Y Cyfarfod Llawn - Y Bumed Senedd
Plenary - Fifth Senedd
01/02/2017Cynnwys
Contents
The Assembly met at 13:30 with the Llywydd (Elin Jones) in the Chair.
I call the National Assembly to order.
[R] signifies the Member has declared an interest. [W] signifies that the question was tabled in Welsh.
The first item on our agenda this afternoon is questions to the Cabinet Secretary for the Environment and Rural Affairs. The first question [OAQ(5)0088(ERA)] has been withdrawn. So, the second question, Neil Hamilton.
The Welsh Fishing Industry
2. Will the Cabinet Secretary make a statement on the impact of Brexit on the Welsh fishing industry? OAQ(5)0097(ERA)
Thank you. The UK’s future exit from the European Union raises many questions and uncertainties for the future of Wales’s fishing industry. To help safeguard the prosperity of the industry and our coastal communities, my department will be developing a forward-looking fisheries policy, as set out in the ‘Securing Wales’ Future’ White Paper.
I’m delighted with the answer that the Cabinet Secretary has provided. Does she accept that the opportunities that will be available for Welsh fishermen and women will be very significant, that the last 43 years have seen a plundering of our seas through the common fisheries policy, the devastation of fish stocks, which have taken many, many years to begin to correct, and that by taking back control of the coastal waters and further regions of the sea, we have the opportunity not only to develop a massive economic resource for Wales, but also to improve conservation in Welsh waters?
I think it’s a little too early to assume Brexit will be as positive as the Member portrays for the fishing industry overall. But I absolutely accept—and I’ve said many times—that, while leaving the EU poses many risks and challenges, there are opportunities going forward. I think market access is absolutely critical, and, as I said, we will have a common fisheries policy going forward—a very Welsh-specific fishing policy—to replace the common fisheries policy. But I do think we need to look at the basic principles of how we do manage our fisheries in Wales. I think there needs to be more flexibility and also adaptable management regimes, going forward.
I hope you wouldn’t listen to the kings Canute at the other end of the Chamber, who believe that they can manage our seas. There is an important fishery in Wales, which is the shellfish fishery, which is extremely important. What are the possibilities as we look at scallop fishing, for example, and mussels of course, to open fisheries that could be certified under a Marine Stewardship Council scheme in order to promote this industry in Wales? Could you develop that side of things so that we can have sustainable fisheries as we leave the European Union?
Thank you. Well, I hope, in my answer to Neil Hamilton, you accepted that I said I think the presumption that it’s going to be a very positive thing is a little early. But, you know, as I said, there are opportunities, and I think we do need that more flexible approach. You mention specifically scallops and mussels, and how we move forward, particularly in relation to seafood. I’m going out to our local seafood expo in Brussels in April, because I think there is a lot we can do for the fisheries industry, which, maybe, have been hampered at times, and it’s about getting that more flexible approach. But I go back to what I was saying: market access is absolutely critical.
Along the same lines, Cabinet Secretary, you know how vulnerable the Gower cockle industry is because of early stock deaths in the Burry estuary. Perhaps the great repeal Bill will safeguard this industry by retaining the shellfish regulations of the European Union, but it won’t actually protect shellfish markets within the European Union at the moment. So, how is the Welsh Government promoting our shellfish within the European Union in order to ensure that our produce will be the first choice, with tariffs or without?
Well, I mentioned in my answer to Simon Thomas that I’m going out to the seafood expo in Brussels. I’ve given funding for that. I think it’s very important that I personally go out there, to make sure everybody knows about our great Welsh seafood industry. We’ve also had the seafood strategy, which I helped launch with the industry about three or four months ago.
The Warm Homes Programme
3. Will the Cabinet Secretary provide an update on funding for the Warm Homes Programme? OAQ(5)0102(ERA)
Thank you. This financial year, we are investing £26.5 million in Welsh Government Warm Homes to improve the energy efficiency of our housing stock and help tackle fuel poverty. I’m currently considering funding options for the next four years and will be making an announcement by the end of March.
Well, I welcome that response, and it will build on the work where, I understand, last year, under Nest and Arbed, something around 8,000 homes were improved with their energy efficiency. And of course, this links to fuel poverty, and that’s what I wanted to ask in my supplementary. The Welsh Government and Cabinet Secretary will be aware of Age Cymru’s statement on fuel poverty, and they’ve made some specific recommendations, building on the work that the Welsh Government has done. They’ve asked for a new strategic approach to tackling fuel poverty, backed by a clear programme and timescales. They’ve asked for robust and regularly updated data on housing stock quality, and reporting on fuel poverty levels. And one of the things they suggest, finally, is that we should consider an ambitious new fuel poverty target based on improving a number of low-income homes to a minimum energy performance certificate rating of C each year. There are other recommendations, but I wonder will she be taking the time to look at the Age Cymru proposals and to respond to them, and to take forward the work that we’ve already been doing in the Welsh Government.
