4. Statement by the Minister for Health and Social Services: Update on the work of the Inter-Ministerial Group on Paying for Social Care

Part of the debate – in the Senedd at 3:10 pm on 4 February 2020.

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Photo of Janet Finch-Saunders Janet Finch-Saunders Conservative 3:10, 4 February 2020

In the run-up, Minister, to the general election your Labour leader Jeremy Corbyn stated in his election bid that Labour would develop a system of free social care in Wales. It is now clear, however, from this statement that you have u-turned already on this and that your solution is to introduce a tax here in Wales.

I would like to thank the Minister for acknowledging the uncertainties in projecting future expenditure needs for social care. This is undeniable. The cost is predicted to grow between £35 million and £327 million a year by 2022-23, which is a huge variation, and makes it that much harder to identify the figure actually needed and to how to fund it going forward.

I would like to share an important message that I hear from those delivering and receiving social care, and they say this: we need to invest more in prevention and early intervention. Too often, things are allowed to—. There's a lack of access to available services, and too often money from the health budget and the social care budget is going in at a very high level when things have reached almost crisis point. Actually, if there were better prevention models, if there were better intervention models, and if money was going in at that lower level, you could assist and support more people at a more reasonable cost, preventing this high-end cost that ultimately arises when people end up in crisis.

According to 'The "Front Door" to Adult Social Care' report by the Wales Audit Office, local authorities are preventing social care demand, but information, advice and assistance—IAA—are not consistently effective. They say themselves they have found a postcode lottery on preventative community services. They also say that regional partnership boards don't always necessarily have the right commitment and buy-in from, on most occasions, our health service, despite our local authorities working really hard in social care departments on very fixed budgets that are not allowed to go into deficit. They find that the regional partnership boards, in some instances, are little more than a talking shop. This, to me, sounds like an ineffective system, so what consideration will you give to making the system we currently have more efficient by putting strong prevention and intervention measures first?

Prevention, of course, is one of the underlying principles of the integrated care fund. Your statement notes that the group is keen to deepen the benefits of the ICF. So why then, tell me, of the 493 projects supported by the ICF in 2018-19, did around 60 per cent of those not continue to receive funding in 2019-20? As a businesswoman, that tells me that the project shouldn't have been started in the first place, or there were excellent projects that you have failed to continue funding. That is not a good way of actually moving forward. This is an important point because, whilst the draft budget provides £130 million into the ICF to help regional partnership boards, the auditor general himself has remarked that there is little evidence that successful projects were being mainstreamed into core budgets.

So, question 2: how can we be sure that the £130 million would not be better spent through a fair distribution of that money between Wales's 22 local authorities, allowing them to lead on prevention and integration and cutting out this ridiculous, costly bureaucracy and financial incapability, because of the money being so ring-fenced and tied to these boards?

Before considering a levy or a tax to our people in Wales, I believe that we need to acknowledge that an extra £1.9 billion will be coming to the Welsh Government following increased health spending in England by the UK Government.

Also, as part of my spokesperson's role within the Welsh Conservatives, I have been proud to work with care home proprietors across north Wales, and I've challenged Betsi Cadwaladr University Health Board in an effort to secure fairer CHC fees. So, with that, will the inter-ministerial group explore the potential benefits of the Welsh NHS making more finance available to support the social care sector?

What has come through to me is that people are fed up. They're fed up with budgets in health boards being allowed to grow and grow in debt and deficit, yet local authorities are bound to deliver a balanced budget. Quite often, as a result of people stuck in beds in the health service, when they really should be in their own homes or in the respective care surroundings that they need, too often money that should be spent by the health board is actually being picked up by our already-cash-strapped local authorities.