Item 6 on the agenda is a statement by the Deputy Minister for Health and Social Services on the 'Rebalancing care and support' White Paper. I call on the Deputy Minister for Health and Social Services, Julie Morgan.

Thank you very much, Deputy Presiding Officer. We remain committed to our vision of securing well-being for people who need care and support, and carers who need support. Significant progress has been made in the nearly 10 years since our first White Paper on social care, 'Sustainable Social Services: A Framework for Action', which marked the beginning of this journey. The Social Services and Well-being (Wales) Act 2014 has reshaped the nature of the sector. It shares with the Well-being of Future Generations (Wales) Act 2015 a focus on well-being, an ethos of prevention and early intervention, and the imperative of co-production and cross-sector working.

Whilst we have a strong legislative framework, there is a range of challenges facing social care, and of course the biggest challenge facing the social care sector is the funding position, set in the context of increasing and more complex demands on services, and years of UK-wide austerity have made their mark on public finances. The Welsh Government has increased local government budgets by £172 million in 2021-22, compared to the current year, but there is uncertainty about future budget decisions at a UK level. Even with the additional funding in the Welsh Government's draft budget, and the significant investment we have made in the sector to address costs arising because of the pandemic, the projected future funding need looks challenging. The Minister for Health and Social Services will update the Senedd in the coming weeks about the work of the inter-ministerial group on paying for care.

The pandemic has put the delivery of care and support under further significant strain, and made the fragility of the sector even more visible. It's difficult, I know, at the moment, to look much beyond each week, let alone to the long-term future, but the impact of the pandemic shows that we must work to put care and support on a much firmer long-term footing. That's why we must increase the pace of our transformational work to make social services sustainable. We must seize the moment when the public's consciousness of social care is at a high-water mark, and look to forge a Wales-wide consensus about what we need to do to build back stronger. We must learn from the way that the sector has worked together during the pandemic to co-ordinate and deliver services, in line with our vision of a healthier Wales.

I am strongly committed to decisions about local services being made as close as possible to local people, and therefore to local democratic accountability. In making that clear statement about local democratic accountability, it is not contradictory to point to the complexity in the social care landscape. I believe there are a number of issues that we need to address through an evolutionary approach to the policy direction that Welsh Government provides at a national level.

In January, I published a White Paper consultation on 'Rebalancing care and support'. I am proposing that to be fit for the future we need legislative measures that we believe are essential to secure our vision. In essence, the White Paper seeks to rebalance care and support so that it is based on a clear national framework, where services are organised regionally and delivered locally. We intend to develop a national framework for commissioning social care that will reduce complexity and ensure that quality is the key determinant of success in the social care market.

We know that continuity of the social care workforce has a significant impact on the achievement of people's outcomes, and therefore there will be a strong link between the national framework and action to support the workforce. A small national office will be set up to develop the framework productively with our partners, particularly in local government and the NHS. Separately, we will establish a professional voice for the social care and social work workforce, at a national level within Welsh Government.

We remain committed to regional partnership boards and want to support them to build on their successes, to strengthen integration across Wales. We will enhance regional partnership boards by providing them with a sharper set of tools to deploy, to deliver their core aims, to better plan and commission care and support where collective action is essential in order to improve people's well-being.

The proposals I've set out will reduce complexity, bolster sustainability and strengthen integration. They will increase transparency rather than obscure local accountability. The proposals are key to securing the vision for social care set out in the social services and well-being Act, supporting people to achieve their well-being outcomes.

The White Paper is a blueprint for a stronger, more balanced, care and support sector. It'll be for the incoming Welsh Government to take forward the results of the consultation about my proposals. And I hope that all Members of the Senedd will encourage all those with an interest to take part in the consultation, so that we can work together to achieve our vision of securing well-being for people.

Thank you, Deputy Minister. You describe the proposals in the White Paper as long-term solutions, and I think we're all looking for a long-term solution, yet it does fail to address what is arguably the biggest problem: finance. Yes, you have noted your inter-ministerial group on paying for social care, however, how much further on are you since the publication of Gerald Holtham's independent report 32 months ago?

You'll be aware that, in my previous portfolio, I held many social care forums and, from those, you really get everything coming forward from those who are working in social care. You have also previously hinted, or there's been innuendo, around the introduction of a social care tax. What is your position on that now? I think I've always made it very clear that I would prefer to see a social care efficiency inquiry undertaken, because lots of stakeholders have always maintained that, actually, there is lots of money in certain areas, but actually getting it out to where the wider need is is not always possible. So, sadly, the White Paper does raise even more questions than answers.

