And the next item is the statement by the Deputy Minister for Social Services on the 'Rebalancing Care and Support' White Paper. And I call on the Deputy Minister for Social Services, Julie Morgan.

Diolch. I updated Members of the Senedd on our 'Rebalancing Care and Support' White Paper consultation on 9 February. The White Paper set out proposals for improving social care arrangements to better enable the sector to achieve the vision set out in the Social Services and Well-being (Wales) Act 2014. The 12-week consultation closed on 6 April. A summary of the consultation responses has now been published on the Welsh Government website.

So, I'd like to take this opportunity to put on record my personal thanks to everyone who responded to the consultation. This summary of responses report provides an overview of the rich and considerable variety of views and opinions that were provided in over 150 responses. The majority of respondents recognised the challenges set out in the case for change. They agreed on the proposals for a simplified, outcome-based system, focused on quality and social value, led strategically and not reactively, and rooted in partnership and integrated working.

An overwhelming majority thought that the complexity in the sector gets in the way of service improvement. A significant proportion of responses agreed that commissioning practices are disproportionately focused on procurement. For these reasons, there was broad support for a national framework for care and support and an increased focus on commissioning by quality, outcomes, rights and well-being. Respondents felt that a national framework could reduce complexity and duplication. Many thought the framework could also encourage and facilitate integration and joint commissioning between health and social services. Furthermore, responses described an important opportunity to strengthen partnerships between commissioners, communities and providers to co-design imaginative local solutions in order to deliver the best outcomes for individuals while ensuring value for money.

Most respondents thought that the national office should consolidate existing national groups where there is added value, such as to reduce duplication, pool resource and to enable greater effectiveness and efficiency. Views on the location of the national office varied. Most local government responses did not support structural change, while others felt that a national office needs to be independent of Government in order to hold partners to account and build relationships with the market.

In relation to regional partnership boards, over half of responses thought that they were limited by their design and structure. The majority of these respondents were from the third sector, independent sector and from citizens. There were calls for a formal review of regional partnership boards' structures and membership as part of any future reform. The majority of statutory bodies thought legislative powers were sufficient to enable regional partnership boards to undertake their existing responsibilities. These responses emphasised that partnerships are about trust and relationships, and that partners need to work together to deliver the necessary change. Many examples were provided from all sectors about how regional partnership boards could be strengthened further, either in their current format or as legal entities.

We know that partners need to work together at a number of levels to meet people’s needs. The third sector were clear that health and social care systems remain difficult to navigate for individuals. Building on the strong partnership working that was demonstrated during the COVID pandemic, I want to see effective partnerships thrive at cluster, local authority, regional and at a national level.

In relation to the Welsh language, a number of responses cited difficulties in providing Welsh language services at a local level, and the challenges regional partnership boards currently face in relation to existing Welsh language duties. There was a consensus that the Welsh language must be at the core of future policy development, and that if a new body is established, then it should be required to comply with the Welsh language standards.

Respondents expressed a clear and overwhelming commitment to work with Welsh Government to further develop these policy proposals. In line with our programme for government, I am committed to introducing a national framework for care and support and to strengthen partnerships to deliver for the people of Wales. How we do that will be informed both by the consultation feedback and through further engagement with the sector.

It is important to look to the future and how we build back a fairer system. Our White Paper proposals are a blueprint for a stronger, more balanced, care and support sector. They are about long-term solutions to enhance our system and ensure sustainable social services. I hope all Members of the Senedd will continue to encourage all those with an interest to work together to achieve our vision of securing well-being for people who need care and support and carers who need support. Diolch yn fawr.

Thank you to the Deputy Minister for your statement this evening. Rebalancing care and support is something that all of us in this Chamber can get behind. We started the journey with the Social Services and Well-being (Wales) Act 2014, and the commitment to integrate health and care. It's high time we accelerated the journey towards person-centred care and co-production of health and care.

