs in the first place, and we need to develop a social care service as an economic development tool.

Because the system, as Nick Ramsay said, is not sustainable at the moment. We must have some way forward and not just think about how we're going to fund an already failing system. Because, at the moment, given the financial limitations on social services within our county councils, the threshold for people to receive care is increasing annually. I see this constantly: older people facing a number of physical and social challenges, they deserve care, but they don't reach that threshold—a threshold that increases every year, the threshold to receive care free of charge from the county, because the funding simply isn't available. I know what people are saying. They're saying, 'Well, pay for it then; pay for your care privately.' That’s what I hear, and we heard that yesterday. But, of course, that isn't an option for very many of our older people; they can't pay, and they go without any publicly provided care, and without any care, and the entire burden falls on the family, if you're fortunate enough to still have family nearby. That’s what we sometimes forget.

Why is this important? Because people are dying because of these cuts in funding and a lack of care provision. People are dying as a result of this. There was a review in The British Medical Journal in 2017 outlining the appalling situation of care in England, where social care funding has suffered a double blow. [Interruption.] Nick.

Thanks for giving way, Dai. I agree with much of what you've just said. Do you agree with me that, during the course of the inquiry, it was ironic that Professor Holtham pointed out that when he looked at public opinion in Wales, it seemed to be that there was a lack of understanding, to a great degree, about the scale of the problem that we're facing? That shows how we really need to address this and get people to understand how we've all got to face this together.

Yes, I would agree 100 per cent, because we need restructuring; just talking about the funding isn't enough. We have a failing system here. We see it from the figures—as I was just going to say—in England. There was a review carried out in the BMJ on care in England, and that the problems in the care system in England had led to 22,000 deaths above what would have been expected. That’s 22,000 additional deaths annually in England because there was no care provision available. So, trying to throw some more money at a failing system without a substantial reform is not going to work and, of course, if our care system fails, then the health service will fail too.

Now, as I said yesterday, we have a partly private system, partly public system, and partly charitable. That’s what health was before Aneurin Bevan insisted on the establishment of a comprehensive national health service to save lives, because thousands of people in the 1930s couldn't access health service treatments at all. That is the situation facing people with care today and the needs of social care, therefore, deserve the same solution as health, namely a national comprehensive care service. Thank you.

Not being a member of the committee, I was not involved in the deliberations leading to this report, but I would like to thank the Finance Committee for their carefully-thought-out report on the cost of caring for an ageing population. Advances in health and social care enable all of us to live longer and healthier lives. Coupled with an increase in population, it is not surprising that the issue of paying for it is coming to the fore and that is why the committee's report, together with the independent report by Professor Gerald Holtham, which we debated yesterday, are entirely timely.

If we look at the current spending, we see that it has, in fact, decreased by 14 per cent between 2009-2010 and 2016-17 as services focus on supporting people with higher levels of need. This means that there are more people with perhaps less acute care needs who are receiving care in their own homes. Of course, it may be that a spouse or partner is providing that care. So, when we look at funding social care, we must give very careful consideration to carers themselves, particularly family members who are providing care for their loved one. In fact, there are around 370,000 informal carers in Wales. We hear many stories of these carers missing their own medical appointments or social activities because of their caring responsibilities. Young carers in particular need our support, and I know that Members from all sides of the Chamber would wish to pay tribute to the work that all carers do on a daily basis. I am pleased, therefore, that the Government has accepted the committee's recommendation that they review whether the assessment that carers are entitled to under the Social Services and Well-being (Wales) Act 2014 is being carried out, and whether those needs are being assessed correctly. 

Turning to the demands on the social care system, the ratio of over-70s to those aged 20 to 69 is going to rise by the early 2040s from 23 per cent to 37 per cent. So, that's a 50 per cent increase within the population—and perhaps I ought to confess a degree of guilt for that statistic myself. The demand for spending on social care is projected to rise by over 85 per cent by 2035, at 2016-17 prices, so that's a 20 per cent increase in spending per head and an increase in numbers requiring care of over 55 per cent. These figures highlight clearly the need to face up to the long-term realities of funding social care. For too long we haven't really grappled with this issue enough. As the committee have stated, the evidence shows that funding pressures along with an increase in population are resulting in a funding shortfall. This is further complicated by the complex arrangements associated with paying for care, which often lead to unfairness.

