Y Pwyllgor Plant, Pobl Ifanc ac Addysg
Children, Young People and Education Committee18/01/2023
Aelodau'r Pwyllgor a oedd yn bresennol
Committee Members in Attendance
|Buffy Williams MS|
|James Evans MS|
|Jayne Bryant MS||Cadeirydd y Pwyllgor|
|Joyce Watson MS||Yn dirprwy ar ran Buffy Williams am ran o'r cyfarfod|
|Substitute for Buffy Williams for part of the meeting|
|Ken Skates MS|
|Sioned Williams MS|
Y rhai eraill a oedd yn bresennol
Others in Attendance
|Albert Heaney||Cyfarwyddwr Gwasanaethau Cymdeithasol a Phrif Swyddog Gofal Cymdeithasol Cymru, Llywodraeth Cymru|
|Director Social Services and Chief Social Care Officer for Wales, Welsh Government|
|Claire Bennett||Cyfarwyddwr Cymunedau a Threchu Tlodi, Llywodraeth Cymru|
|Director, Communities and Tackling Poverty, Welsh Government|
|Eluned Morgan MS||Y Gweinidog Iechyd a Gwasanaethau Cymdeithasol|
|Minister for Health and Social Services|
|Irfon Rees||Cyfarwyddwr Iechyd a Llesiant, Llywodraeth Cymru|
|Director of Health and Wellbeing, Welsh Government|
|Julie Morgan MS||Y Dirprwy Weinidog Gwasanaethau Cymdeithasol|
|Deputy Minister for Social Services|
|Lynne Neagle MS||Y Dirprwy Weinidog Iechyd Meddwl a Llesiant|
|Deputy Minister for Mental Health and Well-being|
|Steve Elliot||Cyfarwyddwr Cyllid, Llywodraeth Cymru|
|Director of Finance, Welsh Government|
|Tracey Breheny||Dirprwy Gyfarwyddwr yr Is-adran Iechyd Meddwl a Grwpiau Agored i Niwed, Llywodraeth Cymru|
|Deputy Director, Mental Health and Vulnerable Groups, Welsh Government|
Swyddogion y Senedd a oedd yn bresennol
Senedd Officials in Attendance
|Dr Paul Worthington||Ymchwilydd|
|Jennifer Cottle||Cynghorydd Cyfreithiol|
|Sarah Bartlett||Dirprwy Glerc|
|Tom Lewis-White||Ail Glerc|
Cofnodir y trafodion yn yr iaith y llefarwyd hwy ynddi yn y pwyllgor. Yn ogystal, cynhwysir trawsgrifiad o’r cyfieithu ar y pryd. Lle mae cyfranwyr wedi darparu cywiriadau i’w tystiolaeth, nodir y rheini yn y trawsgrifiad.
The proceedings are reported in the language in which they were spoken in the committee. In addition, a transcription of the simultaneous interpretation is included. Where contributors have supplied corrections to their evidence, these are noted in the transcript.
Cyfarfu’r pwyllgor yn y Senedd a thrwy gynhadledd fideo.
Dechreuodd y cyfarfod am 09:32.
The committee met in the Senedd and by video-conference.
The meeting began at 09:32.
Croeso i gyfarfod o'r Pwyllgor Plant, Pobl Ifanc ac Addysg heddiw.
Welcome to this meeting of the Children, Young People, and Education Committee today.
I'd like to welcome Members to the meeting of the Children, Young People, and Education Committee today. The public items of this meeting are being broadcast live on Senedd.tv and a Record of Proceedings will be published as usual. Aside from procedural adaptation relating to conducting proceedings remotely, all other Standing Order requirements for committees remain in place. The meeting is bilingual and simultaneous translation is available from Welsh to English. We have received apologies from Laura Anne Jones this morning, and we also have Buffy Williams who will be joining us later in the session. Are there any declarations of interest from Members? I see no declaration of interest.
So, we'll move on to our first item on the agenda this morning, and that's scrutiny of the Welsh Government's draft budget 2023-24. This is our second evidence session and we're very pleased to be joined this morning by the Minister for Health and Social Care, the Deputy Minister for Social Services, and the Deputy Minister for Mental Health and Well-being. So, as I said, we have Ministers with us—you're very welcome—and we have some officials as well with us who are joining us, who are Albert Heaney, director, social services and chief social care officer for Wales in the Welsh Government; Tracey Breheny, deputy director, mental health and vulnerable groups, Welsh Government; Irfon Rees, director of health and well-being, Welsh Government; Steve Elliot, director of finance, Welsh Government; and Claire Bennett, director, communities and tackling poverty, Welsh Government.
So, thank you very much again and I'm sure you'll understand that Members have lots of questions and we've got a lot to get through this morning. So, I'll make a start with some general points. You'll be aware that our predecessor committee consistently called on Welsh Government to present more clearly the draft budget documentation, and how resources for children and young people are being allocated. And we also made that point last year, in our budget scrutiny with you. You'll know that we asked for the written evidence to present clearly the resources relating to children and young people, so that it was clear what was being spent and to understand that value for money is being delivered. To what extent are you confident that we have been given the full picture in the document that's been provided, and is it clear that children are getting their fair share of health and social care funding?
Thanks very much for the invitation to come and join you this morning. Before I answer that, if you don't mind, I'll just set a little bit of context for how the health budget works. So, we get about £10 billion—that's about half the Welsh budget—but the majority of that money just goes directly out to health boards. So, about £8 billion of that £10 billion just goes straight out. And what we've done—. Obviously, you'll all be aware that this has been a really tough year financially, that the inflationary pressures are affecting everybody, including organisations like the NHS and social services. So, the real-term increases are very tough this year, so we've had to really, really focus on prioritising. For example, I've made sure that we've got about £170 million additional for waiting times; well, there are children on those waiting lists, so, obviously, some of that money would go towards them. We've also continued to prioritise mental health; so that's a further £25 million spent on that. And you'll all be aware of the issues surrounding children and mental health, so it's important, I think, to recognise that that's also increased. We've invested a further £10 million in the social care reform fund, and one of the key priorities for us was to make sure that all social care workers are paid the real living wage. So, those are real priorities for us, so that's where they went.
Now, just in terms of how it organises, because the majority of the funding goes to the NHS, the way we work in Wales is that we ask the health boards to make decisions on the basis of the needs of their population. So, they have the information that is relevant to them on the ground. You may have a situation where some health boards have different challenges compared to others, so it's important that they do that on a localised basis. And so, I set some priorities and some guidelines for them to follow, and of course they then have to make sure that they deliver for all people, but that includes children and young people. We don't differentiate for children within that; we don't differentiate for disabled people within that either. So, if you start going down that route, the point is that we could go on for a long, long time, and it's complicated enough as it is. So, there are, however, a number of budget areas within our main expenditure group that are specifically targeted at children and young people.
As I say, this is a really tough budget year, and that inflation impact is significant. And that's why one of the things I've done this year is to be much, much clearer with the health boards about what they should focus on. So, I've set out six priority areas where they should focus. One is delayed transfers of care—you'll all be aware of what's going on more broadly. Access to primary care: of course, that is absolutely key—that's where most people have contact with the health service. And the intensity of that, and children, let's not forget—. Think about group A streptococcus just before Christmas—the number of contacts, for example, with primary care; in December, there was a week where there were 400,000 contacts in primary care. Think about the scale of that in one week, and of course, a lot of those were children, a lot of those were parents concerned about strep A. So, I think it's really important to get an understanding of that. Urgent care—you've all seen the pressure on hospitals; cancer; mental health; and waiting lists. So, those are the six priorities I've set them.
I think the other thing is that we've prioritised, we've protected all the key areas in relation to children. We've prioritised £10 million of new funding to roll out Flying Start and, of course, that's part of the co-operation agreement, which is to try and include a phased expansion of two-year-olds in terms of childcare. And we do monitor everything in terms of our programmes, so I can go into a bit more detail on that. 'Healthy Weight: Healthy Wales', we all know about the real challenges in relation to childhood obesity. We have a programme for government commitment. All of these are monitored very carefully. So, there are a range of specific children's programmes: Flying Start, the childcare offer, Families First, 'Healthy Weight: Healthy Wales', children's mental health—that of course includes eating disorders—and then we have this joint approach with education on the whole-school approach. And then, there's a whole range of social care support programmes on top of that. Sorry if I went on a bit long.
No, thank you. And I'm sure Members have many questions on some of the topics that you've just touched on as well. Just before we move on, I'd like to welcome Joyce Watson here this morning, who very kindly has come to substitute for a time for Buffy Williams. So, thank you, Joyce, for joining us.
We did ask, in our information request before today's session, about the changes between this draft budget 2023-24 with both the draft budget 2022-23 and the first supplementary budget in June 2022. We did ask for indicative 2024-25 allocations. Perhaps you could explain why that wasn't clear in the briefing that we had from you.