Yes, I am aware of Age Cymru’s statement on fuel poverty and, certainly, we are currently considering the proposals that they’ve recommended in the development of our wider fuel poverty policy going forward. We’ve already responded to many of the proposals that they have brought forward in our response to the Nest consultation that was published just before Christmas. So, for instance, we’re proposing to extend eligibility for a package of Nest home energy improvement measures to low-income households with occupants suffering from certain vulnerable health conditions, and we do have fast-track arrangements in place for eligible vulnerable people, which I think is really important. Also, when my colleague, Carl Sargeant, and I were in our respective portfolios—and now we’ve swapped—we decided that we would have a look at a major new data collection for our housing stock, because we did not have that data that we both felt that we should have. So, we have brought that forward and we’ve issued a joint written statement to Members on that.
I welcome Huw Irranca-Davies’s reference to the Age Cymru report, findings and recommendations. You referred to the consultation on a future demand-led fuel poverty scheme, but the Fuel Poverty Coalition Cymru has expressed concern that, by introducing age requirements in the eligibility criteria proposed, this will deny help to many households in fuel poverty that are currently eligible. How will you, therefore, respond specifically to the Age Cymru statement that the 2010 revised fuel poverty strategy is now out of date, and that Wales and the Welsh Government needs to deliver for Wales a new revised fuel poverty strategy, reflecting not just energy efficiency, important though that is, but all the wider social justice issues linked to this important matter?
Well, I mentioned in my answer to Huw Irranca-Davies that I was looking at the proposals that came from the Age Cymru statement on fuel poverty in the development of our wider fuel poverty policy going forward.
Questions Without Notice from Party Spokespeople
Questions now from party spokespeople, and to ask the first question this week, UKIP spokesperson, Neil Hamilton.
Diolch, Lywydd. If I can pick up the gauntlet flung down at me by Simon Thomas in relation to King Canute, King Canute, of course, was the wise man who showed his fawning courtiers that there were limitations on the power of royal authority and government, and he couldn’t hold back the tide, so I feel he would probably have been a man-made global warming sceptic if he were alive today. [Interruption.] But to the business of the day, can I welcome yesterday’s statement from the Cabinet Secretary that she is designating several special areas of conservation for the harbour porpoise and for other sea birds? This is a step in the right direction in creating a coherent network of protected areas at sea to conserve our marine wildlife and habitat. Can she tell us when the Welsh Government intends to complete the marine protected area network in Wales, based on the 2016 Joint Nature Conservation Committee network progress report?
Thank you for your welcoming of the statement in relation to the three extra areas in relation to harbour porpoises. There is a significant piece of work going on around marine policy and marine planning. I think it’s very important that we have the Welsh national marine plan in place, and I hope to do that by the summer.
I thank the Cabinet Secretary for that helpful reply. The Welsh Government is committed to clean, healthy, safe, productive and biologically diverse seas, and there has been good progress made on designation. But, I’m not sure that the same progress has been made on improved management of marine protected areas. In 2012, the Countryside Council for Wales, which is now, of course, Natural Resources Wales, said that 47 per cent of species and 54 per cent of habitats in Natura 2000 sites were in an unfavourable condition and, more to the point, 100 per cent of the species and 79 per cent of habitats were not under secure management regimes to improve conditions. Given that Natural Resources Wales has been financially constrained and has had to cope with a 15 per cent cut in budgets in the last two years, is she satisfied that they have sufficient resources to achieve the objectives that the Welsh Government sets in this respect?
I’m sure the Member accepts that we’re all financially constrained and, certainly, I meet with NRW on a monthly basis—with the chair and chief executive—and I am satisfied that they do have the resources in place, yes.
I thank the Cabinet Secretary for that. In the strategic action plan that the Government published in November 2013 for Wales on marine and fisheries, paragraph 12 referred to the report of the Environment and Sustainability Committee of the Assembly in the last Assembly, in January 2013, and a commitment was made, following that, to six-monthly ministerial statements updating on progress. Unless I’m wrong, we haven’t had one now for about 18 months and I wonder if the Cabinet Secretary has any plans to go back to the six-monthly progress report system that was put in place several years ago.
Certainly, I’ve been in post eight months and I don’t recall bringing one forward, so I will look into that and, if appropriate, make a statement and, if not, I will write to the Member.
Plaid Cymru spokesperson, Simon Thomas.