Whilst there is much in the Welsh Government's White Paper to support, I do have concerns as to whether your proposals for legislation will deliver the aims we all share. I'm also disappointed that there is no substance to today's statement; there is no direction of travel. Deputy Minister, what message does this send to service users, indeed? And what message does it send to service providers? We have yet another Government statement stating things are going to change, but no detail on what or when changes are coming. When will the Welsh Government be able to bring forward the rebalancing care and support Bill? Are we talking a few months or a few years?

I note that there was nothing in the statement regarding the creation of the chief social care officer. This was announced in a written statement last month, yet that is a key plank of your proposals, along with the creation of a national office. Like many of the respondents to your White Paper, I believe that the national office should be independent of Government and so should the chief social care officer. Deputy Minister, do you agree that the post should be filled via a robust public appointments process and how will the Welsh Government appoint someone from within Welsh Government to be a strong voice for the sector and someone who can stand up for the service users and challenge Government?

Aside from the issue surrounding the lack of independence of the national office and the chief officer, the main issue with the White Paper is around the capacity of regional partnership boards. Deputy Minister, you see the regional partnership boards as being central to your proposals for strengthening care, do you feel that, as they currently stand, they have the capacity to deliver improvements to care and complete the integration of health and care?

An Audit Wales report in 2019 highlighted the issues with the integrated care fund and there were also concerns raised that the regional partnership boards were failing to share best practice. Have you addressed the concerns of the Auditor General for Wales and how can you stop regional boards operating in silos? Can you also outline how the regional partnership boards will work alongside the public services boards and how will you avoid duplication of the work?

Finally, what role do you see providers in the independent and private sectors playing in the development of services and how will they interact with the regional boards? I look forward to working with you to deliver co-produced care that focuses upon outcomes and I hope they will soon complete the journey that started nearly a decade ago. Thank you very much.

I thank you very much for those questions and I very much appreciate the fact that you think we can all get behind changes to the system. The principles of the 2014 Act are reiterated in everything that we plan to do, with person-centred social care working to bring social care and health together. What the statement is doing today is as a result of the publication of the consultation that we have just published and to draw the attention of Members to the choices that now lie ahead of us, taking into consideration what's been said in the consultation and in the further proposals that we will be working on, engaging service users and working with different parts of the sector.

The 2014 Act was totally committed to working in a co-productive way, to work closely with the different stakeholders, and we plan to do that. I've already talked to the Chamber about the fair work forum that we have created and who we'll be working very closely with in all these developments. So, I want to assure the Member that we will be working with the sector to come up with solutions, and the purpose of the statement today is to highlight the fact that the consultation has finished and we've published the result of that consultation.

He referred to the new chief social care officer. This is bringing social care on a parity with the chief medical officer, for example. And it is very important, I think, for highlighting the importance of the profession that we do have a chief social care officer. I note that he believes that any national unit should be independent. That was the view that was reflected by some of the responses to the consultation document, and obviously that is something that we will consider.

We work very closely with the independent sector. I meet with the chair of Care Forum Wales on a regular basis and they have worked with us through the whole of the pandemic very closely. So, certainly the independent sector are going to be a key part of how we take things forward, because, of course, in terms of residential care, about 80 per cent of the provision is in the independent sector.

Thank you for the statement today, Deputy Minister. I'm not entirely convinced whether this statement was necessary today. It is not a particularly good sign that a Minister has to explain, having delivered her statement, what the purpose of that statement was. Yes, it's an update, but what we want to know is what is the meat on the bone in terms of the development of the White Paper, published earlier this year, and I'm not convinced that we've had any further information as to the direction of travel.The words are echoed again today, as we heard in the White Paper: the challenges, the case for change, partnership, working collaboratively. We know all of that. We know what the challenges are. We in Plaid Cymru have been able to identify many of those challenges through the work that we did in the previous Senedd, through our care commission.

The question is: what steps will be taken now in order to find real solutions to these challenges? The White Paper gives us some idea of the direction of travel of Government, but, to date, I think we are still waiting to see how that journey will pan out. And I agree with the previous spokesperson: of course we can all unite behind those core principles—they are quite simple, to raise the standards of care that we provide to people—but let us know exactly what we're judging here.

