Part of the debate – in the Senedd at 3:50 pm on 7 January 2020.
It is a serious concern to me that the attitude of this Government toward health funding focuses too much on the sum of money provided to the NHS today, despite the importance of that, of course, and isn't sufficiently focused on how to make health and care services more sustainable for the longer term. There is an intention to substantially increase the revenue funding provided to health, and on the face of it, who could disagree with that?
The problem, of course, is that most of the additional money available for 2020-21 is going to the NHS—an increase of £341 million, 2.6 per cent in real terms. We cannot ignore the fact that increasing the health budget continually at the expense of other areas does weaken those areas, and that, in turn, can add to the costs of the NHS ultimately. It is a vicious circle. Indeed, health expenditure has increased over the years of austerity by some 16 per cent in real terms, whilst other budgets have shrunk by a similar amount. And if we continue without making the investments and without making policy decisions that are innovative and preventative, as we should do now, then the part of the cake that needs to be given to health will continue to grow and now, surely, as the financial shackles are loosened slightly, then now is the time to make that innovative change.
So, when I see minor amounts praised in the budget in the statement made in December—£2.7 million to help primary school children become healthy and fit; £5.5 million for 'Healthy Weight: Healthy Wales'; and diabetes, much of it relating to obesity, costing some 10 per cent of the whole NHS budget—then I can't help but think that we are missing a trick in failing to invest health and welfare budgets in infrastructure for physical activity and sport to make us a healthier nation in the long term.
I see references to £190 million for preventative health measures in this budget. That is only something over 2 per cent of the total expenditure on health. The warmer words that we hear on the preventative agenda must be matched by funding too, and the same is true of mental health. There is still a lack of preventative spend in this budget, particularly for younger people. Also, we can't think in the longer term by continuing to sufficiently support the social care service and the services provided by our local authorities. Yes, there's a proposal to increase local authority budgets by £184 million, but the WLGA itself said that some £254 million would be required for a standstill position. Costs related to salaries weigh heavily, there are pressures from social services and children's services have also increased greatly, and we know that if local government doesn't receive the necessary support for providing social care, then it's the NHS that picks up the bill, ultimately—a vicious circle once again.
I could go on to talk about so many different areas where short-term management is the theme here rather than long-term innovation. The Welsh language is another example. We can all agree on the target of one million Welsh speakers, why, therefore, reduce the budget for the Welsh language specifically?
Llywydd, although we've heard today that we're expecting the first new Conservative Government budget on 11 March, I will make a brief comment on that. It's another example of us having to change our arrangements because of the whims of a Government in Westminster. A budget there decides on expenditure here after we've completed our budgetary process here. There is an alternative way of dealing with that and that is by taking responsibility for this ourselves. But we do know, because of the forecast of a slowdown in the economy and a pledge not to increase income tax, national insurance or VAT and so on and so forth, that there is very little scope for increasing public expenditure further. The economic uncertainty related to leaving the European Union is part of the problem, of course.
But to conclude, today, we are not talking about proposals from Government to change tax rates in Wales, but with the public purse likely to be under significant and increasing pressures to provide the kind of services that people require and insist upon in an uncertain economic context, the discussion on how we can use our limited taxation powers is going to have to become a more prominent issue of budgetary discussions in oncoming years.