Item 4 this afternoon is a statement by the Deputy Minister for Social Services on the learning disability action plan. And I call on the Deputy Minister, Julie Morgan. 

Diolch. I'm pleased to update Members on one of the vital areas of work that the Welsh Government is undertaking, to promote the rights and entitlements of some of the most vulnerable and often overlooked groups in our communities: people with learning disabilities, their families and carers.

Following on from our groundbreaking Improving Lives programme, which ended in March 2021, I want to draw Members' attention to the work we are now taking forward to build on the gains we have made. Whilst recognising the progress that we have made in meeting the needs and aspirations of people with a learning disability, we must also acknowledge that the pandemic has had a disproportionately damaging impact on their everyday lives. This has only highlighted the inequalities that still exist in society and the barriers to be overcome if people with a learning disability are to lead the lives they want to lead and to be recognised as valued members of society, being helped to live, work and develop as individuals, in their own communities, and close to the people who matter most to them.

I'm publishing our learning disability action plan, which demonstrates our continuing commitment to improve the services offered to people with a learning disability. I will also highlight the actions we will take to address the inequalities and disadvantages that many face every day of their lives. The action plan has, very importantly, been developed in collaboration and consultation with people with learning disabilities, the learning disability ministerial advisory group, and partners from across the public and third sectors. We also undertook a targeted six-week stakeholder engagement exercise.

The plan prioritises the key areas, actions and outcomes we want to achieve. It sets out the actions we will take to improve access to public services, including health, social care, education, employment, housing and transport. The priority areas include: reducing health inequalities and avoidable deaths; reducing the need for hospitalisation in specialist units through improved access to community-based services and crisis prevention; reducing long stays in hospitals, and in particular, reducing out of county and country placements; improving access to social care provision; supporting people to live as independently as possible through increased access to advocacy and self-advocacy skills and services, engagement and collaboration; ensuring access to education that meets the needs of individuals; providing enhanced employment opportunities and skills training; increasing appropriate housing that is close to home with integrated support services; improving the support for children, young people and their families through the development of a joined-up approach to children's services across health, social care and education, and in particular, improving how services support young people as they move towards adulthood.

In addition to the investment Welsh Government are making in areas such as employment, education and transport, I am pleased to announce that we are investing an additional £3 million over the next three years from our new social care reform fund to support delivery of the health and social care actions.

Preventative community solutions and the continued development of integrated housing, health and social care services are crucial elements to enable people with a learning disability to be supported and to live as independently as possible. The regional integration fund, launched in April, provides £144 million annually for five years to drive this much needed integrated support. We've ensured that individuals with a learning disability are one of the identified priority population groups for RIF funding.

A detailed delivery plan will be published in August and will contain the specific actions that will underpin successful delivery of these priority actions. It will be a living document and will be updated to reflect any changes to emerging priorities and circumstances. Both the strategic action plan and the delivery plan are flexible and contain actions that are realistic and achievable, given the ongoing focus on pandemic recovery, the continued unprecedented pressures on public services and limits on available resources at a national and local level.

The action plan will help deliver the Welsh Government's programme for government commitments to tackle the challenges that we face and improve the lives of people across Wales, reflecting our values of community, equality and social justice, and our stated well-being objective to celebrate diversity and eliminate inequality in all its forms. This will in turn contribute to the achievement of our national well-being goals for a prosperous, more equal Wales and cohesive communities. The plan has been developed through the application of the sustainable ways of working in the Well-Being of Future Generations (Wales) Act 2015, in particular the priority areas that seek a preventative approach and better integration of services.

The plan also supports the ethos of the collaboration agreement between the Welsh Labour Government and Plaid Cymru, as many of the priorities identified reflect our shared goals of reducing the inequalities experienced by many of the people of Wales. In a commitment to ensuring genuine collaboration and co-production, we have worked closely with partners, including people with lived experience, to identify and agree priorities for action. I believe we have captured the most pressing needs in the plan and I would value your support for these priorities.

Our ministerial advisory group will be monitoring delivery of the plan and I will receive regular progress reports. There will also be a formal review at the end of year 2, to ensure the plan remains current and focused on the issues most important to people with learning disabilities. I will provide Members with a progress report at that time. Diolch.

Thank you very much for your statement this afternoon, Deputy Minister. And, whilst I welcome the statement and the publication of the learning disability strategic action plan, I'm afraid the plan is once again a set of aspirations and warm words, not a plan in any real sense of the word. What the document you published shows is that the Welsh Government has identified some of the challenges those living with learning disabilities face in their everyday lives, and while that is very welcome, what we need is detail on what the Welsh Government is going to do to improve outcomes for people with learning disabilities, and I accept that this is just part of the plan and look forward to scrutinising the delivery plan when it is published over the summer. However, this is the strategic plan, so where's the strategy?