Of course, there has been much debate about the prospect of a social care levy, and the committee have given this very careful consideration. I'm pleased to see that one of the recommendations is that the Welsh Government would need to be able to justify how any funds raised will be used and be able to demonstrate that it will make a difference. This should include explaining what level of care the public could expect in return for their contributions, since it is unlikely that they would support proposals to pay more if the level of care is the same as at present. Before we consider any new taxes, for that is in effect what the levy would be, the public need to be sure that they are getting something that is quid pro quo, and certainly we on these benches would not be able to support a new levy unless and until it is fully justifiable to the taxpayer.

A point my colleague Neil Hamilton made during the committee's deliberations is that we also need to radically improve productivity and efficiency in the health sector. We must ensure that people are able to see their GP when they need to. This would reduce A&E attendances and hospital admissions. Getting people discharged from hospital more quickly and back into their homes, with suitable adaptations and care packages, will also help to reduce the long-term burden on the social care sector. 

The Minister previously announced a falls response project, in conjunction with St John Ambulance, to deal with some of the pressures on the NHS over the winter. We should look at all of these types of projects to evaluate their benefits on social care. To be fair to them, the Welsh Government have already undertaken some excellent work in this area, but to meet the challenges of the future, we must do more. 

Finally, we need to deal with population growth, and that means having a migration policy that suits our national economic interests. We must therefore have proper border controls so that we can truly assess those who have a desperate and proper need for asylum, but with stricter controls on those who come here for economic reasons, and who will, inevitably, put yet more pressure on our already overburdened health and social care system.

As the Chair's foreword to this report states,

'Much of the evidence referred to the Social Services and Well-being (Wales) Act 2014 and whilst witnesses were generally supportive of the Act, there was some concern over the application of eligibility criteria, the undertaking of carers’ assessments and the variation in fees across local authorities. What was also clear was the unexpected costs associated with the Act'.

In its response, the Welsh Government states that its

'programme for transforming health and social care is set out in detail in A Healthier Wales' and that it commenced a three-year

'evaluation of the Social Services and Well-being (Wales) Act, to explore the implementation of the Act and the impact on those who receive care and support, including unpaid carers,' in November 2018.

When I accepted an invitation to work with the last Welsh Government to incorporate proposals within my withdrawn Community Care (Direct Payments) Wales Bill, the subsequent Social Services and Well-being (Wales) Act 2014 code of practice put in place a system where people are full partners in the design and operation of care and support, giving people clear and unambiguous rights and responsibilities. It states that assessing the needs of individuals should be based on the principles of co-production, ensuring that it involves a relationship where practitioners and individuals share the power to plan and deliver support together, and recognising that all partners have vital contributions to make in helping to meet identified personal outcomes. And the ways of working that the public bodies listed in the Well-being of Future Generations (Wales) Act 2015 must demonstrate also include working with others, including third sector bodies and communities, to help achieve goals that have been decided together.

However, a series of reports have indicated that the legislation is not being implemented as envisaged, that the better lives and reduced costs intended are not being delivered, and that urgent intervention is required accordingly. Last winter’s Age Alliance Wales newsletter stated that

'Third sector representatives on Regional Partnership Boards have reported feeling excluded, or at least not fully engaged', and that the third sector has been seen as a bit-part player, with little or no strategic involvement in the integrated care fund and little input into programme planning. Despite their subsequent engagement with the then Minister regarding this, I'm reliably informed that this continues.

Last March’s evaluation of the integrated autism service commissioned by the Welsh Government found that although

'the focus upon co-production and prevention is expected to help improve effectiveness and reduce demand' and

'success requires a co-productive approach involving staff, service users and carers in the design, implementation and evaluation of the service', there are concerns that the top-down approach has stifled this. Only last Friday I attended a meeting with Flintshire council and members of the local autism community to discuss the north Wales integrated autism service hosted by the council, the needs of autistic service users and working together better going forward.

Last November's analysis by mental health charity Hafal of the Welsh Government’s 'A Healthier Wales' plan stated that it

'fails a test of indicating how things might actually change for individual consumers as opposed to providers', that

'it's an example of policy made by providers for providers' and that whilst the provider viewpoint should be respected,

'it is just one perspective and should be wholly subsidiary to that of consumers'.