You were looking for a national framework, but despite exploring integration, you state that no current functions will be transferred from local authorities or health boards. Why? Frustratingly, despite the concerns about regional partnership boards being well known—and in our inquiry, we found many weaknesses—you wish to strengthen them further, so what work have you done on this to actually justify that being where you think the message can be carried out from? How can you justify this when your own White Paper states, and I quote,

'RPBs ability to meet their responsibilities could be regarded as limited' and

'RPBs are concerned about managing a diverse cohort of need across localities'.

It is also explained that a national office for social care would deliver the framework. So, as I hope you'll agree, this should be independent of Government. Can you make that commitment to us today?

Whilst you have outlined the problems that unpaid carers face, you do need to clarify how the framework will improve their lives. And over the next 10 years, it is estimated that Wales will need 20,000 extra social care workers to cope with our ageing population. Therefore, will you be publishing a specific social care workforce plan that includes fresh ideas and a holistic approach to retention, and one that champions continuous professional development to go alongside the White Paper? The Association of Directors of Social Services Cymru noted in December very specifically that one call would be that those pressures continue to be recognised and, clearly, assisting care homes to remain viable during this. Sadly, we've seen so many care homes lose beds or indeed themselves having disappeared.

So, evidence shows that there is much more that your Welsh Government can do. In fact, only yesterday, Care Forum Wales warned that care homes across north Wales will be forced to close unless an emergency funding scheme, the hardship fund, is extended. So, will you be extending that? And can I reasonably conclude that you will look again and perhaps start to bring forward some solutions that really do address the present problems in this sector and those that we've all known about for quite some time? Thank you. Diolch.

Thank you very much, Janet, for all those points. First of all, I want to emphasise that this is only one bit of a jigsaw, and I explained at the beginning of the statement that the Minister for Health and Social Services will be coming to the Senedd to discuss the results of the inter-ministerial group. A lot of work has been done on that group to establish what the cost would be of taking forward certain priorities, and I think that he is in the best position to go through those issues with you. What I presented to you today is only part of the solution that we're proposing. The issue that Janet raised about a social care tax, all those have been considered by the inter-ministerial group and the Senedd will hear about that in due course.

The RPBs are still relatively new, but I think that we have seen signs of health and social services and local government working together better in those forums. What we've had said back to us is that they do not have enough tools to do what they want to do. We think that it's crucial that health and social services do work more closely together, but also to involve the third sector. As the Member will know, on RPBs, the third sector has a place. There's a place for the citizen's voice and a place for carers, and we want to strengthen those voices on RPBs. So, we think that RPBs are good bodies to build upon.

In terms of the national office, the national office could be part of the Government or it could be an arm's-length body. That is something that is in the consultation paper, and I hope that people will respond to the consultation paper to say what they think about that. Yes, we will need a lot of extra social care workers, because we know that we have an ageing population. But, one thing that we do want is that we want people to remain in their own homes as long as they possibly can, because that's what people want. We therefore want to see that we can give as much support for people to stay at home as we can. That is why we also feel that local government is the best place to deliver social care, because local government is close to the community.

We would like to see residential homes, for example, being much more a part of local communities. Many of them are already, but that, I think, is the way that we would like to see things develop. But, because of the fragility of the sector, and because of the huge range that there is within the sector, in terms of the fees that are charged and the fragility of the workforce, we think that by having a central, small body to try and determine how things are done within a national framework—that's what we think will help to address those issues. So, I thank the Member for her comments.

I thank the Deputy Minister for the statement. Plaid Cymru has, of course, undertaken a significant amount of work through our care commission, which made the case for a national health and care service, and for a major shift towards preventing ill health and keeping people living independently. But, ours did so because that's what's best for people receiving the service. So, I'm surprised that the Government's White Paper and the statement, above all, frame this in the context of austerity and financial challenges.

It is the case that healthier people, living independently, will cost health and care services less money than the opposite, but I do fear that using austerity as the main justification may backfire somewhat. Do this because it's the right thing to do, not because the spreadsheet tells you to do it.

The challenges identified in the White Paper are similar to the challenges that we identified, actually: a lack of progress, in general, on the integration agenda; limited data-sharing progress; problems with commissioning. But, I'm not sure that the penny really has dropped with this Labour Government. In 2013, Plaid Cymru tabled amendments to the social services Bill to require partnerships. They were voted down in favour of voluntary agreements. You've been giving voluntary partnerships one last chance for most of the past decade.

It's also, I think, quite telling that your statement doesn't actually mention health or the NHS. So, perhaps the Deputy Minister could tell us how she sees integration working now. Certainly, it doesn't mention housing, or the wider environment. Yes, we know we need more housing adapted to help people stay living there. We need more semi-residential care facilities that avoid the problems with full residential care, whilst still supporting the people in them. But we need to address housing as a core part of this. It seems to me that we have silo working in clear view here.

