I'm in the class of 2011, Llywydd.

Thank you, Llywydd. I'm speaking in my capacity as the Chair of the Health and Social Care Committee. Now, last year, I opened my contribution to this debate by thanking everyone who worked in the health and social care sector, including volunteers and unpaid carers across Wales, for their dedication and their commitment. The winter months, as we know, are always challenging in the health and social care sector, and unfortunately, this winter is no exception at all—far from it. So, on behalf of the Health and Social Care Committee, I thank them very sincerely, once again, for all that they do.

Now, the draft budget includes more than £10 billion for health and social services, as well as, of course, the provision for social care within the local government settlement, and we, as a committee, have explored how the Welsh Government is planning to use these considerable financial levers to achieve its desired outcomes and ambitions for our health and social care. The financial context, of course, is challenging. That's got to be recognised, and constrained, of course, by high inflation and high energy costs, and the impact, of course, of the pandemic and the cost of living continues to affect staff and services. And our health and social care sectors, of course, are grappling with an increased demand, in terms of tackling the waiting times backlog and dealing with longstanding workforce issues. Inevitably, this affects the range of activities that can be delivered, and potentially the timescales of both activity and outcomes. 

We welcome, as a committee, the Minister’s six priorities for health boards. That's very welcome, and if progress can be made in these key areas, it should unlock capacity and free up resources to enable progress to be made in other areas in the longer term. However, if these are priorities, by definition, other areas are not priorities, and we have some concerns that health boards may not have been given clear guidance about which areas the Minister considers as politically acceptable for them to draw back from. So, the Minister said to us in committee that she will review the health boards' integrated medium-term plans once they have been submitted to see whether she is comfortable with the decisions that they have taken. But, we all know that decisions to reduce funding or focus may be challenging or unpopular as well as necessary, and potential opportunities to draw back in some areas at a local level may only be apparent if full consideration is given to regional or national options. So, our report therefore calls on the Welsh Government to update us on discussions with health boards, including any concerns that health boards have raised, and any further guidance that Ministers have given on how health boards are expected to mitigate any resulting impact on the areas that are not amongst the six priorities.

I referred to the pressures that we've seen in health and social care this winter, and we agree with the Minister that addressing these issues relating to patient flow and delayed transfers of care are vital to unlocking the gridlock we have seen in the system. Now, part of the solution has to be resolving the long-standing social care workforce issues that we're all aware of, and we support the Government's commitment to the real living wage for social care workers—I very much support that myself—but we agree also with the Deputy Minister that it will not be enough on its own to address increasingly acute shortages. So, I know that the Minister does understand the urgency of the issues, such as improving access to sick pay, embedding domiciliary care workers in multidisciplinary teams and addressing the discrepancies in pay and conditions for social care and health service workers. But we are not yet persuaded that the social care fair work forum work is being progressed at the pace that is needed, that voluntary measures for collective bargaining or pay structures are adequate, or that there is enough clarity about how the recommendations of the national care services expert group will be progressed to deliver the Welsh Government's longer term ambitions for social care. So, to help us monitor this area, we have asked the Minister to commit to providing us with regular six monthly updates, through our recommendation 9.

So, I thank my colleagues on the Health and Social Care Committee and also the clerking team and the wider integrated team as well for all their support in terms of drafting our report. And, Deputy Llywydd, as a good Member of the 2011 intake, you can see that I'm dead on five minutes. [Laughter.]