So, I think it's really useful to be able to compare one year with the next. So, there are situations where obviously you make in-year adjustments, and sometimes it's good just to get a picture of what's happening at the end of the year. Because we're getting into technical areas, if you don't mind, I'm going to ask Steve Elliot to explain this to you.
Yes. Thank you, Minister. So, I think in the evidence paper, we have shown, for each of the key BELs, the budget expenditure lines, relevant, the movement between last year's budget and the draft budget in terms of the final budget. We haven't shown the movements specifically in-year in terms of supplementary budgets, but by definition, they're part of that movement, and I think there's a degree of explanation there. Also in the annex, we have shown the 2024-25 budget movements as well. So, we've aimed to try and cover it in total, so hopefully it is all in there.
Just for us to be able to scrutinise, it's good for us to be able to see that as clearly as possible. Your paper says that none of the budget areas reduced in the health and social services MEG relate to children and early-years policy. Can you explain the evidence for that, and are you comparing allocations with the final budget 2022-23, or the indicative allocations for 2024-25, or other figures?
So, I think it's really important to—. What we tend to do in these sessions is to focus on where the new money's coming from, but actually, when you're under massive pressure, like we are at the moment, where you're seeing real-term cuts as a result of inflation, I think it's really important to look at where we've managed to maintain the budget. Because, actually, we have had to make really tough decisions across Government this year in terms of maintaining what we already had in place. So, what we haven't done is to reduce funding in relation to children and young people's budgets, and it's really important to remember that we were all asked, across Government, to reprioritise funding across the whole group. So, we have had to do that within health as well, but we have maintained that expenditure in relation to children and young people. And you've seen that we've prioritised £10 million to increase funding for Flying Start, as well as that increase in funding for mental health. So, I don't know if there's anything else, Steve, you'd like to come in on again on the more technical side.
No. I mean, just to reiterate that the Minister's chosen to protect the children's budget areas when we had to go through this reprioritisation exercise and, as the Minister says, we've invested another £10 million in Flying Start. So, there have been no cuts to the budget areas in that sense.
Is it possible to provide some further specific written information on that, just detailing that in terms of the specific areas that you’ve just mentioned about none of the budget areas being reduced?
That was set out in the budget documentation, the areas where we have reduced budgets. It's in the Welsh Government’s draft budget narrative, not the evidence paper.
In other words, everything is kept, unless we’ve said that it’s been cut. It’s easier to see where the cuts are rather than—. It’s the same thing as—
Just to clarify, are you comparing the allocation of the final budget for 2022-23 or the indicative allocation for 2024-25, or different figures?
We’re focused here on 2023-24 rather than 2024-25.
Right. Thank you. Thanks for that, Minister. We’ll move on, then, to some questions from Sioned Williams.
Diolch, Gadeirydd. O ystyried pwysau chwyddiant—ac rŷn ni’n gwybod heddiw ei fod yn gostwng, ond dyw e ddim wedi gostwng o lawer, a phethau fel prisiau bwyd yn dal i fod yn uchel—a'r ffaith nad oes dim cynnydd mewn dyraniadau i blant, sut gallwch chi ein sicrhau ni y gallwch chi gyflawni eich canlyniadau arfaethedig i blant, o ystyried eich bod chi wedi asesu bod teuluoedd â phlant yn fwy tebygol o gael eu heffeithio gan yr argyfwng costau byw na rhai heb blant?
Thank you, Chair. Given inflationary pressures—and we know today that it is coming down, but it hasn't come down by much, and things like food prices are still high—and that there's no increase in allocations for children, how can you assure us that you can deliver your planned outcomes for children, given that you have assessed that families with children are more likely to be affected than those without as a result of this cost-of-living crisis?
Diolch. Rŷn ni wedi gorfod gwneud penderfyniadau caled, ac rŷn ni wedi gorfod gwneud hynny ar draws y Llywodraeth. Jest i roi enghraifft i chi, rŷn ni wedi cael bil eleni am £207 miliwn jest am egni yn ein hysbytai ac ati, yn y gwasanaeth iechyd, doedden ni ddim yn disgwyl. So, jest i roi context i chi am hynny: £207 miliwn, a dim ond £170 miliwn oedd gyda ni i glirio’r backlog o ran y waiting lists. So, dŷn ni wedi gorfod ffeindio mwy o arian tu fewn i’r cyllid eleni a oedd gyda ni. Dŷn ni wedi cael rhywfaint o arian oddi wrth Lywodraeth y Deyrnas Unedig, ond y flwyddyn nesaf, dŷn ni ddim y siŵr os bydd yr arian ychwanegol yn dod. Felly, mae’r pwysau yna o ran chwyddiant yn mynd i effeithio ar bob un.
Beth dŷn ni wedi treial gwneud yw cadw’r ffocws ar front-line services i wneud yn siŵr ein bod ni yn diogelu gwasanaethau iechyd, gwasanaethau iechyd meddwl ac ati. Beth dŷn ni’n ceisio ei wneud hefyd yw rhoi tipyn bach mwy o ffocws ar bethau fel Flying Start, felly mae yna £10 miliwn ychwanegol, lle rŷn ni’n gwybod bydd y pwysau yn arbennig ar y teuluoedd tlotaf. Felly, beth dŷch chi wedi’i weld, er enghraifft, yw bod Flying Start wedi cynyddu. Rŷn ni wedi gweld cynnydd yn y childcare offer. Rŷn ni wedi gweld cynnydd yn y cynnig i rieni o ran y rheini sydd yn gallu cael access i childcare—rheini sydd mewn addysg a hyfforddiant. A hefyd, rŷn ni wedi cynyddu faint rŷn ni’n talu o ran y childcare offer. Felly, mae hwnna yn digwydd, ond, yn amlwg, mae e’n anodd. Rŷn ni wedi gweld toriad o ran cyfalaf, er enghraifft. Mae hwnna’n broblem i ni.
Ond dwi’n meddwl bod e’n bwysig—. Dyw’r arian i gyd ddim yn dod i helpu plant o’r cyllid yma. Felly, os ydych chi’n edrych, er enghraifft, ar free school meals, mae hwnna’n dod o gyllid arall, ac mae hwnna, yn amlwg, yn helpu plant. Mae yna discretionary assistance fund, ac mae hwnnw wedi cael cynnydd hefyd, ac mae hwnna’n targedu pobl sy’n dlawd, ac mae 50 y cant o’r bobl yna gyda phlant hefyd. Mae £9 miliwn yn ychwanegol wedi dod o’r adran addysg ar gyfer y pupil development grant. Felly, mae yna gynnydd, nid jest yn rhannol yn ein cyllid ni, ond mewn rhannau eraill o’r Llywodraeth.
Thank you. We have had to make difficult decisions, and we've had to do that across Government. Just to give you an example, we've had a bill this year for £207 million just for energy costs in our hospitals and so on in the health service, and we weren't expecting that. So, just to give you the context of that: £207 million, and we only had £170 million to clear the backlog in terms of waiting lists. So, we've had to find more money within the current budget that we had this year. We've had some funding from the UK Government, but next year, we're not sure whether additional funding will come forward. So, that inflationary pressure is going to have an impact on everyone.
What we've tried to do is to maintain the focus on the front-line services to ensure that we do safeguard health services, mental health services and so on. What we are trying to do is also to provide a greater focus on things such as Flying Start. So, there's additional funding there, where we know that the pressures will be felt most by the poorest families. What you've seen is that Flying Start has increased. We've seen an increase in the childcare offer. We've seen an increase in the offer to parents in terms of those who can access childcare—those who are in education and training. And, we have also increased how much we are paying in terms of the childcare offer. So, that is happening, but, clearly, it is a difficult time. We've seen a cut in terms of capital, for example, and that was a problem for us.
But I do think it is important—. The funding to help children doesn't only come from this funding pot. So, if you look at free school meals, for example, that comes from another budgetary pot that is clearly a help to children. The discretionary assistance fund, that's seen an increase too, and that targets specific people, those poorest people, and 50 per cent of those people have children too. Nine million pounds in addition has come from the education department for the pupil development grant too. So, there has been an increase not just in our budget, but in other parts of Government.