Thank you very much, Llywydd. First, Cabinet Secretary, you will be aware of the restrictions relating to avian flu in Wales at the moment. If these are to remain until the end of February, then 90 per cent of egg producers in Wales will lose their free-range status. We will then have passed the threshold for keeping poultry indoors and we will lose the status that is very important to both customers and egg producers in Wales. Are you having any negotiations at the moment, via the UK Government, with our European partners about extending this period or about varying the restrictions?
The precautionary measures will stay in place until 28 February. You’re quite right—85 per cent of our egg production in Wales is free-range. I met this morning with the chief veterinary office, and, yes, she is having discussions with the other administrations. I know that, yesterday, she had discussions with Department for Environment, Food and Rural Affairs officials and also this morning, because, obviously, we have now had eight cases of bird flu in the UK. Just, I think, Monday was the last one, so clearly it’s still a very live issue. So, those negotiations and those discussions are ongoing.
I am pleased that negotiations have commenced, because, if the current ban goes beyond February, then we will lose that free-range status. As you’ve just confirmed, 89 per cent of eggs in Wales are produced under that status, and that compares with 44 per cent throughout the UK generally. So, we in Wales specialise in free-range eggs and it’s very important for our egg producers.
The leaders of the agriculture unions at a European level have asked for the 12-week period to be extended. It’s also true to say that the restrictions that you have in place in Wales, as Cabinet Secretary, are ones that you are responsible for. Are you in a position at all to give this Assembly an outline today of whether you will continue with the restrictions beyond the end of February, or are you in a position to put other steps in place for Wales, including high biosecurity levels, in order to retain the free-range status?
I’m not really in a position currently to give you a decision around extending past 28 February. As I said, I met with the CVO this morning and I’m meeting her again next week, following her discussions with colleagues. I think we need to look at a balance. We can’t keep the birds in-house forever. However, I mentioned that we’ve just had our eighth case on Monday across the UK, so it’s about getting that balance. But we are working closely with DEFRA and with the devolved administrations and making sure that we’re taking expert advice also.
Thank you, Cabinet Secretary, and I accept, of course, this is very much a fluid situation. I don’t think that we’ve had new cases in Wales this year, but that’s not to say that we won’t. There is, however, a real issue here because, if free-range status is removed from eggs at the end of February, then, quite frankly, consumers won’t know what they’re buying. With what’s been talked about by the British Egg Industry Council, for example, about the material in supermarkets, information and so forth, I think we’ll lose some of the confidence that consumers have in free-range eggs—very important in the Welsh context—and there will be confusion as to what’s free-range and what’s not. We’ve spent many years working with consumers to persuade them of the animal welfare issues around free-range eggs and people have come with us and are prepared to pay more, which in turn has meant more investment in the industry in Wales. So, if this does carry on past 28 February, what steps are you doing already with supermarkets and egg suppliers in Wales to ensure the consumer really understands the reason for such a change in the designation of the eggs they buy and that we can have ready-made the kind of stickers and information that will go on the eggs sold in Wales, so that people really understand the situation?
Thank you. Simon Thomas raises a very important point. When I came into portfolio and saw that 89 per cent of our egg production was free-range I thought, ‘Wouldn’t it be great to have 100 per cent?’ But, clearly, out of a clear blue sky, this sort of thing drops on you. The free-range industry have already contacted me asking for a meeting; I’m very happy to meet with them. We know of the significant cost it would be in relation to their packaging et cetera, so it is very important that we do all we can to help them. It also shows, when you went into those precautionary measures, it was right to wait. Obviously, bird flu is over in Europe. We didn’t go too soon because of that 12-week period that we could only keep the birds in. As I say, we can’t keep them in-house forever; we need to look at it very carefully. But it is a very fluid situation and I will update Members as we go through the month of February.
Welsh Conservative spokesperson, David Melding.
Cabinet Secretary, when do you expect the marine protected areas steering group to publish its report on improved management?
By this summer.
Thank you for that very pithy answer, Cabinet Secretary. [Laughter.] It was—[Inaudible.] The last piece of work done—. You did commission, or your predecessor commissioned it in March 2014, so it would have taken them a little over three years, alas, and the last major piece of work was done by Natural Resources Wales’s predecessor, the Countryside Commission for Wales, and that said there was a failure of effective management in these really important marine protected areas, but it also said, that report, that a high-level steer was needed from the Welsh Government because across authorities there was currently very low priority in this area. Do you agree?
No, I don’t think it’s a low priority but I do think it’s really important that we have a plan and a strategy. I mentioned in my answer to Neil Hamilton around the Welsh national marine plan consultation also that I think it’s really important that we do all that we can to protect our marine natural resources. It is a priority for me. It’s very complex, it’s a very complex part of the portfolio, but we will be bringing that work forward this year.
And it should be a priority and I think we’ll all be reassured when you deliver on that. Many experts and stakeholders believe that MPAs need a more spatial approach rather than being species or habitat specific. Furthermore, many also argued for non-extraction areas. Is this going to be the likely direction of policy?
