5. Debate on the Finance Committee report: The Cost of Caring for an Ageing Population

Part of the debate – in the Senedd at 3:42 pm on 9 January 2019.

Alert me about debates like this

Photo of Nick Ramsay Nick Ramsay Conservative 3:42, 9 January 2019

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.