I have a simple question, if truth be told. We are still waiting for some work to be done in Westminster, or in Whitehall, rather. The inter-ministerial work has been ongoing to look at how to pay for social care in future. I very much hope that we won't have to wait too long for the conclusions of that work, because it is such a crucial area that we do need to address. But can you give us some idea of how the recommendations that you have, which are slightly ambiguous at the moment, would be impacted as a result of whatever statements or decisions are taken in Whitehall as to the bigger picture in paying for social care in future?

I thank Rhun ap Iorwerth for those comments, and I repeat, really, that the words of co-production and partnership are the absolute key words in most of the statements that we make, and working co-productively and working in partnership is not easy to do, it takes some time, and we are committed to taking this forward in a co-productive way. So, we will continue to build on what these responses are, we will continue to consult with the sector, and we will come forward with proposals as a result of that consultation.

He mentioned about Westminster and what's going to happen in terms of Westminster. Well, we've been assured that there will be a statement from the UK Government before the end of this calendar year, saying what is going to be their direction of travel for social care. I know we've been waiting for this for a long time, and if we don't get something within the timescale that we've been given, we would seriously then have to consider whether we come forward with the wider proposals after that period of time. We think it's very important, if it is at all possible, to get an England-and-Wales solution because of the interface between taxation and benefits, and we wouldn't want the situation to arise, such as arose in Scotland, when they brought in the free personal care and people lost attendance allowance, and the complications of that. So, we think it would be very desirable if we could get a solution for England and Wales, but we can't wait forever, and, obviously, we will have to consider our own way of raising money if we don't get anywhere soon with Westminster.

Clearly, if we're going to institute a different way of paying for social care, we are going to have to legislate. But, hopefully, the UK Government will come up with something. So, in the meantime, I completely support your focus on commissioning quality outcomes, rights and well-being. I want to just highlight that the third sector are clear that health and social care systems remain difficult to navigate for individuals, and you can just imagine what it's like for somebody who suddenly needs the help of society to support their needs. So, I really want to understand a bit better how we are going to simplify things for the citizen who may need social care. We seem to spend an awful lot of time on creating more structures, and I would like to just remind Members, particularly those who are new to the Senedd, that the Public Accounts Committee, in its report on the well-being of future generations Act, had a really clear recommendation that the

'Welsh Government must not create any new partnership or collaborative structures to fulfil any functions unless it has...explored whether existing partnership structures could undertake those functions instead', or,

'the new structure could replace existing ones'.

We need to do a cull of structures, frankly, because the citizen is absolutely in the undergrowth when it comes to the alphabet soup of structures.

We already have a really clear commitment by the health Minister to bring health services closer to where people live, and we have the successfully piloted neighbourhood nursing schemes. So, I'd really love to know what progress has been made on mainstreaming these self-managed teams, whose mantra is to work in partnership with the people they are caring for and with the other stakeholders surrounding that individual. And I think that was echoed in a report I just happened to have fallen upon from Flintshire, which really focuses on exactly these issues, which is about ensuring that we have local solutions that are really meeting the needs of individuals and local circumstances. So, I'm not quite sure what the role of this national office would be—that seems to be a step in the wrong direction. So, I wondered if you can clarify all of that.

I thank Jenny Rathbone for those very important points. Taking forward a national office is something that there is a mixed reaction to in the consultation responses, but there is probably more support than not. And the purpose of having a national office is actually to simplify the whole system, because, at the moment, we've got hundreds of providers employing thousands of people, and each negotiation that takes place in terms of what the fees are for care homes, for example, has to be done on that individual basis with that individual care home, and there are 22 local authorities commissioning, so it's incredibly difficult. And I think, for individuals trying to negotiate the care system, it is very, very complex and very difficult. So, we think that a national body would be a way of simplifying things, and certainly trying to work during the pandemic with the mass of providers has been very difficult in terms of getting key messages through to those individual providers. So, I certainly see a national office as something that will simplify things.