I think the Member will have to await the policy when it’s issued later this year.
Animal Welfare
4. Will the Cabinet Secretary outline what the Welsh Government is doing to improve animal welfare across Wales? OAQ(5)0087(ERA)
Thank you. The ‘Wales Animal Health and Welfare Framework—Achieving High Standards Together’ explains the approach we are taking to achieve continued and lasting improvements in standards of animal health and welfare across Wales. The 2016-17 implementation plan sets out specific actions we are taking forward in this 12-month period.
Cabinet Secretary, you’ve made it quite clear in a recent response to a written question I asked that you’ve not made any representations to your ministerial counterparts across the UK about the possibility of an animal abuse register and you’ve also confirmed that you have no intention of raising the issue of increasing penalties for animal offences at all at this present time. Given that I understand you’re meeting with the Secretary of State for Environment, Food and Rural Affairs tomorrow, can you confirm that you will now raise these matters with the UK Government, and following that meeting, will you also publish a statement outlining the Welsh Government’s agenda for improving animal welfare throughout the fifth Assembly?
In relation to the animal abuse register, Bethan Jenkins had a short debate on this issue and I have committed to looking very closely at having such a register. I don’t think I need to have discussions with my UK counterparts in relation to that.
I am meeting with the Secretary of State tomorrow. She’s coming to Cardiff at my invitation to accompany me to a stakeholder event around Brexit discussions. So, I’m not promising to raise this with her, but I will certainly look at the point you mentioned.
I don’t want to misinterpret what’s been said, but I think in response to me previously, you’ve said that you wanted to take a comprehensive and effective approach, and you’ve said that you wanted to look at what the UK was doing to be able to take stock of what we could be doing here in Wales, so that we weren’t replicating or putting a register in place that wasn’t necessary. So, I wondered if that type of discussion has happened. You’ve also said to me that you would meet with the British Veterinary Association this month and I’m wondering if that has taken place, so that we can get to an understanding as to whether you’d be minded to look at this further or not.
I am continuing to look at it, quite comprehensively actually. I had a very good presentation from a vet from Scotland around work in this area, and I will certainly write to the Member about the presentation, because I think it would be very beneficial for you and any other Member who wanted to see it. So, it is ongoing and I will update Members in due course.
Cabinet Secretary, the Royal Society for the Prevention of Cruelty to Animals consider that there’s a hidden problem in Wales in terms of monkeys and other primates. They think that around 120 are being kept as pets in Wales, and some of them at least will be suffering unnecessarily, as a result of inadequate care and the fact that they’re not suitable for being kept as domestic animals. The RSPCA are, in fact, calling for a total ban on the keeping of monkeys and other primates as pets in Wales. Will you consider the case for such a ban?
Yes, absolutely. I’m aware of the campaign by the RSPCA and I’ve asked the chief veterinary officer to have a look at it for me.
The Welsh Government introduced the Animal Welfare (Breeding of Dogs) (Wales) Regulations in 2014, regulating the puppy industry in Wales. Can the Cabinet Secretary provide her assessment of the effectiveness or otherwise of that legislation, and how much funding, in particular, has been provided to local authorities to facilitate the enforcement of it?
Yes. I’ve already given a commitment that we are going to review that legislation, because I need to make sure that that legislation is the most appropriate, and that piece of work will be beginning in the spring of this year.
Biodiversity in Marine Environments
5. What policies are in place to increase biodiversity in marine environments? OAQ(5)0090(ERA)
Thank you. I recognise the value of maintaining and enhancing marine biodiversity and building the resilience in our marine environment. The marine strategy framework directive requires us to achieve good environmental status of our seas. It sets out the measures we are taking to protect, maintain and restore the environment.
Thank you for that, Cabinet Secretary. The Welsh Government supports the UN Convention on Biological Diversity and that commits us to halting the decline in biodiversity by 2020, and then starting to reverse that decline. I read just recently about the fall in the numbers of sewin in Welsh rivers and seas. A mark of Wales in many ways—sewin. It does bring home how vigilant we need to be in this area and ensure that these targets are met and exceeded.
Yes. I absolutely agree with the Member and I am very committed to Wales completing its contribution to a well-managed ecologically coherent network of marine protected areas. You’ll be aware of the network assessment that we undertook last year, which demonstrated that Wales is already making a significant contribution towards the UK network, for instance. We’ve got 128 marine protected areas in Welsh water, but we are working to ensure that that network is effectively managed, so that it does continue to contribute to the conservation and improvement of our area.