Turning to something the statement does mention, the workforce. I too welcome some of the work that's been done on this, but it's worth remembering just how often the party of Government voted down attempts to ban zero-hours contracts in social care. As the Plaid Cymru commission recommended, it's our firm commitment that we will place social care staff on NHS pay scales, and finally make good the aspiration of making social care a valued career that people can aspire to. I wonder if the Deputy Minister can outline where she stands on that.

And finally, I'll turn to the commissioning practices. The problems of focusing on price over quality are heavily mentioned in the White Paper. Now, we know the Government proposes a national framework for commissioning, but I want to know more details about how this Government's proposed framework will avoid the race to the bottom that left our care homes so exposed to the pandemic. I remind you again that my proposal is for a set of national frameworks providing the backbone for local delivery in a properly integrated national health and care service for Wales.  

Thank you very much, Rhun. Your last statement does not sound dissimilar to what we are proposing.

There are a lot of issues there. If I start off on the workforce, I am absolutely committed to recognising the value of the social care workforce. Certainly, this pandemic has absolutely highlighted the importance of the workforce. The public do, I think—maybe some for the first time—realise how crucial a job the social care workforce are carrying out. I was very pleased that we were able to recognise their work by acknowledging them with the £500 bonus, which was very well welcomed. But also, I think, it was an absolute recognition of the work that they're doing.

In the work of the inter-ministerial group, the pay of the social care workforce has been one of the dominant issues discussed. And, of course, as I've said, the Minister will come and speak to the Senedd about the range of options and their costs that have come up through the inter-ministerial group. A few Members said that we shouldn't let austerity determine it. We're not letting austerity determine what we're doing; we're just saying, really, that one of the results of austerity is that this situation is even more acute.

We are building the professionalism of the workforce already. As you will know, we have established a register of social care workers, which has been widely welcomed by the sector, and the social care worker card has also been very widely welcomed. We have tried, during the pandemic, to get as much parity as we possibly can between the health and social care workers. I think that there are huge challenges with social care, and I absolutely agree with you, Rhun, that it is crucial that health and social care work closely together.

I do feel very strongly that people who need social care help should be kept in the community as long as they possibly can, because that's where they want to be. But, of course, we do need the support for them to be there. I do think you're absolutely right in mentioning housing. Housing is one of the key issues that we have looked at in the inter-ministerial group, and things like extra housing and extra support in the community is one of the areas that I think that we definitely should be following and one of the things that the Government would support.

Thank you very much, Deputy Minister, for your commitment to decisions about local services being made with local people, because I think that has to be our starting point. Unless we have democratic accountability and proper engagement with the people who need the framework, the services that we need to provide them, then we really are not looking at the jigsaw that I like to refer to, which is the well-being goals infographic. We really do need to be addressing all the well-being goals when we're thinking of older people, not just younger people. I really do think that we have a challenge to address the preventative agenda to ensure that older people are living well longer. So, I very much welcome your aspiration to ensure that people are able to live for as long as possible in their own homes. I'm just wondering, if we really do have locally run services, whether regional partnership boards are able to really manage those and are really focused on local communities.

I was very interested in the pilots that we did into the neighbourhood nursing teams. Now we have the report, and we also have a commitment to roll out those neighbourhood nursing teams across the whole of Wales. I would be distressed to hear that we aren't going to have a joined-up health and social care set of teams who are going to be locally managed rather than always having to refer back to some bureaucratic organisation. I don't see how else they're going to be sensitive and responsive to the needs of local communities. I think it's right to base them in local government, but I do think that is a work in progress; it's not a given that just because they're local government services they are really focusing on the individual needs of very local communities. One of the most important things about the neighbourhood nursing teams was the use of artificial intelligence to do some of the tasks that otherwise take huge amounts of management time, i.e. matching up the constantly changing needs of local communities with the skills of the multidisciplinary team. So, I wondered how a decent and much more modern information technology system will enable these self-managed teams to be able to have the most responsive services that citizens want. There's no time to go into more detail now. I very much look forward to responding to the White Paper.

Thank you, Jenny, for that. Obviously, I think the neighbourhood nursing teams are something we could have a more detailed discussion about outside the Chamber. I do believe that local accountability is crucial, and I know that there's a long way to go in terms of the integration with health and social care, but that is one of our absolute aims. That is why, of course, we are building on what has been achieved so far by the regional partnership boards, which are varied across Wales. The amount of progress that has been made has been greater in some areas than others, but I'm determined that we will strengthen them and that we will make sure that the third sector, for example, has a strong voice there, as well as local government and the health services.

Thank you very much, Deputy Minister.

The proposal under Standing Order 12.24 is to debate items 7 and 8 on our agenda together, but to have separate votes. Do I see any objection to that proposal? No, I don't.