The results of the survey conducted by the Wales Neurological Alliance on behalf of the cross-party group on neurological conditions, 'The Social Services and Wellbeing Wales Act—experiences of people living with a neurological condition', published last month, found that although the Act has been in force for two years, people living with neurological conditions are not being asked what matters to them, are not being made aware of their rights to an assessment, are not getting information about support and advice services, and are having to pay out of their own pocket for support.

Shockingly, the survey even found that guidance with this Act has been used to prohibit the direct payments that have successfully provided quality person-centred care previously. And only last week, hospices providing key front-line services told me that although health boards are expected to submit their three-year palliative care plans to the Welsh Government by the end of January, their health board has not engaged with them at all.

This is the harsh reality, and it demands urgent action to address the unnecessarily damaged lives and wasted resources resulting from this. 

Can I now call on the Minister for Finance and Trefnydd, Rebecca Evans?

Thank you. I thank the Finance Committee for undertaking what is a really important inquiry, because the way that a society treats its older people is very much a reflection of its values, and I do commend the committee for choosing this particular important area to consider. There's a real focus in the committee's report on aspects of social care policy, and we've heard lots of those just now in Mark Isherwood's contribution, as well as on the important wider financial challenges of caring for an older population. I'm really pleased that the Welsh Government has been able to respond positively to the suite of recommendations in the report. I put on record my gratitude to the former Minister for Children, Older People and Social Care for his work on this particular agenda.

The Welsh Government is already making some demonstrable progress on improving the vital care and support that older people require. We're committed to making Wales the best country in which to grow old and, as was highlighted during the inquiry, we're reshaping the way that care and support is delivered so that this vision does become a reality. 

With this in mind, I'll briefly set out the work that's being undertaken in the key areas that the committee highlighted in its report, building, of course, on the issues raised in the debate on the Holtham report on paying for care, led by my colleague the health Minister yesterday, which outlines one potential way forward.

Informal carers, so those family members and friends who provide care on an ongoing basis, play a vital role in supporting people in later life, and I think Dai Lloyd's contribution in particular reminded us very powerfully of that. 

The committee's recommendation to conduct a review of carers' assessments is being undertaken through an evaluation of the impact of our social services and well-being Act. This commenced in November and it will include engagement with carers themselves. It will consider what impact the Act is having on informal carers and what has changed since the Act come into effect. It will identify to what extent the Act is facilitating the critical support they require to continue caring and also whether any further improvements will be necessary. In addition, we're undertaking a major publicity drive to raise awareness of the Act, a particular strand of which will be to ensure that informal carers are aware of their rights and are encouraged to seek information and a carers' assessment where they might require them.

Without an appropriately trained and experienced social care workforce, any attempt to implement improvements or raise quality are doomed, and I think this was well recognised in the chair of the committee's contribution. The committee fully recognised this in recommending that we prioritised the development of a strategy for the social care workforce. The Welsh Government committed to this in 'A Healthier Wales: our Plan for Health and Social Care', with a range of workforce improvement measures being implemented. These include regulations to improve terms and conditions by reducing the use of zero-hours contracts, a suite of health and social care qualifications to provide a clear career pathway, and rolling out registration to reflect our commitment to professionalise the workforce.

High on our agenda is the long-term funding of social care, which is core to its sustainability. The committee emphasised the growing demand for care that we could see in the future from an ageing population and the challenge that this poses. Due to this very challenge, we prioritised social care in our strategy 'Prosperity for All', which commits to developing innovative funding models to meet anticipated demand. You'll know from yesterday's debate of our commitment to explore options for new Welsh taxes, including a potential social care levy, to raise additional funding. These proposals form the basis of the work of our inter-ministerial group on paying for social care, established last summer and tasked with providing the policy perspective to these financial considerations. Its work is at an early stage but we will continue at pace this year to enable an informed judgment on the viability of a levy, for example, and whether this would realise the benefits that we envisage.

