We now move to the short debate. If Members are leaving, can you do so quickly? We now move to the short debate, and I call on Vikki Howells to speak on the topic she has chosen—Vikki.

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.

Other responses from RCT council include the use of technology. The RCT assistive technology lifeline will be enhanced to provide a 24-hour, mobile, rapid-response service for 365 days a year to people using an RCT lifeline pendant. And of course, the council is also committed to invest in extra care facilities across Rhondda Cynon Taf, and I've been very impressed by those when I've gone to visit them. They're part of the council's commitment to modernise older people's residential and day services, and I'm proud that both Aberaman and Mountain Ash in my constituency will soon host extra care facilities.

The foundational economy model also enables us to approach the issue of social care from a fresh perspective. I hope the arguments around the foundational economy are now well rehearsed. This is recognition of the economic importance of those everyday essential items and services that have, until recently, been sidelined within economic policy making. Alongside utilities, food production and manufactured necessities are those universal welfare services that citizens expect and access on a daily basis, and a key strand here is the provision of social care.

As the Centre for Research on Socio-Cultural Change found, failure to properly nurture this part of the foundational economy may have particularly far-reaching consequences. For example, well-resourced private enterprise has displaced smaller, family-run care homes with larger, purpose-based accommodation. These prioritise shareholder return and lead to an underpaid workforce, high public spend, and poor care outcomes. So, I welcome the new commitment to the foundational economy at the heart of Welsh Government. Moreover, resources are being allied to rhetoric here, and it's good to see funding being allocated to a range of social care projects under the foundational economy challenge fund. Twelve social care projects were successful under that strand of the FE challenge fund, such as the £100,000 given to PeoplePlus Cymru to develop upskilling projects with social care employers to deliver quality training for staff. I look forward to the spreading and scaling of best practice, and the renewed focus to grow the missing middle.

Co-operative models of social care provision could also provide an additional solution. Social care co-ops build up people-centred approaches to service delivery. Instead of remote head offices and the prioritisation of shareholders, they lead to truly community-anchored businesses, local economic investment and social benefits. Organisations can be built in this way around workers who are motivated by having a direct say in the running of the care provider, its ethics, operation and strategic generation. Revenue that would otherwise be frittered away in dividends and other distributions is actually invested in the service, and relationships with service users are key. Moreover, people who use well-being and personal care services have more say in how those services are run, and what is on offer. They firmly place people using services at the heart of the service design and delivery. In doing so, they provide responsive services that are citizen-directed, giving a stronger voice and greater control to people in need of services and those who care for them. This often results in better quality, well-targeted services.

I'm grateful to the Wales Co-operative Centre for highlighting several excellent examples of this delivery model. Time prevents me from listing all of these, but I just want to mention the Cartrefi Cymru Co-operative. This supports people with learning disabilities in Wales to lead fulfilled lives, both at home and in the community. They became a co-operative a little over three years ago. Membership is voluntary and open for people they support, employees, and community supporters to work together on two co-operative goals.

I want to explore the vitally important matter next of the social care workforce as another key challenge. I'm grateful to conversations with a number of organisations and individuals about this, not least a lovely lady, Mrs Bishop, with whom I spent a very valuable afternoon, where she described the positive impact that carers from RCT council and the council's services made to her life. I also want to put on record my thanks to my trade union, the GMB, for a discussion on how they support members who work within the care sector.

I welcome the direction in policy that has taken place in recent years in terms of professionalisation of the social care workforce and recognition of the vital work they can do, but this absolutely must be backed up by appropriate resources, giving care workers salaries that reflect the importance of their vocation. Otherwise, staff could end up moving fairly seamlessly into nursing, because the wages are so much higher there, and then the shortage of social care staff will simply be exacerbated.

It is a positive intervention that the domiciliary care workforce must now register with Social Care Wales, that they must meet criteria in terms of qualifications: qualifications that mean that we recognise caring for what it is, a highly skilled vocation of singular importance to our communities. I think it's fair to say that these care workers are highly skilled, but all too often their skills are not recognised or formally valued. Taking this forward, there are challenges in the different pay and terms and conditions between the private and public sectors. For example, a private sector care worker earns on average £2 an hour less than their local authority counterparts.

There can be challenges around negotiation with the private sector. I was a little shocked to learn that there are over 25,000 registered providers of private social care in the UK. As the Finance Committee reminded us last year, there are also challenges in that a high proportion of staff are ageing, and there is a reliance on staff from abroad. I would like to see further measures to professionalise the workforce, with any increase in funding allocated to this end. This must be linked to greater recognition of the important role that carers carry out to stop the 33 per cent turnover rate. Welsh Government interventions, such as ending compulsory zero-hours contracts and ensuring pay for travel time, are not just key to achieving this, they are also morally right and fair.

