Part of the debate – in the Senedd at 5:35 pm on 11 December 2019.
Diolch, Dirprwy Lywydd. For my short debate, I'll be examining some of the challenges related to the delivery of social care in the twenty-first century. With this being such a wide topic, I cannot cover every aspect of the debate. For example, I will focus my remarks largely around the provision of adult social care. However, I hope to provide sufficient illumination for some key challenges whilst also, where appropriate, touching on some possible solutions.
The first challenge that we face relates to demography. The numbers aged over 65 will increase both absolutely and proportionately over the next decade, and the numbers needing care could increase by a quarter. Wales has an ageing population, and it's only getting older. This, combined with rising costs and increasingly complex and chronic conditions will pose economic costs. That is the challenge we must face.
The Health Foundation noted that Wales spent nearly £400 per person on adult social care. They estimated that costs would rise by over 4 per cent a year over the next 15 years. By 2030-31, we'd be spending an additional £1 billion on social care in Wales. Around a third of local government spending in Wales is allocated to social care for over 65s, and population trends mean that this is only set to grow. The Welsh Government has invested additional money to help with the delivery of social care. For example, the 2019-20 budget contains an extra £50 million to alleviate the front-line pressures on local government. But Age Cymru, amongst others, suggests that the service is already underfunded, and that is just in terms of meeting present need.
Extension of free-at-the-point-of-use social care is something we should aim for, and I welcome that my party is standing tomorrow on a manifesto that clearly commits us to extend this if we receive the fair funding boost that we could expect from a UK Labour Government. Age Cymru powerfully suggests that that's paramount to collective societal responsibility for social care funding. They say that responsibility for funding should shift from the individual to society. They call for a new and sustainable model of funding that is fair, equitable and transparent and supports planning for future care costs.
One potential model is provided in Professor Holtham's report on paying for social care. Holtham explored the arguments and the various models of determining a sustainable and fairly funded outcome, but his conclusion was clear: raising a specific levy to pay for a specific outcome would meet public concerns. That's especially true if the levy were age and income-dependent and contributory. There would be a role for the social security system to step in to help those who need it. Holtham also explains why a funded system would be more efficient than a pay-as-you-go system; rates could be smooth and equitable between generations. Hypothecated outcomes would provide cast-iron guarantees for hypothecated input. Any fund could potentially offer wider economic benefits as a catalyst for 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 and be self-sustaining.
Indeed, lest we get too caught up in costs, we should remember that this is fundamentally about providing a pragmatic solution to what is the most critical of future needs—namely, ensuring that we meet the care needs of current and future generations, and that we do so in a way that enshrines dignity and the very best standards. This would offer one innovative use of the new powers relating to taxation that this Senedd enjoys. I look forward to the findings of the inter-ministerial group on paying for social care in due course.
I also want to take some time to talk about how my local authority, Rhondda Cynon Taf, is responding to these pressures. The council is adopting an ambitious course of action to transform its social care delivery, underpinned by the vision set out in the Social Services and Well-being (Wales) Act 2014. I'm grateful to councillors, officers and coalface staff for taking the time to talk to me. I was particularly impressed by Stay Well at Home, the flexible, community-based initiative developed by RCT along with Merthyr council and Cwm Taf Morgannwg health board, using money from the Welsh Government's intermediate care fund. The service consists of a multidisciplinary team made up of social workers, occupational therapists, physiotherapists and others. It operates seven days a week, eight till eight, and is supported by a range of community-based responses, bringing in groups like Care and Repair, toogoodtowaste and others. It aims to prevent unnecessary hospital admissions and ensures timely discharge for those people that require admission to hospital. And that shows one consequence of us not meeting the social care challenge, and that is bed blocking. This crucial service is due to expand next year.