I went on a visit on Monday to Cemlyn, which is a coastal site owned by the National Trust on the north Anglesey coast. It’s a very important site in terms of biodiversity, including a high percentage of the global population of the sandwich tern. It is one of the oldest nature reserves in Britain, going back almost a century. Anyone who’s familiar with Cemlyn will know that it’s in the shadow of Wylfa. Does the Minister agree with me, therefore, that the developers of Wylfa Newydd should be proactive, and take all possible opportunities to support the National Trust in its efforts to safeguard and develop this sensitive site for future generations?
Yes, absolutely. It’s a very important site, and I would absolutely agree with the Member.
Cabinet Secretary, before meeting you this morning, the Climate Change, Environment and Rural Affairs Committee warmed up with a session on our marine inquiry, which we’re commencing. Members were struck by the sheer complexity of legislation in this area, overlapping responsibilities, the wide range of different protection areas and the rules around them. I wonder with the extension of Welsh responsibility beyond the 12-mile limit, so taking that area from the UK Government, and with Brexit, will there be scope for rationalising the system with one based more around the principles of the Well-being of Future Generations (Wales) Act 2015, and promoting that goal of increased biodiversity in our marine environment?
Yes, absolutely. I think that’s one of the opportunities, as opposed to the risks and the challenges, and you’re quite right. David Melding mentioned the UN Convention on Biological Diversity. We have the EU nature directives. We have our own directives, as you say, and we’ve got our own legislation in place now, both in the Environment (Wales) Act 2016 and the Well-being of Future Generations (Wales) Act 2015, so I think there is the possibility of doing that.
The Inland Waters of Wales
6. When will access to the inland waters of Wales be back on the Welsh Government’s agenda? OAQ(5)0094(ERA)
Thank you. Access to water has never been off our agenda. The Welsh Government is keen to secure improvements in opportunities for people to enjoy the outdoors. I have considered the responses to a Welsh Government consultation on accessing the outdoors, and intend to set out my approach in the coming weeks.
I thank the Cabinet Secretary for that answer, and would like to acknowledge here that the Welsh Government has done a great deal to open up the countryside over recent years, but this has largely been concentrated on land usage rather than on water access. It is some nine years ago when the Sustainability Committee published its report in response to a 10,000-signature petition received by the Petitions Committee. Amongst other things, their report stated that the situation with regard to access to water was untenable and that new legislation was required. Now, you will know of Waters of Wales. It’s a community of independent campaigners representing swimmers, boaters, walkers and other interested parties, which seeks to have legislation that would enshrine rights of responsible access to inland waterways throughout Wales. I do acknowledge, as my colleague mentioned with the marine environment, it’s a very, very complex issue that you would have to deal with, but does the Cabinet Secretary not agree that after some nine years, it is time for the Welsh Government to address this issue, especially given that such rights would impact positively on the tourist trade, and also greatly assist in the objectives of the health and well-being Act?
Well, I was actually a member of the Sustainability Committee back in 2009; it’s actually 2010 I think we had our inquiry into access to inland waters. And what the Welsh Government has been doing to date is actually following the recommendations from that committee report. But we have had a review of legislation on access to the outdoors, and we’ve had a subsequent public consultation, which I referred to in my initial answer to you, which has involved lots of stakeholders. We had a workshop that specifically looked at the issue around access to inland water. As I say, I will be making a statement over the coming weeks in relation to it.
Cabinet Secretary, I thank you for the answer you’ve just given and the indication that you’re going to be announcing shortly the decision on the consultation. Obviously, when the Green Paper came out, there were deep concerns from anglers in relation to the impact it would have on fishing stocks and breeding times. And perhaps the question of ‘responsible’ access is the important word. I met with my local anglers’ society last Friday night, and they’re still concerned over this business of timings of access to ensure that when the fish are breeding, they’re not disturbed. Will you therefore ensure that the voluntary process that you’ve identified is perhaps the best way forward to ensure that there is a good relationship between the anglers and those who wish to use the rivers, so that all can get the benefit from the inland waterways?
Yes, absolutely. I think it’s a very emotive issue. I remember when I was a member of the Sustainability Committee, my postbag was quite full from both anglers and canoeists, and as a Minister it’s just the same. It is incredibly emotive. It’s about, I think, considering not just anglers, not just canoeists—it’s about walkers, it’s about swimmers, it’s about gorge walkers; I’ve had correspondence from people who enjoy gorge walking. So, I think we need to get it right. It’s about looking at the additional benefits also—the health and well-being benefits—and, again, I think we’ve seen that from the coastal path, for instance, so we need that with our access to our inland water too.
I’m of the same opinion that voluntary agreements are the best way forward, but, of course, one does recognise that getting that agreement can be difficult at times. What consideration has the Government given, therefore, to appointing a mediator or mediators in such situations—a role that NRW could perhaps play—in order to ensure that we do come to voluntary agreements, which hopefully then will be far more successful?