Wrth gwrs, dŷn ni’n siarad fan hyn am eich cyllid chi a’r pwyslais yna sydd wedi cael ei roi ar draws yr adrannau ar y blaenoriaethau yma i ddelio gyda'r argyfwng costau byw. Ac, wrth gwrs, rŷn ni'n gwybod, fel gwnes i grybwyll, fod plant a theuluoedd gyda phlant gyda rhai o'r grwpiau sy'n cael eu heffeithio waethaf. Mae'n dod yn ôl i'r pwynt, am wn i, ynglŷn â chael asesiad effaith ar hawliau plant. Mae'r Arsyllfa ar Hawliau Dynol Plant a Chanolfan Gyfreithiol y Plant Cymru, yn hanesyddol, wedi dweud bod Gweinidogion wedi methu â gweithredu eu polisi eu hunain a’r ddyletswydd sydd ar y Llywodraeth, fel sy'n cael ei nodi yn y cynllun hawliau plant, a chymhwyso asesiad effaith ar hawliau plant cynhwysfawr i'r gyllideb ddrafft. Mae'r sefydliadau hyn a'r pwyllgor yma wedi galw’n gyson ar Lywodraeth Cymru i gyhoeddi asesiad effaith manwl ar hawliau plant ar y gyllideb ddrafft. Felly, beth yw eich barn am y rheswm bod gwahaniaeth barn mor fawr, yn gyson, ar bwysigrwydd hyn? Fe wnaethoch chi ddweud yn eich ateb blaenorol dyw'r gyllideb iechyd ddim yn ystyried anghenion plant yn benodol, ond mae yna gymaint o gyrff, a'r ddyletswydd byddwn i'n dadlau, yn dweud bod angen gwneud hynny, yn enwedig yng nghyd-destun yr argyfwng costau byw.
Of course, we are talking here about your budget and the emphasis that has been put across the departments on these priorities to deal with the cost-of-living crisis. Of course, we know, as I mentioned, that children and families with children are amongst those worst affected. It comes back to the issue around having a children's rights impact assessment. The Observatory on Human Rights of Children and the children's legal centre have historically said that Ministers have failed to implement their own policy and the duty that is on the Government, as is set out in the children's rights scheme, and apply a comprehensive children's rights impact assessment to the draft budget. Both of these organisations and this committee have consistently called for the Welsh Government to publish a detailed children's rights impact assessment on the draft budget. So, what's your reason for the fact there's such a big difference of opinion on the importance of this? You did say in your previous answer that the health budget does not consider the needs of children specifically, but there are so many bodies, and the duty, I would say, that say that you do have to do that, especially in the context of this cost-of-living crisis.
Mi wnaf i ofyn i Julie ddod i mewn mewn munud, ond jest cwpl o bethau ynglŷn â ble rŷn ni yn uniongyrchol wedi edrych i helpu. Mae yna Healthy Start scheme tu mewn i'n cyllideb ni—£6.9 miliwn yn y fan yna, sy'n helpu plant sydd yn ifanc, sydd yn dod o deuluoedd tlawd, i brynu ffrwythau ac ati. Mae gyda ni'r NHS low income scheme, ac mae hwnnw’n help gyda, er enghraifft, costau deintyddol, sbectol, contact lenses, help i fynd a dod o'r ysbyty. A hefyd mae Designed to Smile, so mae hwnnw hefyd yn rhywbeth yn uniongyrchol i helpu plant yn y maes iechyd. Ond os alla i ofyn i Julie Morgan ganolbwyntio ar yr ochr hawliau plant.
I'll ask Julie to come in in a moment, but just a few points in terms of where we have directly looked to help. There's the Healthy Start scheme within our budget—£6.9 million there—which helps those younger children who come from poorer families, to buy fruit and so on. We have the NHS low-income scheme, and that helps with, for example, the cost of dentistry and so on, glasses, contact lenses, travelling to and from hospital. And then there's Designed to Smile—that's a direct programme to help children with regard to health. But if I can ask Julie Morgan to focus on the children's rights side of things.
Thank you very much, Sioned, for that question. I'm aware that this committee has consistently put this question forward. We continue to believe that we need an integrated approach to impact assessments that enables us to better understand the impact of spending decisions—the intersectional and the unintended impacts of spending—to maximise the impact of available funding. This has been a view that has been taken for some time, and I know that the successive committees have challenged this. But what we think is that it's very important that a decision is not made in isolation about children, that we need to look at all the intersectionalities. We do think that an integrated approach to impact assessments is the best way of going forward, but we have worked with the budget improvement impact advisory group to explore how we undertake our strategic integrated impact assessment, and a sub-group was established, and a shared plan of work is being developed with some changes implemented that were published in December 2022. We are committed to continually reviewing our approach on this issue, and I think we'd be very happy to explore how we can better reflect children's rights as part of this work. So, we are open to discussion, but the belief is that an integrated approach is more effective. Recently, we've been able to give a briefing to the children's commissioner, which is very important, and we did wonder if the committee would like a technical briefing as well on the integrated impact assessment.
That would be very welcome. Thank you, Deputy Minister. Sioned.
Diolch, Gadeirydd. Un cwestiwn mwy penodol ynglŷn â’r dyraniadau. Yn eich papur chi mae yna gyfeiriad at ddyraniad o £171 miliwn ar gyfer y grant plant a chymunedau. Allwch chi egluro beth yn union mae hyn yn ei gynnwys, gan ei bod yn ymddangos nad yw’r cyfan o'r £174.3 miliwn sy'n cael ei drosglwyddo o brif grŵp gwariant llywodraeth leol a chyllid wedi ei gynnwys yn y llinell gyllideb ar gyfer y grant plant a chymunedau yn y prif grŵp gwariant iechyd a gwasanaethau cymdeithasol? A jest eisiau gofyn cwestiwn yn benodol ynglŷn â Dechrau’n Deg a'r £10 miliwn yna—dyw e ddim yn glir o'r atebion rŷn ni wedi’u cael hyd yn hyn. Mae yna gyfeiriad at arian ychwanegol, ond dyw e ddim yn glir os yw hwn yn arian newydd. Mae e wedi dod, mae'n ymddangos, o fewn y gyllideb iechyd.
Thanks, Chair. One more specific question regarding allocations. Your paper refers to an allocation of £171 million for the children and communities grant. Could you clarify exactly what this comprises, since it appears that not all of the £174.3 million transferred from the local government and finance main expenditure group has been included in the budget line for the children and communities grant in the health and social services main expenditure group? And I'd just like to ask a question specifically about Flying Start and that £10 million—it isn't clear from the answers that we've had so far. There has been a reference to additional funding, but it's not clear whether this is new funding. It has come, it appears, within the health budget.
I think it's a bit confusing because money has been moved out of the budget and other money has come in. So, if I go through it, in 2023-23, the children and communities grant consists of the following six programmes: childcare and play, Families First, Flying Start, out-of-court parenting support, promoting positive engagement for young people at risk of offending, and the St David's Day fund. The employability support programmes that are contained in the children and communities grant in this financial year—and that includes Communities for Work Plus and the employability element of the legacy fund—have been transferred to the economy main expenditure group. So, that funding has gone to the economy MEG, which has reduced the amount, but, added on to the fund are the out-of-court parenting support, which has been included, and which I mentioned, and the grant has received additional funding of £10 million to support phase 2 of the Flying Start expansion. So, that adds up to £171.045 million. The employability stuff is going out to the economy Minister, and the other stuff is added in, and that is this £171 million. And the Flying Start money is new money.
Iawn. Diolch, Gadeirydd.
Okay. Thank you, Chair.
Thank you, Sioned. Thank you, Deputy Minister; that's very helpful information for us. We'll move on to some questions now on emotional and mental health from James Evans.
Thank you. I'll direct my questions to the Deputy Minister, if that's okay, to give the other two Ministers a break for a while. Minister, can you explain the exact additional allocations for children and young people's mental health in the draft budget for the next two years, 2023-25? What will this money actually be spent on, and how will it support the whole-system approach that you've talked about quite a lot?
Thank you, James. As Eluned has said, we have secured a very significant additional allocation for mental health. You'll be aware that Welsh Government committed to provide £50 million extra in this financial year, rising to £75 million and then to £90 million in the third year. I'm really pleased that, despite the huge financial constraints we're facing, the Welsh Government has honoured that programme for government commitment to mental health.
I think it is important to note as well that, as Eluned said, most of the mental health money goes out to the NHS. The mental health ring fence is over £760 million, and that goes out to the service, and we expect NHS organisations to comply with that ring fence. That ring fence isn't a demarcation for children and young people and adults, but, obviously, we expect health boards to spend to meet the needs of their population, and, also, to meet the priorities that we've set out. And we've been very clear that, in mental health, the child and adolescent mental health service is a priority.
In terms of the additional funding that is retained within Welsh Government, there are a number of priorities that impact on children and young people. One of the things that I've been most struck by since coming into post is how challenging the workforce issues are, and that is the same in CAMHS. Every time I visit a children's mental health service, I hear about how difficult it is to recruit, how, when there's new money, it's a question of robbing Peter to pay Paul, and staff are moving around the system. So, it was very clear that addressing the workforce issues, and having a sustainable workforce, is a top priority for me, really. Health Education and Improvement Wales and Social Care Wales have developed, as you know, a mental health workforce plan, which comes with a very sizeable price tag. It is an all-age plan, but will undoubtedly benefit children and young people. So, a top priority for me, from the extra money, is to fund that plan, so that we have a sustainable workforce going forward.