Deputy Minister, how will progress against each of these priorities be monitored, and, more importantly, assessed? Without clear monitoring and targets, how will we know we are doing the right thing in the right way? Whilst the additional moneys outlined in your statement are welcome, how are they to be allocated? And how will you asses effective spending? For example, the £3 million from the social care reform fund will be used to support delivery of section 3 of the plan, which covers 15 specific actions. How far will the funding go in supporting a review of local authority day-service provision, developing tiers 2 and 3 of the Paul Ridd Foundation modules, as well as developing training and recruitment plans for learning disability nurses? 

Deputy Minister, I share your ambition to improve the lives of people with a learning disability, and we must do everything in our power to break down barriers and eradicate inequalities, but we are not doing that, and this plan, as it stands, will not change things. It's been three years since the easy read resources for annual health checks were produced. These resources, developed under the previous plan, are still not widely available. We have to do better, and so much better at that. This is why we need proper monitoring of this plan and the outcomes it delivers.

Is the learning disability ministerial advisory group the correct vehicle to monitor the plan given that it is subject to the plan? The LDMAG is currently opaque and people with learning disabilities and groups that represent them do not find the group accessible. I welcome the intent to make the group more inclusive—it's needed. If you look at the group on the Welsh Government's website, you would think that the group last met in December 2019. I'm sure that's not the case, but how are people living with learning disabilities supposed to know? This group is supposed to advocate for them.

Deputy Minister, I hope you will use the time between now and the publication of the delivery plan to strengthen it, and I look forward to working with you to improve the outcomes for people with learning disabilities. Thank you.

Thank you very much for that wholehearted endorsement of this plan. I think your response is as usual, but, in any case, I welcome the fact that you want to work with us on this.

I am sure that the Member heard me say that the detailed implementation plan will be introduced in August, so I think perhaps he had better wait to see that before he goes much further in his criticism of, in particular, the MAG, the learning disability ministerial advisory group, which I cannot praise too much. It is led jointly, with one of them being a women with learning disabilities, and it is very representative of different groups in the learning disability world and in society as a whole. They have pressed me strongly, have come up with a huge list of recommendations, are fighting for greater equality, and I'm really proud that we've got such a fantastic group and we want to make it even more inclusive. So, I think they won't take it very well that you have been very critical of them, especially as they have produced this plan jointly with other groups.

But, in any case, in terms of the £3 million, that, of course, is in addition to the other money that we put into learning disabilities. But, I have got a detailed breakdown of how that £3 million will be spent. I'm not sure we want to go actually penny by penny through it now today, but certainly one of the important things is to look at how we reduce avoidable deaths because, as you know, people with learning disabilities are much more prone to ill health. You mentioned the health checks issue. This was a very important part of the Improving Lives programme, that people with learning disabilities, who do sufferer disproportionately from certain illnesses, should have a yearly health check. Unfortunately, the pandemic arrived and it stopped that completely. In most cases, that was cancelled. We're now starting that again. Originally, £600,000 was put in to do it during the last financial year, we're putting another £350,000 in. Obviously, that will be carefully monitored because the health checks is one of the really important things that we want to do. 

You mentioned the Paul Ridd Foundation, the education, and the first stage has been done. I'd like to really pay tribute to the Paul Ridd Foundation and to his family who have campaigned relentlessly so that there will be a better understanding of people with learning disabilities, so that they get the treatment that they need in hospitals. In that £3 million is the money in order to ensure that the second and third phases go on. So, I can account completely for that £3 million and how it's being spent.

The other point I'll pick up in what the Member mentioned is the day services. That's an issue that I am very concerned about, because I know many of the day services—virtually all of them—closed down during the pandemic and not all of them have opened up yet. So, I'm very keen that we look at this. We are reviewing this situation, but we want, when they do open up again, to be absolutely sure that they are what people with learning disabilities want and that they are included in the planning of those day services.

This is a plan that highlights the key issues, the important issues, the challenges, of course, facing people with learning disabilities, their families and paid carers. I think it's fair to say it's hard to disagree with the aspirations, but where detail is lacking in elements of implementation, I think it's really important that we push Government for those details. One of the elements that are really important is real clarity on how progress is going to be monitored and evaluated. The Deputy Minister told us today that the ministerial advisory group will be monitoring delivery. I look forward to the progress report that the Deputy Minister is promising us before the end of the year, but I think we could do with more transparency about what it is exactly that we are measuring here so that we know what outcomes we are striving for.

