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 3:22 pm on 4 February 2020.

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Photo of Rhun ap Iorwerth Rhun ap Iorwerth Plaid Cymru 3:22, 4 February 2020

I'm not entirely sure what you've announced today, to be honest with you. Maybe you can give us a bit more information about this conversation that you're keen to start today and what form that conversation might take. There are references in your statement to all sorts of international models for paying for care. I read it that you want to have some sort of conversation, as I say, about raising a tax or perhaps a levy to fund social care, but given the long lead-in time for UK Government to agree to the devolution of any new taxes, I think, perhaps, you're happy enough to just keep on kicking that particular can down the road for a while longer.

You're quite right to say, of course, that there is concern about the sustainability of care as a whole—the care that we'll need to provide for our ageing population in future. And you know what? Given the narrative around concern about the cost of providing social care in particular, I can understand why it would appear to make sense to think of some sort of fund, perhaps, to build up to pay for that in future, but I think there are some real flaws in that. We can have a conversation about it, as you say. But we think that the question isn't about finding money for social care; the question is about paying for health and care services in the context of an increasingly older population in future. That means funding for the NHS and funding for social care and funding for good housing and tackling poverty and so on, amongst a whole host of other public services that are needed. The clear gap, I think, in funding, isn't social care, per se, or the NHS, or the other services separately; it's that lack of investment in services that prevents people from becoming ill in the first place and requiring NHS and social care. If we are to build funds—and I think we do need to think differently about models for the future—I think perhaps we should be thinking in terms of building up a transformation fund to get us to that care service that is fit for the twenty-first century and beyond, indeed. 

In response, actually, to some comments made by the Conservatives' spokesman, I think we can't just build the future of Welsh health funding on what we hope a UK Government might decide to spend on health in England in years to come. I think, based on the track record of successive Conservative Governments, their willingness to cut services deeply makes me nervous about hanging in there with a begging bowl for decisions on the NHS in England to be made. 

I'll come on to just a couple of questions. I have sympathy with the Minister's view that we need an honest conversation about the level of taxation paid. I believe it's a matter of principle that the best way is to fund care, both NHS and social, from general taxation, but I would strongly argue also that, if the Government does intend to raise taxes to fund health and care services, you'll only find support for that if, in exchange, there aren't going to be charges still for people who need those services. For example, that they would not have to sell their homes as well. 

A couple of claims were made in your statement. The statement claims that free personal care and care home accommodation could cost £700 million a year, but the accounts for local authorities—recent accounts—show that they've raised only £163 million from charges for social care for over-65s. Of course, you would also have to account for behaviour change, with self-funders moving into the funding, but the gap is still rather considerable. The Barker commission estimated the cost of providing free social care for those with moderate and critical needs for England would be £5 billion, which would translate to Wales as being around £250 million. In fact, LE Wales's own research in 2014 estimated this cost, which included under-65s as well, to be around £350 million. So could you explain why the figure you use is so considerably different to other estimates? A cynic would suggest that you're trying to undermine the case for social care free at the point of need whilst in the same breath claiming to aspire to that. Linked to this, you've stated that the research conducted by LE Wales on the additional funding needs required to maintain existing services by 2022-23, which is not far away, range from between £35 million and £327 million. That seems to me to be an extraordinarily wide range, so perhaps you could explain to me that wide gap in more detail.