In terms of other priorities that impact on children and young people, the committee will be aware that we've just completed the delivery unit review of CAMHS services in Wales. I've had a presentation on that. They'll make recommendations to the Welsh Government and all the health boards, and we will want to make sure that we can fund the implementation of that plan as a priority.
You're aware, because I know that you had Jeremy in last week, that we are investing—and the money for the whole-school approach rises to £14.4 million next year. Half of that is coming from health budgets, half from education. That is a really important part of our whole-system approach to mental health, along with our NEST framework. And I think it is important to say that it's not just about money, it's about making sure that that system is working together, and we've tried to underpin that with our policies, like the NEST framework and our whole-school approach guidance.
At the other end of the spectrum, obviously we've got a co-operation agreement commitment with Plaid Cymru to develop sanctuary pilots, and that is also funded in the budget. That work is being taken forward in partnership with the Plaid Cymru designated Member. You'll be aware that transitions are a concern, and we're waiting for the work that Dave Williams described to the committee to be completed, to see if there's any additional funding that we need to direct at transitions. I spoke before in the committee about our 111 'press 2 for mental health', which I think will be an absolute game changer for mental health in Wales. That is an all-age service. That will be used by people who have concerns about children as well.
And just to say that there are other things as well in the system that are happening because of Westminster. We've got the liberty protection safeguard reforms, which are Westminster reforms but that we have to implement, and unfortunately, they've been very clear that we are not receiving any additional funding to implement those reforms, which do impact on children, because it brings children between 16 and 18 into the LPS system. So, unfortunately, we've also had to make some of our additional money available, and quite a substantial amount—up to £9 million—available to implement LPS in Wales. So, I think that, hopefully, demonstrates that we are supporting our prioritisation of children and young people with funding but also with the policies underpinning our work.
Yes, thank you, Deputy Minister. It's obvious from your answer that there are a lot of demands on your part of the health budget, and I totally recognise that. You mentioned CAMHS quite a lot in there, and the review that you've done into CAMHS. I think it's very positive to note as well, that CAMHS first appointments have fallen across Wales, and I recognise that, and that is to be welcomed. But how confident are you that this can be improved and it can be maintained, and that there has been no impact in terms of waiting times for that follow-up appointment from the initial contact as well? And are you confident that you've got enough money within your area to make sure that this can be sustained?
Well, thank you for the recognition that the waiting times have improved. As you know, we've taken a very rigorous approach to driving improvements in the area of CAMHS, with the meetings that we have every month with health boards and the direction that Eluned gives to the service, that this is a priority, so I'm really pleased to see those improvements. All the health boards are working on improvement trajectories, and I do think that they are sustainable, because we've factored in things like workforce challenges into those trajectories, so I think they are realistic. We are going to direct more funding, as I say, to implement the delivery unit review of CAMHS. I think that's very important. Our initial focus has been on the performance in specialist CAMHS. We do still have performance challenges with under 18s, local primary mental health services, the referral to intervention Part 1(b) of the Measure, and that's going to be a particular focus for me over the next few months. But in order to achieve all of these sustainable changes, the workforce is absolutely key, so that's why we're having this workforce planning. As part of the workforce plan, we've got short-term measures and long-term measures to try and make the system sustainable.
Okay, thank you. I want to move on—I know that we've discussed this before—to another priority area and it's perinatal mental health. We only have the one unit in south Wales. Within the draft budget allocation, are you confident that people are going to get equal access to service in perinatal mental health?
Well, I think it's important to recognise that the vast majority of families who access perinatal mental health services won't need a mother and baby unit. It's the women who are most ill, often with postpartum psychosis, who are going to need to access that mother and baby unit. And we are providing £3 million of recurrent funding for perinatal mental health services for community perinatal mental health teams. All parts of Wales now have a perinatal mental health team, and they're all working towards meeting the Royal College of Psychiatrists's standards, which is very positive, I think.
We've got the MBU open now in Tonna, the Uned Gobaith. I've been very pleased to go and visit it and see the fantastic work that they're doing. The committee will be aware that Welsh Health Specialised Services Committee was reviewing the unit, and I'm pleased to say that they have confirmed that the unit should continue and is providing appropriate care, and that the care is in line with key quality standards with only minor adjustments needed. I recognise, obviously, the point you're making about the MBU in north Wales, and I am very committed to doing everything that we can to deliver MBU provision for north Wales. The committee will be aware that we're working with the NHS in England to deliver beds for north Wales in a joint unit just over the border. WHSSC did a piece of work to assess need for MBU provision in north Wales and concluded that there wasn't enough demand for a standalone unit in north Wales, which is why we've got the partnership arrangement with England. But, I do want to say that I'm following this very closely; I'm having monthly updates from WHSSC, and we are continuing to keep issues like demand under review.
Thank you. I think James—
It's still me, I think. I'm taking over.
I think James is going to talk now about children's physical health.
And it's still you, Deputy Minister, I'm afraid. I want to talk about the 'Healthy Weight: Healthy Wales' strategy. In the paper, the budget refers to £6.63 million being allocated in 2023-24, which is the same as what it's been before. I don't like using the word 'crisis', because I think it's used far too loosely at the minute, but there is a problem with obesity among young people across Wales. I use the word 'problem' not 'crisis'. And there is a widening gap between the poorest in society and the most well-off in society with people who do struggle with obesity. So, I want to know, do you think that there's enough money there to actually address the obesity problems in Wales, going forward?
Thank you, James. I know that you've got a long-standing interest in this area, and you're absolutely right to highlight the very significant challenges that we face, which have been, unfortunately, made worse by the pandemic, as we know. You've highlighted the funding that is in the budget. It's £6.63 million for next year. That's the second year of our two-year delivery plan of our 10-year 'Healthy Weight: Healthy Wales' plan. The plan has a very strong focus on deprivation and tackling health inequalities as part of that, and there's a very strong focus in the plan on children and young people. So, we've got a strong focus on early years and prevention, through things like free school meals; our breastfeeding delivery plan; Healthy Start, which Eluned mentioned; we've got our daily active programme; active travel; and the Welsh network of healthy schools scheme. And in addition to that, you'll have seen from the budget that we've allocated £600,000 to pilot specific children and families projects, and we've got three of those, which are in Merthyr, Anglesey and Cardiff, and they've been specifically chosen because of deprivation factors in those areas and to give us a sense of the challenges in those particular communities. So, we'll be looking carefully at those pilots and how we can scale delivery if those are working well.
Out of that £6.63 million, as well, we've also got the £2.9 million for the all-Wales weight management pathway. And, as part of that, all health boards are expected to develop a children's service as well—that's very important—a tier 3 children's service. And we are seeing progress on that, which I think is positive. And an example of that is that Swansea have just launched a new service at level 2 and 3, with a team including a paediatrician, clinical psychologist, nursing and dietetic professionals, as well as physios, et cetera. But I think, to be really clear about 'Healthy Weight: Healthy Wales', there is no silver bullet on this issue, and I know that you're well aware of that. This is a really complex issue and that's why our delivery plan is so multifaceted and tries to target people, settings and systems. And, as part of that, as you're aware, we've just consulted on plans to make the food environment more healthy, with particular focus on children and young people—things like takeaways around schools, restricting the sale of energy drinks to children, et cetera. So, it's a multifaceted approach to what is a very complex issue. I'm sorry, that was quite a long answer.
I've got a follow-up relating to it.
Can I—? I think Joyce Watson would like to come in briefly on this one.
Thank you. In terms of children being healthy and having a healthy weight, are you doing some joined-up work with sports clubs, but, more crucially, local authorities who are at risk of closing, and in fact have closed many of their sports outlets—swimming pools et cetera come to mind—because of their crisis management with reduced budgets? And I'm just interested to know how that's going to play out, because in some areas, the local swimming pool or the local football club or tennis club is the only opportunity that some young people have to access any recreational activity that happens outdoors.
Thank you, Joyce, and yes, we are joining up the initiatives with physical activity and indeed, we're working across Government with all Ministers focused on what they can do in this space. And there's a lot of work to join up with physical activity initiatives. We've recently funded something called football FIT FANS working with football clubs around Wales, and although that's adult-focused, that will hopefully trickle down.
We also work really closely with local authorities, which deliver our exercise referral scheme. Obviously, I recognise the challenges that you've highlighted in relation to local authorities, and I think, unfortunately, that is a symptom of the fact that we are really suffering with these inflationary pressures that haven't been fully met by the UK Government.
Thank you. Just quickly, can I ask if you disaggregate that data on the 'football fit' to make sure that it's not all going to one gender whilst the other's being missed out?
No, we've been really clear from the start: this is men and women—absolutely.
Back to James Evans.