That is something we are going to have to consider. The access to the water is probably the most contentious issue that’s come out of the consultation. The advice from Natural Resources Wales does say that the existing voluntary access agreements—. There’s only around 4.6 per cent of the total main river length of Wales available for canoeing and kayaking, so we need to have a look at that. You’re quite right; maybe if there was a need to mediation, NRW would be the most appropriate organisation to do so, but I’m having a look at all the responses, and will bring forward a statement.
Grazing Rights on Common Land
7. Will the Cabinet Secretary make a statement on grazing rights on common land? OAQ(5)0099(ERA)
Thank you. Well-managed common land provides significant economic, social and environmental benefits to the people of Wales. Grazing rights are an important part of the management regime on common land. The Commons Act 2006, which is currently being implemented here, provides an established process for the delivery of their protection.
I’m told by planning officers at Caerphilly County Borough Council that disputes over grazing rights are a private matter between interested parties. The local authority holds a register of common land and village greens, but it has no statutory powers to protect or enforce an individual’s right to graze animals on common land, or so they tell me. The local authority says any such disputes should be settled by recourse to legal advice.
I’ve been working on the case of a constituent within my constituency and a constituent of Andrew R.T. Davies, in that region, both farmers, who wish to graze animals on common land and are finding they’re coming up against quite difficult barriers. Seeking legal advice can be costly and very time consuming, and a barrier—simply a barrier—for many of them. Can the Cabinet Secretary, therefore, ensure that guidance is clear, so that the need to take legal action is minimised, and if necessary, could she decide whether it might be appropriate to update current advice on this matter?
Yes, I’m certainly very happy to look at that. I am aware that we have exchanged correspondence, and I’d be very happy to look at that also to see if there’s any more we can do. But I’ll look at the guidance, and if there’s a need to update it, we’ll be happy to do so.
Cabinet Secretary, could I endorse the comments that Hefin has made? Both of us have been dealing with a particular issue around Eglwysilan common, but in many parts of Wales these are huge tracts of land that have rights built up over many years—many centuries in fact. As pressure, especially urban pressure on urban commons has built up, there are real issues now over what were the traditional uses of those commons by farmers and grazers in the area. With the change of title of lord of the manor, people are trying to exercise rights they don’t have although they own that title of lord of the manor. I’d be grateful if the Cabinet Secretary could bring a statement forward to indicate what levels of support are there to protect the rights that have been built up over many years, and to protect the traditional use of those commons so that they can continue to be enjoyed, not just by graziers, but by the people who live very close to them, and the threats that have been made in recent weeks and months can be put to one side.
My officials are doing a significant piece of work at the moment around the Commons Act, so I’ll certainly look at that specific point and, if appropriate, bring a statement forward.
Mynydd y Gwair Wind Farm Development
8. Will the Cabinet Secretary make a statement on the Mynydd y Gwair wind farm development? OAQ(5)0096(ERA)
The Mynydd y Gwair development is a commercial wind farm in strategic search area E. It has received all necessary consents and I understand construction starts next month. The developer will invest £50 million and provide employment during the build, generating enough clean energy to power up to 22,600 homes.
Thank you for that response. Members will be aware that the application to develop a windfarm on land under the ownership of the Duke of Beaufort, near Felindre, Swansea, is one that has gone on for 20 years and has created a great deal of local opposition. The most recent saga, in addition to what you’ve just said there, is to do with the access to the site from the A48 at Pontarddulais. As regards that point specifically, can you give the Chamber an update about the latest discussions you’ve had with the developers, and when and how do you expect that the current situation will be resolved?
Well, I haven’t had any specific discussions with the developer. I will check with my officials if they have and I’ll write to the Member.
There is plenty of opposition, still, to Mynydd y Gwair, and local residents are concerned about the potential impact on the local bat population as well. I raise this as the lesser horseshoe bat champion for the Assembly. Residents do point to the recent Exeter university report on bat mortality caused by blade disruption to sonar and to the potential of roosts near the proposed access track to the site. The company’s qualified ecologist is satisfied that the bat roosts that they have found are not in trees that are planned to be cut down, whereas another qualified specialist has advised that roosts have been found in another tree that is due to be felled. As there appears to be some confusion about which trees and which roosts everyone’s talking about, do you think that there should actually be some clarity achieved before any trees are felled?
I think that’s an issue we certainly need to look at, and I’m very happy to do that and will update the Member.
Community Renewable Energy Schemes
9. Will the Cabinet Secretary make a statement on community renewable energy schemes? OAQ(5)0095(ERA)
The Welsh Government has a strong track record in supporting community renewable energy schemes. As a result of Welsh Government support, 11 schemes are up and running, providing benefit to the local area, and five more are in construction.