I'd like to see work undertaken to ensure parity of esteem between private and public sector, but also between the social care workforce and those involved in related sectors like healthcare, reminding care workers of the rights to which they are entitled. It's only fair that we give these workers their due. In doing so I hope we will enable social care to be seen as an attractive career option. This will encourage new recruits to join, give them the support they need to become experienced members of staff, and make sure they stay in the sector for the long term.

The last challenge I want to consider is how we appropriately support unpaid carers. Some 96 per cent of care is provided by unpaid carers. Carers Wales's 'State of Caring' profile provides an important insight in this area. Drawing on their 2018 work, some key findings stand out. This is a gender issue: more carers identified as women than men. Nearly one in three carers are themselves disabled. Nearly one in four have childcare responsibilities. Nearly a third are working, of whom nearly half work full time. Some 56 per cent care for more than 90 hours a week. One in four carers care for two or more people.

Research published by Carers UK on Carers Rights Day provides a further key to the scale of the issue. The average person in Wales will have a 50:50 chance of caring by the age of 45, long before retirement age. And in Wales, women will care by the age of 42. Caring during our working lives is becoming more and more likely as people live longer and need more help with their day-to-day lives. Women taking on more of a caring role and at a younger age can limit their economic participation, their lifetime earnings, and their income in later life. 

The challenge is emphasised when we remember that someone living in Wales has a 70 per cent likelihood of providing unpaid care to another person. That is the highest rate in the UK. We know that the contribution of unpaid carers is literally priceless. If it were not, there would be an additional cost to public finances of some £8 billion. But the dichotomy between providing full-time care and needing to work can cause painful dilemmas. I've dealt with constituents who've needed to give up work to care for loved ones. The recompense provided by the carer's allowance does not go nearly far enough to meeting need. There is some support out there, and I welcome the practical assistance enshrined in the Social Services and Well-being (Wales) Act 2014. But there are still other barriers that we need to overcome.

The purpose of my debate was to look at some of the challenges we face to try to sketch out some of the solutions. A short debate can never provide all the answers, but as I close, I want to at least finish by saying 'Thank you' to all who provide such vital care day in, day out. 

Thank you. Can I now call on the Deputy Minister for Health and Social Services to reply to the debate? Julie Morgan.

I'd like to begin by thanking Vikki Howells for convening this debate today on this very important subject. I think the short debates are very useful in order to highlight particular subject areas, and I think she's done that very well today. 

Social care is an area of public services that is getting much more attention, and I think the reason for that is that we can all see the demands on social care that are getting much greater, and certainly it has been an issue in the general election campaign. Need is increasing and the resources that can be raised by local government and national Government to meet the need are struggling to keep up. I don't want to dwell on this point in my own contribution to this debate, which I hope will be positive and optimistic, but I think it is important to recognise, as we look forward, that our starting point is much more difficult than it could have been if different decisions had been made at a UK level. 

The first point I want to make about meeting the care challenges of the twenty-first century is that our policy and legislative framework serves us well in that regard. The legal base for social care, taking it forward, is forward looking. Vikki Howells mentioned the social services and well-being Act, and this fundamentally puts the individual at the centre of planning their care and support needs. This is a leap forward and strongly reflects our own values of supporting the most vulnerable people in society. Everyone in Wales deserves to have their care and support needs met, and in a way that their voice has been heard and acted on. So, we have the social services and well-being Act as a fundamental legality here in the Assembly, which is very important for social care. The Well-being of Future Generations (Wales) Act 2015 is also very important, because it has locked in the idea that we need to consider the long-term future in all the decisions we make, and I think that this is a huge step forward for Government and public bodies in Wales. 

Then, in terms of the policy direction, 'A Healthier Wales', our long-term plan for health and social care, is the basis for our action. And I think Wales is, in fact, the only UK nation that has a forward-focused strategic plan for health and social care. As a plan, it certainly grapples with the major long-term trends that will impact on Wales. And in the spirit of this debate, I'd like to make some reference, briefly, to some of those future trends. 

Demographic change, as Vikki Howells mentioned, is already with us and its effects will accelerate, with the projected doubling of the number of people over the age of 85 over the next 20 years. And this demographic shift is really, perhaps, our greatest achievement as a society. It's a triumph of the NHS and certainly something to be celebrated, but we have to be realistic about its impact on our public services, and Vikki Howells has referred to that. Social Care Wales estimate we will need an extra 20,000 social care workers to respond to the increasing care needs that will come with this growing elderly population. And our ageing society is a challenge not just for social care, but for the whole of Government and that's why, next year, I will consult on a strategy for an ageing society. It will set out the actions we need to take in response to demographic change, and also set a vision that challenges Welsh Government and all our partners to step up still further in the time ahead. 

In saying this, we need to be mindful that the area that has seen the increase in spending in local authority social services departments over the last few years, in fact, isn't older people, it is children. There's been far more expense generated in order to look after children, particularly children with complex needs, than for older people. And I think this is because children are living from birth with more complex conditions and their care is becoming much more resource intensive. And we're also seeing more children in Wales being looked after, and Members will know that this Government is working with our partners in local government to try to turn the curve of the number of looked-after children in Wales. I think this debate offers an interesting perspective on this. 