Yes, one more thing on this before I move on. The £6.63 million isn't a lot of money in the grand scheme of things when you divide it out between all the health boards. And one thing I'm very keen on is making sure that money is actually delivering on what we say. You hear anecdotally that things get swallowed up in NHS bureaucracy; NHS boards create lovely plans, set up teams, and nothing actually gets delivered on the ground, which is one of my bugbears. So, what I want to know from Welsh Government's point of view: how do you ensure that that money is actually delivering for the people who need it and that it's not being kept in health boards to fund posts and create lovely strategies that actually don't do anything?
Well, the £6.63 million is only part of the money that health boards are deploying in this area. We're also expecting them to use their core resources as part of this work. You'll be aware that they've got duties under the Well-being of Future Generations (Wales) Act 2015 to tackle health inequalities. So, they have to do that as well. And we do monitor the money that goes out very closely to make sure that it is being spent in the way that we want it to. So, in relation to the all-Wales weight management pathway, we get regular updates from health boards about where they're at with developing those services. So, I don't think there's any question of health boards using the money to do other things; they're very clear, and Eluned has also been very clear that tackling obesity is a priority. So, we do expect them to deliver on these priorities. And we've got a very high level 'Healthy Weight: Healthy Wales' implementation board, which is monitoring this as well, which I chair.
Okay. Thank you for that. I want to move on now to something that I know is very important to you, eating disorder services, and the additional £2.5 million that is going into eating disorder services, and that's very welcome, and I think we need to see more money going into that area, because we're hearing more and more people are accessing those services now. But how do you see that additional money improving the service? Because we don't have a specialist eating disorder centre here in Wales. Is it something we could potentially see in the future, that specialist unit here in Wales for young people on eating disorders?
And another thing on this—it's probably actually for the Minister directly around workforce as well—to make sure that our new GPs who are coming through the system are fully aware of eating disorders, and, when people do present to them, that they actually signpost them in the appropriate way, rather than just giving them protein drinks or waiting almost till the end, til they're almost on death's door, until they actually can seek some help. Thank you.
Thank you, James. And as you've highlighted, we are putting recurrent extra money into eating disorder services, because we do want to consolidate the improvements that we've seen. That additional funding is going to be targeted at continuing to meet the four-week waiting time for eating disorder services. We're making good progress; we’ve got the clinical lead now in place. We’ll have the clinical network working with the clinical lead across Wales, and, in terms of in-patient provision, we’re seeing some really good work in parts of Wales to make sure that young people are treated within the community—so, north Wales has a speed team, where the vast majority of patients are being treated within the community, and only the most acute cases are being referred to the north Wales adolescent service. And I think that’s what we want to see, isn’t it? We don’t want young people having to go into hospital. Alongside this, the Welsh Health Specialist Services Committee is also looking for me at the issue of having in-patient provision in Wales, and that’s a sort of planned thing over the next two to three years.
But, as I say, I think the gold standard, really, is to treat young people in their homes with their families, where they live their lives, and I’m going around all the eating disorder teams and there’s some fantastic work going on with some very committed people in this area.
Thank you. It’s really positive, actually, to hear that you’re looking at an in-patient unit in Wales. I think a lot of people who are listening to committee who do stuff with eating disorders and who’ve gone through that system will probably be very heartened to hear that you’re looking at that.
It would be an adult unit, mind, but, obviously—
Yes, adult, but I think it’s positive that it’s being looked at.
Okay, final two questions from me, Deputy Minister, you’ll be pleased to know. Your paper also states that Welsh Government have reprioritised the £7.2 million annual prevention for early years funding from April 2022, which is used by directors of public health across local health boards to specifically support intervention on obesity and tobacco policy areas. Can you give us details of what this reprioritisation actually means?
Thank you, yes. So, from April 2022, we directed local health boards and Public Health Wales to prioritise this funding towards programmes that support reductions in obesity and tobacco. So, that’s things like rolling out our in-patient smoking cessation support in all health boards in Wales to support a reduction in the number of people smoking in pregnancy, which obviously affects children, and to support prevention work in the obesity and overweight space, in line with our ‘Healthy Weight: Healthy Wales’ strategy.
Health boards have submitted plans and £7.2 million has been shared between the seven LHBs and confirmed for the 2023-24 financial year as part of the draft budget. I don’t know how much detail you want me to go into.
As much as you would like, Minister.
Really? Okay. [Laughter.] So, all the health boards have plans. So, for example, in Betsi, some of the money is being used to expand the support offered to pregnant women to initiate and continue to breastfeed. Powys Teaching Health Board are introducing First 1000 Days healthy lifestyle support workers in maternity and health visiting services, with the aim of reducing smoking, optimising healthy weight and enhancing physical activity. They've also proposed a prevention and early years programme for overweight and obesity to increase the proportion of children and adults of a healthy weight. Cwm Taf have got a programme called Bump Start to support pregnant women who are obese to ensure healthy weight gain. Hywel Dda have also got a maternity services smoking cessation programme; Cardiff and Vale proposals include an early years healthy weight programme to reduce childhood obesity; and Aneurin Bevan—I'm just trying to give you some of the examples that relate more specifically to children and families—they're doing a Help Me Quit maternity service and providing further support to monitor smoke-free legislation at existing smoke-free spaces. We're waiting to agree Swansea Bay's bid at the moment, but we understand that their plans will include a maternal behavioural change support programme for pregnant women, and also work with schools to provide support around smoking and vaping. The committee will be aware that we've got the JustB programme to tackle smoking in schools. That was paused during the pandemic, but is really getting going again. That's targeted at some of the schools where we're likely to see a higher smoking prevalence, so we're also funding that in Wales.
That's really helpful. I'll just bring Sioned Williams in on that point.
Diolch, Cadeirydd. Fe soniodd y Gweinidog ar y dechrau fod hanner y gyllideb iechyd a gofal cymdeithasol yn mynd yn syth mas, heb ei chlustnodi yn benodol, i'r byrddau iechyd ac rydych chi wedi sôn am nifer o raglenni a mentrau fanna—
Thank you, Chair. The Minister said at the start that half the budget for health and care goes straight out, without being earmarked specifically, to the health boards. You've mentioned a number of programmes and initiatives there—
Sorry, Sioned. I think there's an issue with the translation at the moment, isn't there, or is it just my headphones? I think we've got an issue with the translation, sorry, Sioned.
[TRANSLATION: 'Hello. Sorry, just testing quickly.]
[TRANSLATION: 'Can you hear me okay?']
Yes, that's better.
I can now, but I only caught the first sentence of that.
I'll start again.
Dim problem. Rôn i jest yn dweud—
No, problem. I just—
Sorry, it's started again. There's some kind of feedback on—
There's some sort of—
Yes, interference on the translation.
[TRANSLATION: 'We'll try the other interpreter. That might work a little bit better. Is that coming through?']
Yes, that's better.
[TRANSLATION: 'Okay. Thank you very much.']
Thank you. Sorry, Sioned.
Dim problem. Rôn i jest yn dweud y cawsom ni gyd-destun gan y Gweinidog ar y dechrau ynglŷn â'r ffaith bod y gyllideb iechyd, hanner ohoni hi, yn mynd yn syth allan, onid yw hi, i'r byrddau iechyd, heb ei chlustnodi, fel eu bod nhw'n gallu penderfynu beth yw eu blaenoriaethau lleol nhw, ac rydym ni wedi clywed nawr gennych chi yn yr atebion i James Evans yn sôn am nifer o raglenni a mentrau sydd i fod i helpu plant yn benodol, byddwn i'n dweud. Ond rŷn ni hefyd yn gwybod taw dim ond un bwrdd iechyd sy'n teimlo eu bod nhw ddim yn rhagweld gorwariant sylweddol eleni. Felly, rwyf i jest eisiau gofyn pa mor ffyddiog ydych chi a sut ydych chi'n mynd i fesur nad yw hyn yn effeithio ar wasanaethau a rhaglenni fel y rhai dŷch chi wedi bod yn sôn amdanyn nhw.
No problem. We heard the context from the Minister at the beginning of the meeting with regard to the fact that half of the health budget goes straight out to the health boards, without being earmarked, so they can decide what their local priorities are, and we heard your responses to James Evans, talking about a number of programmes and initiatives that are meant to help children specifically, I would say. But we also know that it's only one health board that feels that they don't foresee a significant overspend this year. So, I just wanted to ask how confident you are and how you are going to measure whether this impacts the services and the programmes such as those that you have outlined.
Thank you, Sioned, and I think it's important to be clear that, when we say that the money goes out to the service—. And obviously, health boards have to try and meet the needs of their population, but they also have to deliver the priorities that we set for them, and I think those priorities are really clear. A reduced list of priorities has been issued because of our straitened financial circumstances, but the health Minister has been very clear that mental health and CAMHS is a priority. The integrated medium-term plans that all boards have to use have mental health very clearly in there as a priority. There are meetings, a plethora of meetings, between officials, the delivery unit, individual health boards to make sure that the focus is there on delivering on mental health. So, they have to deliver on those priorities.