Thank you very much once again, Secretary, for that response. Very differently to the Mynydd y Gwair scheme, the response of local residents to the Awel Aman Tawe windfarm has been very positive, partially because of the size of it, but partially also because the local community profits directly from it. Would you agree, therefore, that there are lessons to be learnt by Welsh Government in terms of the need to support local communities that wish to see renewable energy schemes being developed, and what are your plans in that field?
I’m very happy to support local energy schemes. I’ve been very fortunate, in that I opened a small hydropower one in Merthyr Tydfil, I visited the one that you refer to, and I mentioned in my initial answer to you that we’ve got 11 schemes up and running due to the working of the local community. I think there are some very passionate people out there who are very tenacious. It’s a long process, and they’re absolutely determined to see the end. We’ve got a further five in construction, and I’m very happy to make sure that that funding is available to support those localities.
Many of us in the Chamber, Cabinet Secretary, are concerned about ensuring shorter economic supply chains in Wales to shore up local economies, and local energy generation is one key sector for that work. What steps can the Welsh Government take to encourage municipal energy generation in Wales?
I think there are some fantastic opportunities to be able to make savings in the areas that you’ve discussed. I’ve encouraged all Welsh public bodies to maximise the opportunity and, certainly, our green growth Wales initiative will help deliver these projects by providing a number of services, but also substantial finance.
One of the logjams that happen in this area, though, Minister, is within local councils that have to grant the applications of the various schemes that come forward. Do you believe that local councils are adequately knowledgeable of the benefits of local community schemes and, in fact, adequately knowledgeable of the best way of promoting them, whether it’s wind power, whether it’s river energy, or whatever it might be? Do we need to have further discussions or do you need to have further discussions with the Cabinet Secretary for local government as to how we might be able to encourage the removal of this logjam throughout Wales, so that we can get more of these schemes up and running?
It’s very important that local authorities do have that expertise in-house or, if not, they can collaborate with a neighbouring local authority to ensure that they do. I think that we don’t want to see logjams. I think it’s very important that these schemes are up and running as quickly as possible. I mentioned in my answer to Dai Lloyd that some of the people I’ve met who’ve brought forward these local schemes are very tenacious, because they’ve had to be. So, it’s really important that we don’t have those logjams in place.
Green Spaces and Parks in Wales
10. Will the Cabinet Secretary make a statement on the importance of green spaces and parks in Wales? OAQ(5)0086(ERA)
Thank you. The availability of quality green spaces and parks is important to people’s health and well-being. They provide opportunities for healthy recreation, support biodiversity and contribute to reducing flood risk and air pollution. Everyone should have access to quality green space near to where they live.
Thank you. I was absolutely delighted that Pontypool Park was named the best park in Wales for 2016, following a public vote by the charity Fields in Trust towards the end of last year. The park was also shortlisted from 214 entries for the UK’s best park award, narrowly missing out to Rouken Glen Park in Scotland. We have so much to be proud of in Pontypool, and the park itself is unique. How many parks in Wales, or across the UK, can say that they are home to ponds, Italian gardens, a playground, an historical shell grotto and folly, Pontypool rugby club, a leisure centre and even a ski slope? Will you join me in congratulating Pontypool Park, and also in paying tribute to all the hard work and dedication of the friends of Pontypool Park who give up their own time to ensure that the park is kept clean and tidy for everyone to enjoy?
Well, I was hoping that was a rhetorical question and you didn’t want me to actually give you a figure. Yes, I’m absolutely very happy to congratulate Pontypool Park. Maybe the Member would like to invite me to visit.
I suppose, really, everybody is entitled and deserves green spaces, except in the west of the capital city. Could you justify the environmental vandalism and destruction of ancient woodlands and fields in the west of Cardiff? Can you justify that please?
Well, no; I wouldn’t be able to justify that.
Cabinet Secretary, the Open Spaces Society has called on local authorities and developers to make 2017 the year of the village green. They urge developers to include registered village greens within their sites, so that local people have a guaranteed green space for recreation. Will the Cabinet Secretary agree to raise this issue with her Cabinet colleagues to see what can be done to increase the number of village greens in Wales?
Yes, I would be very happy to discuss with Cabinet colleagues if that’s appropriate.
Aberthaw Power Station
11. What discussions has the Cabinet Secretary had with Natural Resources Wales regarding Aberthaw power station since 1 January 2017? OAQ(5)0089(ERA) [W]
Thank you. As the environmental regulator of Aberthaw, Natural Resources Wales is responsible for reducing the nitrogen oxides emission limit in Aberthaw’s environmental permit, in line with the court judgment. Aberthaw must then comply with the revised limit. My officials will continue to monitor the progress of NRW and RWE towards compliance.