I'm aware of the Public Accounts Committee's work, and I certainly think that their proposal that existing structures should be looked at first is absolutely right. And one of the things that we are considering is strengthening the RPBs, which, of course, are existing structures that were there to strengthen the working between health and social services, and where a considerable amount of money is put in by the Government for them to work together. The £129 million ICF funding and the transformation funding of £50 million per year is there to stimulate the working together. We do think that RPBs need to be strengthened but, of course, they are existing bodies.

And finally, I know the Member's referred to the third sector—well, I think it's absolutely crucial that we involve the third sector in as much as we possibly can, and I think it's very illustrative really that, in the responses to the White Paper, the third sector were, on the whole, consistently supportive of strengthening the RPBs, because that's where they've got a voice. They don't feel they've got a strong enough voice, but they are represented there on the regional partnership boards, along with a citizen representative, a carers representative, and it's that multifaceted sort of board there they support.

Thank you, Deputy Minister, for your statement this evening, now. I think some of my comments probably come off the back of and are similar to what the Member for Cardiff Central was referencing there in terms of the national approach to some of this. Of course, your statement is off the back of the consultation on the White Paper, and in the summary of responses that was published, I just want to reference a couple of sentences that jumped out at me. First of all, this one that says that,

'Mostly it was thought that a national framework would be beneficial'

—and there's a caveat there, then—

'if it was defined clearly, reduced complexity and enabled local decision-making.'

And later on in the paragraph, it goes on to say,

'The importance of local circumstances was highlighted and the ability of organisations to define and secure provision in a way that meets their own priorities.'

So, there's a big focus within the consultation response on the ability of local decisions to be maintained and made, and, as we know, we have these things that have local democracy, a very close level, called local authorities, which are often best placed to make those decisions at a very local level. We have, of course, seen through the pandemic where local authorities have that local knowledge in terms of intelligence and support for their residents and the difference that they can make. So, there are clearly some concerns within these proposals about things moving from the local level to the regional and then up to the national level, and the opposite of devolution, which many of us would like to see. So, I'd ask what is it you're going to do to ensure that local authorities with that intelligence and expertise—? What is it you are going to do to engage with them and continue their provision meeting their residents at a very local level? Thank you.

Thank you, Sam, very much, for that question—a very important question. We do intend local authorities to continue to deliver and commission social care services, because it's absolutely crucial that these services are as close to the public and close to the local area as possible. So, we certainly don't see any diminishing of the role of local authorities in this field.

We think that we need a local, regional and national service, and we need more effective regional provision and we need a national framework that does not diminish the delivery at a local level. I feel very strongly that the provision of social care should be linked very strongly with local services, because they're the people who know best, and I feel that it's possible to build up the community through the services that you have locally, and the knowledge of the local community is absolutely crucial. So, we are determined that the delivery of local services and the local knowledge will not be diminished by these proposals, but we are planning for a national approach that will make it simpler and will be able to provide parameters that will prevent some of the confusion that exists at the moment. It's a very fragile sector and we want to strengthen it, but we want to strengthen local accountability as well.

I want to put on record the thanks that we all owe to the social care sector, who have worked tirelessly throughout the pandemic. They've given their all in terms of commitment and, very often, sacrifice to see people through a time in their life where they need that care and support, and I'm sure there's nobody here that would disagree with that statement.

Minister, the 'Rebalancing care and support' White Paper has predicted that the demands on the services delivered by the social care sector are going to rise significantly by 2040, and we all know the reasons, and the reasons are that we're living longer, and, as we live longer, when we need care, those needs are, indeed, more complex. And it also acknowledged that the social care workforce is facing lots of challenges. That's what the paper's all about. And one of the areas I want to focus on is staff, and the recruitment of staff, because you clearly won't have a service if you don't have any staff to deliver it. And there's one figure that jumps out, and that is not a surprising figure: that the majority of staff who work there are women over 40 years of age. It is clear that, when we're talking about care, we're talking about people. We're talking about people accessing care from people they very often don't know, inviting them into their homes. And that diversity is critical in terms of taking that forward. So, whatever happens in taking this forward, we have to improve both the diversity of the workforce and the terms and conditions that the workforce work under. And one of the reasons for the shortages is, indeed, the poor terms and conditions, and that again is mentioned in this report.