Obviously, we monitor their performance against a whole range of measures. I meet with the vice-chairs regularly where there are particular concerns in health boards, as we did have in Cardiff and Vale, actually. Most of the children waiting in Wales for CAMHS were on the Cardiff and Vale waiting list. So, I met individually with Cardiff and Vale several times, because we were so concerned about the position in Cardiff and Vale, and I'm delighted now that they've worked really hard to turn that around. So, I don't think there's much wriggle room, really, for health boards in terms of not delivering on these priorities. I have been crystal clear that children and young people are my top priority, and I feel very strongly that, if we get it right for children and young people in mental health, we will get it right for everyone. Everything that I do as a Minister is focused on delivering for children and young people.
Diolch. Diolch, Gadeirydd.
Thank you, Deputy Minister. Would it be possible to have, if the guidance is published, a copy of the written guidance to the health boards for this committee to have a look at, if that's possible?
I think we offered that last week, didn't we, to another committee. I think it's public, but let me just check. I've set it out publicly anyway, so I'm more than happy for you to see that. It's no secret.
Thank you. Diolch, Minister. Back to James Evans. [Interruption.] You've finished.
Lovely. Thank you. Perhaps just at this point I'll just take you back—sorry, Deputy Minister—to perinatal mental health for a second. Just a question around what is happening to those Welsh residents who do need a perinatal mother and baby unit who live in north Wales at the moment, given that work with NHS England is ongoing at the moment.
I think the position—Tracey will correct me if I'm wrong—is that, obviously, if they need a mother and baby unit then they would still be offered the opportunity to have a mother and baby unit either over the border or, if they wanted, to come to south Wales. I recognise that that is not ideal, which is why we are determined to deliver MBU provision for north Wales according to the timescales that we've set. Just to say as well that I've been very clear with WHSSC that I expect the plans for the unit, although it is in England, to take account of things like the Welsh language, which we know is so very important when people are in acute distress.
Brilliant. Thank you, Deputy Minister. We've now got some questions from Ken Skates. Ken.
Thanks, Chair. Thanks, Ministers. I have some questions about safeguarding and care-experienced children, if I may. The Welsh Local Government Association and Barnardo's have both flagged up significant financial pressures on the children's social care workforce in the context of this draft budget, with concerns about a staffing crisis, as they put it, and a greater reliance on more expensive agency staff. How would you respond to such significant concerns about funding a fragile workforce that's on the front line and mitigating safeguarding risks to children?
Thank you very much, Ken, for that question. We do know that the social care workforce is under stress, and I think it's been well tabulated about the difficulties there are in recruitment and retention. But if I run through what finance we actually give to address this—. The social services workforce grant was introduced in 2018-19, and in 2023-24 it's £45 million. This grant is used to support a range of workforce-related interventions in local authorities, in children's services, in staffing challenges, services for older people and dementia care. We also provide £7.15 million for the sector through a Social Care Wales workforce development grant, and that's administered by Social Care Wales through the local authorities. That funds a range of programmes, including learning, development and qualification.
Social Care Wales have also got a workforce plan for the social work profession, and that includes a new post-qualification framework, supporting an approach that allow focus on specialisation in the childcare sector, and that would be modules. This workforce plan was developed after working very closely with stakeholders, because we want to make the social work profession as attractive as we possibly can, because obviously it is such a vital, rewarding job, but I know it has been under severe pressure.
So, we're giving those specific grants. Also, I'm sure you will have seen our social care WeCare Wales advertising programme, where we try to reach people to show them the importance of social care. There have been really good illustrations there, very moving illustrations, actually, of the value of social work. So, that is extensively portrayed on the WeCare Wales advertising programme.
And then, very importantly, we have put more money into help for undergraduate and postgraduate students in Wales. That’s been something that’s been coming up for a long time, about the funding for social work students. So, the injection of funding amounts to a package of almost £10 million, and that’s over the next three years, and the purpose of that is to help to grow the social workforce. I remember particularly going to a meeting with social workers that Albert and I went to it—I suppose it’s a couple of years ago now, but it takes a long time to bring these things in—and it was so clear, the fact that the bursaries were not what they would want or expect, and what a struggle they had, really. But I’m really pleased that we’ve been able to bring in that £10 million, so that is to try to help get more people going on the social work courses. So, we’re trying to attract it in that way.
We’re also working with the sector to support social care employers to recruit workers from overseas, and we have published resources to try to encourage that, and we’re planning to deliver more online support. We know that the cost for agency social workers, as you referred to, is making a significant impact. Financially it’s a big impact, but also it’s culturally, because it’s not possible to work in the same way as you’re able to do with permanent staff. So, we’re really aware of this, and the Association of Directors of Social Services is working with the sector to see how we can work more effectively with agencies. So, we are taking a whole range of measures to try to encourage social workers to come into the field, but I absolutely accept what you say, the importance of it, particularly in relation to the important safeguarding duties.
Thanks, Minister. You may be aware that we’re in the middle of taking evidence at the moment for our inquiry looking into the Welsh Government’s commitment to explore radical reform of the system for care-experienced children, and your budget paper refers to an allocation in the social care reform fund for radical reform of children’s services, saying that it has increased from £3 million to £10 million. Are you able to clarify exactly what new reform the £3 million was for, and what reform the additional £7 million is intended to fund?
Yes, thank you very much. We are committed to radical reform of children’s services and I’m really pleased that you’re doing the report, in the inquiry that you’re doing. I think that’s going to be very, very valuable, the findings from that inquiry. The radical reform of children’s services is to try to get more children to stay at home with their families, support children in their own homes, help with advocacy for the parents, and if children do have to come into the care system, that they’re able to be placed near their homes. So, we want to have a real turnaround in the system, and we want to have more restorative approaches, and possibly fewer risk averse behaviours. But I know I am coming to committee, aren’t I, on 9 March, so I’m sure we’ll be discussing those sorts of issues at the meeting.
So, the work on the transformation programme was supported originally by the £3 million, as you said, Ken, and that was allocated in 2022-23, and the additional £7 million was in 2023-24. That will build on the work that we’ve been doing so far on preventative interventions for families with children on the edge of care, and that will include a national practice framework where we hope we’ll have consistent practice throughout Wales. We’ll increase provision for children with complex needs on a regional basis and also strengthen corporate parenting, because we think it’s really important that we develop corporate parenting and develop it beyond what it is at the moment. So, that’s some work we’re going to use this money to do.
Also, we have been going round all the local authorities, looking at them and discussing what their plans are for their children’s services, and encouraging them to move towards the vision that we have. We want to substantially reduce the number of children who are in the care system, and for those local authorities who have not been able to do so, we plan to use this fund in order to help them achieve that. So, that's just touching the subject, really.
Thank you, Deputy Minister, and we look forward to welcoming you in March as well, on that point. James on this point as well, I think.
Just to go back a step, Deputy Minister, you talked about agencies with regard to social workers, and you said you're working with them. I'd like to know what you're working on, really, with them, because, as somebody who sat in local government for a while, I know agency staff do take huge amounts away from the budget in children's services, and actually trying to retain staff is very difficult when agency staff are earning almost double what staff employed by a local authority are paid. So, can you outline what work you're actually doing with the agencies to address this, please?
I think that is, you know—. The points you make are very important, but I do say, obviously, we do sometimes need agency staff as well. So, I think that is important to remember—that when there are crises, you do need agency staff. But the Association of Directors of Social Services Cymru are working with local authorities to try to address this particular issue, but, obviously, the fact that there are not enough permanent staff is one of the major issues. And so, all of the things that I've mentioned—
It's the 'how' they are working to address it.
Yes, it's how. So, Albert, perhaps you'd want to come in on that.
Thank you. Thank you, Chair. Thank you for the question. Just to support the Minister's comments, the approach being taken is firstly to look at how we can strengthen around social work and social work support. So, social work, as you'll be aware, is a highly skilled, highly complex professional role, and, to do that, we have been looking at a number of approaches—about students coming in, so that the bursary will increase from £6 million to £10 million, as the Minister's described, over the next three years. Alongside that, then, really looking at their experience. So, Social Care Wales have produced a lot of supporting materials that will allow the professional induction to be well supported within the workplace. And, in thinking about the complex task of social workers, we're also very keen and have developed a range of supportive tools through Social Care Wales—indeed, professional support service provided to support social workers by the British Association of Social Workers Cymru.
On the work with the agencies, it's not direct work with the agencies and the providers of agency social workers; it's working with the Association of Directors of Social Services, it's working with local authorities. On behalf of the Minister, I chaired a meeting pre Christmas to bring together key partners, and also involved the NHS shared services in Wales, because they have a lot of experience and a lot of learning. The thinking around that is to look at how we approach our use of agency staff, as employers, local authorities will be operating 22 times at the moment. So, we were looking to bring together that national expertise in a way of shaping and, ultimately, reducing the dependency and the need for agency staff. That is about strengthening our support for social workers in their day-to-day practice. Thank you.
