Part of the debate – in the Senedd at 4:56 pm on 19 October 2022.
I welcome the report of the Public Accounts and Public Administration Committee from its inquiry into care home commissioning. I also welcome the opportunity to speak on the topic in the Senedd.
This report clearly highlights the challenges faced in the complex area of care home commissioning for older people, with the intention of improving the system so that it is more equitable for all. It's fair to say that the challenges facing the sector are wide and far reaching. The committee heard evidence about the accessibility and quality of care home provision in Wales, the variations and complexity associated with funding care home placements, the difficulties faced in attracting and retaining staff in the industry, and the proposed policy reforms relevant to its field.
The report's recommendations are aimed at addressing some of the important issues, and if implemented, will help to strengthen and simplify the process of care home commissioning. Such improvements are important for us all, as social care is a service that touches the lives of individuals and families in every part of Wales. Sadly, for a service that is so crucial, social care is criminally undervalued. Workers are not given the respect they deserve and this is reflected in poor terms and conditions. The Government will no doubt mention the introduction of the living wage, but as TUC Cymru concludes, it is not enough. It is worth pointing out that this conclusion was reached last year, and long before economic mismanagement by the Tories in Westminster exacerbated the cost-of-living crisis, which has made social care less attractive.
It is not just pay that care workers get hammered on, either: terms and conditions are weak. As the TUC also pointed out, thousands of care workers in the outsourced sector are not contractually entitled to proper sick pay. They estimate that around 5 per cent of staff are not even eligible for statutory sick pay. Apart from the immorality of this, the situation will inevitably lead to ill workers coming into contact with vulnerable people because they cannot afford to take a day off sick. How can this be in the twenty-first century?
Many of the problems identified in the report could be solved by a merger between health and social care. This has been a long-standing policy of Plaid Cymru and I'm pleased that movement towards this goal is covered by the co-operation agreement that we struck with the Government. The commitment to get a report from an expert group to explore the creation of a national care service, free at the point of need, as a continuing public service cannot come soon enough. Through the integration of health and care workers, we can raise the recognition as well as the reward that is long overdue for social care workers.
I must also mention the lack of community hospital capacity in the NHS, which is having a knock-on effect on social care as well as our health service. Just last week, my Plaid Cymru colleague Rhun ap Iorwerth mentioned the drop in the number of hospital beds in Wales from around 20,000 at the end of the 1980s to just over half that in the present day. The demise of the community hospital can partly explain the downward trend, and it's having a huge impact on the NHS, causing bottlenecks in hospitals and elsewhere. I understand the push to treat more and more people at home, as many would prefer this, but for some it's not appropriate, if they are not well enough or not mobile enough to live at home. In such circumstances, without an adequate package in place, they remain in hospital. A community hospital bed would be a much better solution. These beds do not cost as much as district general hospital beds, and I echo Rhun's call for the Government to look into the matter with urgency. Diolch yn fawr.