I think that Nick Ramsay's contribution in particular outlined just how challenging this agenda is and how big some of the questions are that we have to grapple with, and I completely agree with Nick that a good way forward is one that would develop some kind of cross-party consensus, because this is a challenge that will be facing all of us, regardless of our parties. And I know that the health secretary and I are both very keen to listen to other parties and their ideas and explore the way forward together. And I have to say as well that I do welcome the way and the spirit in which Members are engaging in what is a really important agenda.

So, alongside this we'll be engaging with the public regarding their views on paying for care and its implications for them. And as the committee rightly recommended, we need to undertake such engagement, and will shortly consider a proposal to undertake an awareness-raising campaign to ensure that people understand the importance of social care and the system that is currently in place. And the Chair of the committee referred in his speech to the widespread confusion that currently exists in terms of paying for care.

I think this piece of work will pave the way for a more targeted engagement on the options to raise additional funding as these options unfold, and, certainly, Mark Isherwood reminded us of the importance of putting the individual at the heart of these decisions. 

Finally, to pick up on a specific recommendation, I'm pleased to confirm the completion of our 'Taking Wales Forward' commitment to increase the capital that those in residential care can retain without having to pay for their care. This was to raise the figure from £24,000 to £50,000 within this Assembly term. This amount is currently at £40,000 and we intend to raise it to the full £50,000 from April. To support the implementation of this, we've announced a further £7 million a year in the local government settlement from 2019-20, taking the overall implementation funding provided to £18.5 million a year. As the committee recommended, we will continue monitoring to ensure that this funding is sufficient to enable authorities to fulfil their social care obligations, and I look forward to continuing the discussions that we've had over the past two days. Thank you.

Thank you. Can I now call on Llyr Gruffydd to reply to the debate?

Thank you very much, Deputy Presiding Officer. Could I thank everyone who has contributed to the debate? I won’t refer to every contribution, please forgive me, but I’ll just endorse a couple of the points that have been made. Certainly, in the contribution made by Nick Ramsay, the reference to the level of salaries within the sector compared to those stacking shelves—I think that is one that does underline where the sector is in that context at present. And, of course, in her response, the Minister did refer to some things that the Government is doing to look at terms and conditions of that kind of employment. The bottom line, of course, is that people will want to see an increase in salary, and until that happens it will be very difficult to show the people who work in the sector that society does value the contribution that they make.

Nick mentioned the references that were highlighted during our work around the need for a UK-wide resolution, and I think that probably reflects the view of the committee or its preference in that respect, but, of course, if that isn't forthcoming then we need to get on with it and do it ourselves. I'm hopeful that the Government is of the same belief, because, as Nick said, we're in an unsustainable situation in the long term, although I think the long term isn't as long as some people think or hope it might be. 

David Rowlands reminded us of the young to old people ratio that's changing fast, and that, of course, is demanding a big response from our health and social care services. It's for us, therefore, to find a way of delivering those services. Mark Isherwood reminded us as well of the value and the opportunities that come from a co-productive approach, of which I'm sure the national conversation could be the start of. 

I also want to thank Dai Lloyd for his contribution this afternoon. There is an opportunity here, as Dai suggested, for us to be ambitious and to be innovative. We need to show the same ambition, the same innovation and the same bravery and courage that we saw when the NHS was created, and not throw money at a failing system. That’s not the answer, as Dai said. We need to change the system as well so that we have a more sustainable system.

So, I want to thank the Members who contributed to this debate and I also want to thank the clerking team of the committee and everyone who gave us evidence as part of this process. I’m very pleased that the Welsh Government has accepted all of the nine recommendations that were made, either fully or in principle. There is a consensus, I’m sure of that, that we need to act now and that the time has come for us to tackle this situation once and for all.

I want to close by echoing the recognition that we as a committee want to give to the voluntary carers out there—the glue that holds the service together. The reliance on them is very heavy, but is does cause a risk to the sustainability of social care provision in Wales. We’ve heard about the concerns about pressures on the workforce. We’ve heard about the challenges facing us.

Could I thank you all and could I say that it has been an encouraging response by the Government? But, of course, all of this activity now that is happening needs to lead to results and changes to a funding system that, I think we can all agree, is running out of time. Thank you.

Thank you. The proposal is to note the committee's report. Does any Member object? No. Therefore, the motion is agreed in accordance with standing Order 12.36.

Motion agreed in accordance with Standing Order 12.36.