Okay. Back to Ken Skates.
Thanks, Chair. The Welsh Government’s budget improvement plan says that the invest-to-save fund is being refocused to concentrate programme for government commitments relating to improving outcomes for looked-after children, and you say that the first tranche of funding has already been agreed, which is aimed at supporting foster carers. Are you able to say exactly how much this allocation is, what it's for and over what period? Thank you.
Yes, and thank you very much. I think this is a very positive development that the invest-to-save fund has now been dedicated to children, and I think it does show our commitment to children and young people that we are doing this. So, what we call it now is the 'looked-after children change fund'—we've changed it from 'invest-to-save' to that—and that was created in 2021. The purpose of the fund is to support the Welsh Government's programme for government agenda specifically related to children and young people. Now, the budget remains in the finance and local government MEG, and it's been made available to Welsh Treasury and social care policy officials to come forward with proposals, working with partner organisations, and the budget is supported by repayments from previous investments, because, if you remember, the invest-to-save fund was a budget that provided loan finance to public and third sector organisations. So, it's difficult to actually predict the amount that will be available in the fund each year, but it's anticipated that there'll be approximately £3.6 million available in 2023-24, £4.3 million in 2024-25 and £2.8 million in 2025-26. So, that's the funding we anticipate will be available.
Now, we've already agreed funding of £879,000 for a three-year step-up, step-down pilot scheme in fostering, as you mentioned. This scheme provides a pioneering approach to supporting families on the edge of care, trying to reduce the number of children coming into care, and improving outcomes for the families. So, we've got specialist, highly trained family support foster carers, who will provide intensive support to families—so, keeping the children at home, and the foster carers are going in and giving as much support as they possibly can. So, we've already agreed £879,000 out of this fund for that. And also, we hope to do further support: to Foster Wales, £5.6 million over three years; the National Adoption Service, £1.6 million over three years; for parental advocacy—we think it's really important that parents are able to have the services of advocacy services, especially when their children are on the edge of care—and fostering well-being, £869,000 over three years. So, we have got some challenging programmes that we are intending to bring in.
Can I just check, are they new allocations to those existing programmes that you've just mentioned?
Well, support for Foster Wales to recruit, retain and attract foster carers, obviously, that is adding on to what we're already doing. This is additional money for the National Adoption Service, doing a whole range of things, obviously, some of which we are already doing. For example, I'm very keen that we improve contact with birth families and do a lot of work on that, and that's one of the bits that's included in there. So, that is additional to what's already there. And parental advocacy is additional as well. I don't know whether you've got anything to say on that.
Yes. Just to add, Minister—thank you, Chair—the change fund, obviously, is implemented from the current financial year, so 2022-23, but running over a three-year period. So, yes, indeed, it was additional funding from this financial year, covering a range. There were three key funding streams that come together: there's the change fund, innovation; there's the radical reform fund, which we've talked about already; and, of course, Ministers will be supporting the elimination-of-profit funding as well. And just to give an example of the elimination of profit, in this current year, the spend will be £10 million, but in the next financial year, that will be £16 million, rising then in 2024-25 to a £19 million spend. Thank you.
Okay. Thank you. Ken.
Thank you, Chair. Just one final question from me. Your paper refers to a comprehensive review of the national minimum allowance for foster and kinship carers to cover the full costs of children in their care. The review, I understand, was undertaken in 2020, and your paper says that you're currently considering its findings in order to determine future payment rates. Why has there been a delay in taking this forward, given the importance of good-quality placements? And are you able to confirm that the NMA letter for 2023-26, expected in the coming weeks, will reflect the new rates, and will those new rates apply to independent fostering providers as well as local authorities?
Well, to answer those last two questions first, the rates will apply to both local authority and independent foster carers. I am expecting to issue this letter in the coming weeks, and it will say what the new rates are for the next financial year. This is quite a complicated subject, and quite a complex situation, really, because fostering services currently across Wales, they pay three types of payments to foster carers: an allowance for the child, using the national minimum allowance framework, currently set by the Welsh Government; an additional fee for fostering, which is the foster carers payment for undertaking the role, and this can vary enormously across the different local authorities in Wales, and that's set by the fostering service; and also, many local authorities make additional payments, such as Christmas or special occasions—you know, they do the additional payments. So, there are those three types of payments and, currently, the 22 local authorities provide different payment levels to their foster carers, and often, it's very complex differences and quite substantial differences. So, Foster Wales are working on harmonising all the payments made to foster carers, and the national minimum allowance is one of those payments.
In terms of why we haven't done it already, I think that the fact that we've had to respond to the impact of COVID has helped to cause a delay, but we do absolutely appreciate the importance of this. Because if we are to do all the things that we want to do—we've just been talking and Albert was just talking about eliminating profit from the service—we've got to have more foster carers, because they're an absolutely crucial part of the service we bring.
So, the review we commissioned did look at the actual costs of looking after a child, and it is something that we are still working on. One of the other important issues is the issue in relation to kinship carers, because, as you know, we have been using kinship carers much more frequently now than we ever did in the past, and it's something that we support strongly. Because we do feel that if a child can't live in his or her home, they should be with someone in the family, if possible. And there has been a lot of concern about the rates that are paid to kinship carers, and we are hoping to harmonise those as well, to make a much more comprehensive package. So, that is also being done. So, the letter will send out the revised rates, and I hope that will all be happening very quickly.
Thank you, Deputy Minister. Thank you, Ken. Buffy Williams has now been able to join us, so questions from Buffy.
Thank you, Chair. I apologise for my lateness this morning; unfortunately the weather got the better of me. Thank you, Minister.
Your paper refers to a £10 million transfer from the delivery of core NHS services action to support the expansion of Flying Start. How can you guarantee that this additional money will be spent on Flying Start children, given that allocations for it are not ring-fenced within the children and communities grant?
Thank you, Buffy. I'm glad you managed to get to us. The funding for Flying Start expansion is ring-fenced within the children and communities grant, so it is actually ring-fenced. The remainder of the funding within the children and communities grant is not ring-fenced, and local authorities have the ability to determine funding levels for the programmes they support themselves. But we did decide that we would ring-fence this particular element, to ensure the expansion could progress as quickly as possible, because the expansion of Flying Start—eventually, we hope, to all two-year-olds—is one of our key programme for government commitments and part of our co-operation agreement understanding. We are working very hard on ensuring that Flying Start is now expanding; we're moving on to the second phase in April. We did ring-fence this for that purpose, to make sure that it was used. And, if there are any underspends in any area of the co-operation agreement, that funding is put towards overspends in other parts of the co-operation agreement. So, I can assure you that that funding is very carefully guarded and will be used for the purposes it was intended for.
And your paper says that you have recognised the disproportionate effect on gender, particularly linked to childcare. However, while Chwarae Teg welcomes the additional investment in childcare, it says that
'expanding provision to two year olds through Flying Start has clear limitation',
as it only provides part-time provision, and is largely limited to certain postcodes. Chwarae Teg goes on to say that
'Flying Start must evolve to ensure parents of two year olds have access to the same 30 hours of support that parents of three year olds can access through the Childcare Offer'.
How realistic are the calls for future expansion, and what is the likely impact on children of allocations being moved from NHS core services to fund Flying Start within this draft budget?
Well, thank you very much. Obviously, I think it's a matter of rejoicing that we are expanding Flying Start, basically, and this is a process. We are in very difficult straitened times. You heard from the Minister at the beginning that we had to look at all our services in order to achieve savings, the same as other Government departments, and the fact that we have put this commitment into expanding Flying Start, I think, should be applauded. So, I hope the organisations that are giving this evidence—and I absolutely understand that it's their role to try to push things on as much as they can—recognise that expanding Flying Start in these difficult circumstances shows the commitment of the Welsh Government, and it shows the commitment of the co-operation agreement, to achieve more for children.
So, we have committed to deliver a phased expansion, but it is intended eventually to reach all two-year-olds, which does address the postcode issue. It started off going to the areas of most deprivation, which seems to me absolutely the best way to start if you've got a limited amount of money. Let's put the resources in where they're needed. Let's put them in where the greatest need is. So, that's why it went to those areas. But we did put in an element of outreach. So, those existing Flying Start areas have always been able, over the last couple of years, to be able to outreach to reach children in other areas, because it's very frustrating, I know, that if a certain area is deemed a Flying Start area and you've got people really in need just over the border, that you should have the ability to access them, if it's feasible and you're able to do that from where the Flying Start operates. So, that already exists. But our development of increasing the numbers, working with the local authorities, we're already in phase 1, and phase 2 will start in April. And that, I think, shows our commitment to two-year-olds.