However, I know that Vikki is concentrating on adults in her contribution, but I think people don't often realise that it is children that are causing the most expense. We are trying to bring down the number of children that have to be looked after in care, but safety is the basis of bringing down those numbers. We have to better support families and communities, and build responses that will enable us to turn this curve, and then when children need to go into care we need to ensure that provision is available close to their home. 

On the subject of resourcing, Vikki mentioned the inter-ministerial group on paying for social care, which is looking at the challenges for the future. We've always favoured Wales being part of a UK approach to ensuring that people don't face large care costs in later life, and we'll see what this week's election brings in that regard. But if there continues to be a policy failure at a UK level, the inter-ministerial group is working to develop a made-in-Wales solution that is right for the care needs of the twenty-first century. Additional resources, as important as they are, are only part of the answer, and Vikki Howells mentioned the proposals that came from Gerry Holtham's work; we are looking at that in the inter-ministerial group.

But another global trend is the impact of technology and how this will impact on social care is a very important area. I believe that social care must always be an intrinsically person-to-person endeavour, but at the same time the appropriate use of technology will become more important in meeting care needs. And it would obviously be foolish to try and predict the far-off future technology changes; rather, the role of Government in this area is to encourage and support social care providers to make the best use of technology that already exists, and also help them think creatively about the future.

I know that Vikki Howells mentioned the foundational economy, and that is certainly something that we are very strongly supportive of in the Welsh Government. As she said, the fund that has been set up has supported a number of innovative ways of addressing social care, and I was very pleased to go and visit some of those when the last ones were announced. I'm very pleased to hear of the ambitious aims of Rhondda Cynon Taf council, particularly of the Stay Well at Home scheme, which I also know about, which is very good.

I'd just like to say about one of the things that's facing us for the future, which is the issue of climate change, which, obviously, is one of the greatest challenges facing us. There is a climate emergency and be it more extreme weather or immigration to the UK driven through the hardships that climate change will cause in other parts of the world, we need to get into a position where public services here can adapt, and that includes social care. We also need to work so that the hundreds of providers of social care in Wales can support the overall ambition of moving at pace to carbon neutral, which I think is very important when we think of the huge number of staff that we have got working in the social care system, many of them on an individual basis.

I also intend in 2020 to bring forward a national plan for carers. Vikki spoke powerfully about the contribution of carers. Across Wales, there are around 370,000 unpaid carers of all ages who support a loved one who is older, disabled or seriously ill without being paid to do so. They contribute hugely to Welsh society and I think it's important to say that the vast majority of those carers are pleased to do it and want to do it, and are looking after a loved one, and we should be doing our utmost to support them to do that. But we do know from reports that have come about carers that they are struggling and they often have a lot of difficulties. But I think it's so important that we recognise the enormously important role carers play, provide support to them and also enable people to have a life alongside caring. I'll be working with the ministerial advisory group on carers and other stakeholders in 2020 to develop a national plan for carers in 2020.

To finish, I'd like to make two further points. The future social care system in Wales should be a balanced system. Independent providers will remain a key part of the system, and we have fantastic independent providers in Wales, and we are dependent on them. And some of them are at the leading edge of practice. As a Government, we want high-quality, independent providers to play a key role. But we will also support local authorities who wish to bring more provision directly under their control. We also want to see co-operatives, as Vikki Howells referred to, playing a bigger role in a balanced care market. In the new year I intend to provide a statement that sets a framework for pursuing the rebalancing of social care.

Finally, then, I think, in the end, this debate does boil down to the very important point that Vikki made: how we can grow the capacity and capability of the workforce, to take the opportunities and respond to the challenges ahead. I'm acutely aware of the challenges that social care professionals face in delivering high-quality person-centred care on a consistent basis. Social services departments and social care providers are packed full of committed, skilled and hard-working people. Social care for very many people is a vocation, not just a job. What we must do is increase the status of the workforce—Vikki Howells mentioned the registration that we are introducing. We need to tackle the disparity in wages that she has also mentioned. She's mentioned the progress we've made on zero-hours contracts, and I think this is probably one of the absolute key issues that we have to deal with. Our greatest concern must be the growth in the capacity and capability of the workforce. In particular I want social workers to have the time to relate to and care for people. Equally, the workforce of the future won't be enabled to step up to the challenge ahead if it is, as I've said, low paid and unstable. As a Government we are focusing on fair work, and social care is in the vanguard of these developments.

To conclude, we sometimes say in our debates that the status quo is not an option; never has that been truer of social care, looking out into the rest of the twenty-first century. In many ways, we are in a good place, but there is much work to do. I think we know what the direction is that we want to go to, but I thank Vikki Howells very much for raising this question in the Chamber tonight, and I look forward to working across the Senedd to meet these challenges in the time ahead. Thank you.

Thank you. And that brings today's proceedings to a close. Thank you.

The meeting ended at 18:03.