I'm going to ask people here today to reflect on something that is within that report, and that is about the anxiety that individuals receiving care would feel if they don't know who is going to turn up for their care, or when they're going to turn up, because the flux in the market is such that they can't be reassured. And yet we're asking those individuals to trust other people with the most intimate care at a time in their life when they feel the most vulnerable. So, I think if there's one thing that I would like to see coming out of this, it's looking at that workforce being delivered in a way that people feel some sort of power for themselves so that they're not always just done to. 

I thank Joyce Watson very much for that important point and for emphasising the crucial nature of the workforce in this field, because, as she said, the workforce are delivering the most intimate services to very vulnerable people. It couldn't be a more important job, and I think our role in Government is to do all that we can to boost that workforce, to give it confidence and to show that we recognise the value of the work that is being done.

One of the things that we've already discussed in this Chamber that we are doing is to raise the wages to the real living wage, and I think that is absolutely crucial. I think the terms and conditions as well are very important, and that's where we are getting advice from the social care forum that we are working with, which includes the unions, the employers, Welsh Government and other organisations. We have brought in a registration system, as she will know, for domiciliary care workers, and we're in the process of bringing it in for residential care workers, which again recognises the expertise that this workforce—mainly women, as she said—have, and the care and the love they deliver it with. There is a high turnover, and that is something that does create a lot of uncertainty. So, we want the job to be one that people will want to stay in.

Our definition of fair work does include equality and inclusion, and that is something that the forum is actually considering. And we have been working to raise the profile of social care through the WeCare.Wales campaign, which is managed by Social Care Wales. This shows the range of roles that are available in the social care field, and also uses case studies based on real workers, ensuring that underrepresented groups are represented as role models. Social Care Wales also works directly with schools and employers, using these materials to try to recruit people into the sector. But the workforce is the strength of the sector, and she's absolutely right that we have to consider what we can do to improve terms and conditions, pay, and make people want to stay. 

And finally, Jane Dodds. 

Diolch, Llywydd. I welcome the proposals, including setting out a clear national framework to support services to be planned regionally and delivered locally, and the strengthening of partnership arrangements. I just want to focus briefly on services for young people and young adults within this framework, particularly those with learning disabilities, and the barriers in place for social services to ensure that these young people and young adults and their families are able to access the full range of services they need. A 2018 Care Inspectorate Wales study found that most local authorities were struggling to meet their sufficiency duties and to find suitable placements to meet the needs of young people and young adults. In relation to choice and availability for residential resources for those with additional needs, I have no problem if those resources' primary aim is to provide high-quality care and to meet the standards required, but I'm very concerned at residential resources where their primary aim is to make a profit. The children's commissioner has also called again to move away and ultimately end profit-making in care services. So, may I ask what consideration will you give to those representations made by the Children's Commissioner for Wales and directors of social services with regard to the role of for-profit providers of care for young adults and those with learning disabilities as part of these plans to rebalance care and support? Diolch yn fawr iawn.

I thank Jane Dodds for that very important question. Yes, I've had many discussions with the children's commissioner about this particular issue and I know she feels very passionately about it. I've talked to young people and children about this issue, and I've been struck by how deeply they feel that the circumstances of their lives have enabled some people to make a profit from it, and they feel that very deeply. Speaking to the young people that I've spoken to, I felt that it was really wrong that they felt in this position, and many of them do feel very strongly about it. So, it is as a result of discussions with young people and with the children's commissioner that we have given a commitment in our manifesto that we will move towards ending profit-making services for children and young people. That is the commitment in our manifesto. We would aim to do this over the five years of this term. I don't anticipate that this will be easy to do, because a lot of the work is in the profit-making sector, and we certainly would want to do it in a way that didn't disrupt anybody's placements if they were happy and settled, but I think we must move towards greater non-profit-making provision, greater local authority provision. That is the commitment in our manifesto, and we are starting to scope the way ahead as to how we will achieve that.

I thank the Deputy Minister, and thank you all for your contributions this afternoon. That brings today's proceedings to a close. Thank you.

The meeting ended at 18:18.