We are also expanding the childcare offer to three-year-olds and four-year-olds, which I think the Minister referred to earlier on. One of the commitments of the programme for government is to expand to children in education and training, where their families are in education and training, and that started in September, so we'll soon, I hope, be able to give an assessment about how much take-up there has been of that. But, certainly, there was quite a big lobby for that to be done. Although there is some existing provision already there for students who are parents in education and training, but we're hoping to fill in some of those gaps. And also, as the Minister also said, we have increased the hourly rate from £4.50 to £5. So, I hope that shows our commitment to expand when our finances are limited.
The Observatory on Human Rights of Children and the Children's Legal Centre Wales say that with more than 34 per cent of children in Wales now living in poverty,
'it is absolutely critical that Welsh Government publishes a coherent and cross-governmental child poverty strategy and action plan that clearly demonstrates how policies across ministerial portfolios will be adequately financed to urgently address child poverty.'
When will the new child poverty strategy be published, and can you confirm if it will include an action plan and spending plans? How have you worked with the Minister for Social Justice in this regard?
Thank you very much. Well, the Minister for Social Justice has given a commitment to refresh our child poverty strategy this year, so that it reflects the very challenging circumstances that we're in at the moment, and that that will set out a renewed undertaking to support those who need the support most. We have had an unprecedented last two or three years and, obviously, we need to look afresh at our child poverty strategy, because we do know how people and families have suffered and are suffering at the moment. This strategy, because I have to say it is the responsibility of the Minister for Social Justice, but I do work very closely with her because, obviously, childcare is one of those key areas that do address these challenging circumstances. It's all very linked, so I do work very closely with her.
So, the strategy will set out the long-term objectives for tackling child poverty in Wales. I think, as well as setting out the objectives of all the Welsh Ministers, because it has to be a cross-governmental strategy, it will also recognise the contribution that all parts of society will make to deliver the change needed for children and families. It will be set in the context of the current cost-of-living crisis, and the development of a longer term approach to preventing and reducing poverty and inequalities, because lots of the initiatives that we've taken, we accept, are short-term initiatives and we do need a longer term approach to address inequalities and, obviously, this strategy, when it comes out, will inform future budgets and our expenditure. And also how our programme for government will be delivered under these very challenging circumstances, because our programme for government is addressing many of the inequalities that exist, and we've got to make certain it's embedded. The work to do this, I know, is involving children themselves and a lot of partnership working in order to come up with a proposal.
But, of course, I have to say that many of these levers are with the UK Government and we really need to see a change in what the UK Government delivers to have a really feasible, viable strategy. So, in any case, I will be continuing to work with the Minister for Social Justice to come up with this strategy, which is going to be this year.
Thank you. Thank you, Minister. Thank you, Chair.
Okay, thank you, Buffy, and just finally a question from Sioned Williams.
Jest eisiau dilyn lan ar y strategaeth. Mae'r comisiynydd plant wedi bod yn gwbl glir bod angen cynllun gweithredu ochr yn ochr â strategaeth a nodau tymor hir a gwerthoedd traws-lywodraethol. Ond mae’r comisiynydd plant a sefydliadau gwrthdlodi ac ymchwilwyr gwrthdlodi fel Sefydliad Bevan wedi dweud bod yna strategaeth ar ôl strategaeth wedi bod, ond bod angen cynllun gweithredu gyda gweithredoedd sydd wedi'u clymu wrth amserlen a gwariant. Felly, jest eisiau gwybod, o’ch dealltwriaeth chi—. Rŷch chi wedi dweud eich bod chi yn gweithio’n agos iawn, a dŷn ni wedi clywed y bore yma sut mae'r portffolio iechyd a gofal cymdeithasol yn effeithio cymaint ar blant a'r anghydraddoldebau mae plant yn eu profi, yn enwedig nawr yn sgil yr argyfwng costau byw. Felly, o'ch dealltwriaeth chi, a oes yna gynllun gweithredu o'r fath yn mynd i fod yn eistedd ochr yn ochr â’r strategaeth?
I just want to follow up with regard to the strategy. The children's commissioner has been entirely clear that we need an action plan alongside the strategy and long-term aims and objectives and cross-governmental values associated with that. But the children's commissioner and anti-poverty organisations and anti-poverty researchers, such as the Bevan Foundation, have said that we've had strategy after strategy, but we need an action plan with actions tied into a clear timeline and expenditure. So, I just want to know, from your understanding—. You said that you are working very closely on this, and we've heard this morning how the health and social care portfolio has such a major impact on children and tackling inequalities that children face, particularly as a result of the cost-of-living crisis. So, from your understanding, is there an action plan that will sit alongside this strategy?
I'm sure there will be an action plan, but, obviously, at the moment, we need to work on the strategy, which, as I say, will be coming out this year. But I think, as I said before, there are really two elements of this. There's the immediate response of just trying to alleviate the huge difficulties that families are in at the moment and, obviously, we've been able to do that with the fuel allowance, the discretionary assistance, an increase in money—those sorts of initiatives, which are short term and aren't a long-term strategy. I think we have to have a long-term strategy, but that's got to be in the context that so many of these levers are with the UK Government, so it's going to be very difficult to get a strategy unless we have a Government in the UK that recognises its responsibility in terms of running the benefits system, for example. So, I think we need to take that into consideration.
Wrth gwrs, ond o ran y gwariant sydd o fewn y gyllideb, a dŷn ni'n gwybod bod lot fawr o arian Llywodraeth Cymru wedi cael ei wario ar fentrau gwrthdlodi ac i ddileu anghydraddoldebau ar gyfer plant. O ran yr arian yna, rwy'n derbyn y pwynt yn llawn bod angen mwy o arian, ond o ran yr arian sy'n cael ei wario, yr hyn rŷn ni'n clywed gan bobl fel y comisiynydd plant yw bod angen sicrhau gwariant effeithiol ac sydd wedi ei ffocysu o'r arian yna drwy gael cynllun gweithredu ochr yn ochr â strategaeth. Felly, roeddwn i jest eisiau gofyn eich barn chi ar hynny.
Of course, but in terms of the expenditure within the budget, we know that a great deal of Welsh Government funding has been spent on anti-poverty initiatives and to eradicate inequalities for children. With regard to that funding, I accept the point that we do need more funding, but in terms of the money that is being spent, what we hear from people such as the children's commissioner is that we need to ensure effective and focused spending through having an action plan alongside the strategy. So, I just wanted to ask your view on that, specifically.
Yes, I agree with you that we do need that focused funding, but I hope we've described today some of the focused funding that already exists, and that is the way that we are working in health and social services. Children and young people are a priority for us all, which is why that budget hasn't been touched, but we need to combine that work, in a cross-Government way, to come up with a strategy, with an action plan, that will take us forward as a whole. The point I was making is that, obviously, what we control, we've got to decide how it goes, but I don't think we will ever have a totally effective child poverty strategy unless we have a UK Government that recognises its responsibility—just, for example, the benefits system.
And just to add to that, because I'm assuming we'll be finishing soon—
We will be.
—and to end on more of a political note, I think this is an area where it is a political decision. We know that child poverty levels under a Labour Government went down significantly. You can see the increase from 2010. It is absolutely clear that, from the moment the Conservative Government came in it started shooting up. Now, what we can do—you're quite right—is to try and effect change within where we are able to in Wales. One of the key things, I think, that we are aware of, is that preventative action is much better than trying to fix it afterwards, and I hope what you've heard today is the commitment from, certainly, our department, to make sure that we get in early to try and prevent the problem in the first place. That's certainly true for mental health, and it's certainly true for things like childcare, the first 1,000 days—all of those kinds of things. Those are measures that are practical, but unless we get significant changes from the UK Government, then the issue of child poverty is going to remain a serious challenge for us here in Wales.
Okay. Thank you, Minister, and Deputy Ministers for attending this morning, and to your officials as well. You will receive a transcript in due course to check for accuracy, as normal, but diolch yn fawr, thank you for joining us this morning.
We'll now move on to item 3, which is the papers to note. We have six papers to note this morning. Are Members content to note those papers? I see that all Members are content.
bod y pwyllgor yn penderfynu gwahardd y cyhoedd o weddill y cyfarfod, y cyfarfod cyfan ar 26 Ionawr ac ar gyfer eitem 1 ar 2 Chwefror, yn unol â Rheol Sefydlog 17.42(ix).
that the committee resolves to exclude the public from the remainder of the meeting, the whole of the meeting on 26 January and for item 1 on 2 February, in accordance with Standing Order 17.42(ix).
Cynigiwyd y cynnig.
Item 4, then, is to move into private session. So, I propose in accordance with Standing Order 17.42, that the committee resolves to meet in private for the remainder of the meeting and the whole of the meeting on 26 January. Are Members content? I see that all Members are content, so we will now proceed in private.
Derbyniwyd y cynnig.
Daeth rhan gyhoeddus y cyfarfod i ben am 11:03.
The public part of the meeting ended at 11:03.