On funding, we've had the announcement of the £3 million for delivery of health and social care actions. There are other elements of the plan for which there will be a need for substantial funding, and I think there are still gaps in what exactly those funding commitments are that we can expect from Welsh Government in order to fulfil the aspirations. Perhaps the Deputy Minister can give us more of an idea today of those elements of funding that, perhaps, Welsh Government is still trying to quantify, but at least give us an idea of the direction of travel that we might be headed in. And speaking of travel, transport only has one action in the plan, and accessing public transport as well as travel training is very important to people with a learning disability. Can I ask what plan is in place to improve the accessibility of transport for those with learning disabilities?

We have discussed on many occasions the importance of nurses within the healthcare workforce as a whole, of course. It's very concerning that this plan makes no reference to learning disability liaison nurses, who play such an important role. Is the Welsh Government reviewing that particular anomaly and what improvements are being made?

Perhaps a final general question relating to the pandemic. Of course, the pressure that the pandemic brought on services is well known. Many support structures were removed or reduced dramatically. Already challenging and complex caring situations were made worse, but we're talking now about returning to normal. Is Welsh Government also considering the likely longer term impacts of the pandemic, what they might be on people with learning disabilities, their families and carers and what steps might need to be taken and investment might need to be made to mitigate in the longer term?

I thank Rhun ap Iorwerth for those points. I think some of them are very well made. In terms of the detail, I think it's absolutely crucial that, in terms of implementation plan, which will have the detail, there will be the opportunity for Members to see that. It will be monitored by the MAG, which, as I say, is well represented with people with learning disabilities with lived experience. I think that's absolutely key. Obviously, they will be reporting to me as well, and at the end of the year, you will have that opportunity to see how the implementation is going. Obviously, progress will be evaluated. Some of the areas that we want to see improve will be easy to evaluate, for example the health checks that are so crucial. The pandemic came and cut those off, but we will certainly be able to see how those yearly health checks start and also whether they do achieve in identifying some of the illnesses that are linked with learning disability at an earlier stage in order to enable people to live healthier, happier lives, basically.

Some of the measurements are relatively easy to measure, others are more difficult, but, obviously, people with learning disabilities will be and should be taking advantage of all the other strategies for everybody in society. In this, we are doing particular targeted help towards people with learning disabilities, but if we have a truly integrated, equal society, they should be taking advantage of everything that we're doing as a Welsh Government. There are many other funding commitments other than the £3 million I mentioned; that was just the latest new bit that is identifying particular things to take forward.

In addition to that £3 million, there's obviously the £144 million regional investment fund where learning disability is a priority. So, we hope to see some projects from that. There's the core funding of £700,000 to health boards and to Improvement Cymru from the older people's, carers and disabled people's learning disability budget. So, there's that £700,000 as well. And then there is, of course, the money that I've already mentioned that has been given to progress the health checks—£600,000 in the last financial year and £350,000 in this financial year. So, there's a whole range of financial benefits that are coming forward, but I'd like to say, really, that we want to be sure that people with learning disabilities are taking advantage of all the things that we fund in the Welsh Government. 

Certainly, nurses are a very important part of the way of progressing, and I think I already mentioned what the Paul Ridd fund was doing in a wider way in terms of educating people in the health system in order to ensure that people do get the best help they can.

I think the pandemic has had a huge effect on everybody, and, I do believe, a disproportionate effect on people with learning disabilities. So, we have to look particularly at loneliness and isolation, because I think there has been a disproportionate effect of people with learning disabilities feeling lonely and isolated and having a great problem with coping. It's been particularly difficult for their carers, because the carers have obviously had great difficulties as well. So, I think, in the way that we look at how the pandemic has had a longer effect on children and older people, we have to include people with learning disabilities in that. 

I'd first like to draw everybody's attention to the St Teilo's Estyn report, which said that the needs of pupils with additional learning needs are met exceptionally well. Unlike in some schools, pupils who need bespoke support get bespoke support to thrive and achieve to the best of their ability. I saw that last week when I visited.

I'd also like to pay tribute to Bridgend College, which is exceptional in the support they give to young people to enable them to make the transition from school to the world of work. Some go on to excel in their chosen field, but sadly others of lesser ability seem to find other opportunities for growth and making a contribution to society shrink exponentially, and in a really frightening way in some cases. So, I'd like to understand better how we are going to enhance the employment opportunities for people who may have limited intellectual ability but certainly want to make a contribution. If we have IEPs for pupils, what about individual employment plans for people with learning difficulties?

Additionally, I wondered if you could say a little bit more about how you're developing appropriate housing close to home, with integrated support services, because it seems to me that's crucial for carers, particularly as carers get older and need to be cared for themselves.

Thank you very much, Jenny Rathbone, for that contribution. It's great to hear about St Teilo's and about Bridgend College. I've had constituents from my own area who have attended Bridgend College, and, indeed, I think it's an excellent place. I think every family's worry and fear is what's going to happen after the colleges end, and one of the priorities listed here is to do something about better employment opportunities for young people with learning disabilities, and that's one of the areas that is planned to be followed up in the detailed implementation plan. It's certainly been flagged up by people with learning disabilities as one of the very important areas that must be covered. There have been efforts made to approach employers to employ people with learning disabilities, and I was very pleased yesterday when I visited a project and met a young man with Down's syndrome who was working in a garage one day a week. He was absolutely thrilled. The first thing he told me when I was introduced to him was, 'I work in a garage one day a week.' I think there's a great deal of scope for extending that sort of approach to employers and develop the scheme that already exists in terms of approaching employers. I think that's very important.

In terms of housing and care, the Minister for housing did make a statement recently here in the Chamber about the additional money that is going to set up housing and care systems, and we are hoping that the RIF will come forward with £144,000 there. We hope it'll come forward with some innovative schemes for people with learning disabilities. I know the Member has had parents in her constituency who are getting older and are worrying, as they are in my constituency, about what's going to happen to those young people. It is a huge worry, and I hope that, with this plan, we will be able to tackle those issues. Certainly, the will and commitment is there to do it, and it's very carefully monitored by people with that lived experience.

Thank you, Deputy Minister. The Welsh Government's plan to introduce a new action plan to improve the lives of people in Wales with a learning disability is welcome. People with learning disabilities often face additional life challenges. They're more likely to have additional health problems, such as autism, epilepsy and dental problems, just to mention a few. Not always, but they can be at a higher risk of leading an inactive lifestyle that can lead to further health complications. We did talk about COVID-19. Like almost every part of our country, COVID-19 has had a major impact on services for learning disabilities. These services support some of the most vulnerable people in our society and must be one of the priorities moving forward. This is compounded by the fact that they are more likely to be exposed to poverty, poor housing conditions and unemployment. In 2006, the Welsh Government introduced annual health checks for people with learning disabilities to increase early detection of developing ailments. But many GPs do not offer this service due to lack of evidence about the long-term health benefits. I think you need to look—

The Member now needs to ask his question, please.

I wanted to ask about these things that should happen. I think I will leave it there.

Thank you very much for those questions. Certainly, individuals with learning disabilities are predisposed to respiratory and cardiac disease, diabetes, musculoskeletal problems and gastro conditions, including some cancers, along with what the Member has highlighted. Individuals with Down's syndrome are likely to develop dementia at an early age—around 30 years old. So, these health checks are absolutely vital. That was part of the Improving Lives programme, which was our previous plan, which did include the health checks. But they all stopped when the pandemic started, in the same way for nearly every sort of check—they all stopped. So, there has been a big setback because of the pandemic. But we are reinvesting £350,000 this year now to start up those checks, which will be monitored. I think the Member makes a very important point about how vulnerable people with learning disabilities are to the impact of poor health, and these health checks are absolutely vital.

Finally, Hefin David.

I'd like to thank the Deputy Minister for all the direct work and involvement she's had with people who have learning disabilities, and also advocates on their behalf. I know she's held meetings across Wales with such people.

The question I've got is regarding the point she makes about joined-up services between education, health and social care, and particularly how the action plan is going to address what I called in the debate last week the pinball effect, when you bounce between health, social care and education. It can lead to you waiting longer than maybe—. You might have a short wait for a healthcare worker, but then that cumulative effect means you're waiting a long time for the end result. I'd like to ask how that will be considered in the action plan, whether there may be ways of alleviating and whether, perhaps, parallel processes to reduce those waiting times might be an effective measure. At this point in time, I'd only want the Minister's opinion on that.

I thank Hefin David for that contribution and for all the work that he's done in this area and in other connected areas. With the parallel routes, it does cause problems and it does cause delays, so the action plan does want the development of improved and integrated children's and young person's learning disability services across early learning, schools, health and social care, and also including transition to adult services. We have set aside £175,000 of the £3 million I mentioned to undertake detailed mapping of services to identify gaps and needs. One of the issues as well is we really want to improve transition to adult services, because as well as the parallel paths, there is the big hurdle when you transfer to adult services. So, I thank him very much for that important point, and that is certainly one of the things we are considering in the action plan. 

Thank you, Deputy Minister.