I thank the Cabinet Secretary for her reply, which didn’t actually specify what discussions she’s had. But, within the last hour, I think all Assembly Members have had a letter from the Cabinet Secretary, setting out what’s happened recently with Aberthaw. I note, from that letter, that Natural Resources Wales did not write to RWE, who operate this plant, until 6 January this year, although the court case was last September. They didn’t write to ask about permit variations until 6 January—incidentally, after I’d put in freedom of information requests asking what on earth was happening. That permit regulation needs to bring the nitrogen oxide emissions at Aberthaw below the 500 mg/cu m ceiling value, which the court judgment put in. They are still—according to your letter to Assembly Members—breaking that four months later than the European Court of Justice ruling. You say that it’s Natural Resources Wales that is responsible for permitting this, but clearly they haven’t pulled their finger out to do anything about it. This reflects very badly on us as a nation and yourselves as the Government.
The letter was issued to Assembly Members. I think it was David Melding who made a request of the First Minister during First Minister’s questions last week. As Simon Thomas said, it just set out the limits throughout. There has been a fall, but you’re right that further work is going to be required to ensure that Aberthaw is able to operate before the 500 mg/cu m emissions ceiling. There have been a significant amount of discussions between my officials and NRW, and I’ve asked my officials to monitor the situation closely.
The crucial thing here, Cabinet Secretary, is that this power station will now keep generating power into the medium term to meet peak demand. So, it’s part of the power-generating infrastructure and people must be reassured that these high standards—or higher standards, anyway—are followed as a matter of course, and don’t just suddenly come into the public domain when particular Assembly Members put pressure on the Welsh Government.
I absolutely agree, and I do want to assure Members that I’ve been having discussions. I’ve met with RWE, I’ve met with Aberthaw, I’ve met with my colleague Jane Hutt in relation to this, and I have ensured that officials are monitoring the situation very carefully.
I thank the Cabinet Secretary.
[R] signifies the Member has declared an interest. [W] signifies that the question was tabled in Welsh.
The next item on our agenda is questions to the Cabinet Secretary for Communities and Children, and the first question is from Sian Gwenllian.
Vibrant and Viable Places
1. Will the Cabinet Secretary make a statement on funding plans under the Vibrant and Viable Places programme for 2017/18? OAQ(5)0104(CC)[W]
I thank the Member for Arfon for her question. The Vibrant and Viable Places programme has been successful in providing support and investment in many communities across Wales. A future capital regeneration programme is under consideration and I’ll be providing further information to Members shortly.
Thank you. Can you confirm whether the current programme is to come to an end at the end of March, and what will happen following that? Will the programme continue as it is, or will it become part of something larger? What will the guidance be, and what is the timetable for that? Local authorities are eager to have the details as soon as possible so that they can plan for the future. Indeed, there is uncertainty and a lack of clarity more generally in the regeneration field. Do you agree that the vision is not clear at the moment, and if the intention is to reduce poverty then will the programme set clear outcomes in order to assist in making the difference that both of us are working towards?
I’m grateful for the Member’s question. She will be aware of the great work that’s gone on in her constituency, in Gwynedd, in terms of Vibrant and Viable Places actions taking place there. The Member is right to say that we haven’t yet formulated a future programme from VVP. The intention is for it to come to an end, and I will make a further decision on that. I think what was hampering the issue was about the amount of regeneration capital funding that was available to me. I’m grateful to the finance Minister and discussions with him on the ability to enhance that profile. From those discussions with him I am able to start looking at a future programme, which may be a VVP 2, or indeed another version of that.
Cabinet Secretary, I hope you would agree with me that Newport has seen beneficial use of Vibrant and Viable Places for city-centre regeneration, creating accommodation and alternative use to retail effectively. Whatever the future holds in terms of Vibrant and Viable Places or a similar scheme, will you continue to work closely with Newport City Council to take forward this important and beneficial regeneration programme?
Indeed, and I’m grateful for the opportunity to visit Newport with both yourself and the Member Jane Bryant to see the fantastic effects that VVP has had in your communities and neighbouring areas. It is something that I’m taking very seriously about how we continue with work to develop communities in the way we have in the past. I’m looking forward to announcing new schemes in the future. I will keep the Member abreast of that proposal.
Last week you mentioned that some Vibrant and Viable Places projects were going to be getting more money because of underspends in other areas, which strikes me as slightly odd, that some local authorities seem be quite bad at following guidelines if some are underspending and others haven’t got enough money. Because we’re not talking just about replacing falling-down car parks here; we’re talking about something that interests me very much: lifelong living and the housing supply that would meet that. So, are you planning to use any of this underspend to target specific projects, and particularly the kind of housing that can brought into city centres, which isn’t just affordable housing and then nothing else, but something that has a lifelong throughput to it?
Of course, the Member raises an important issue about how distribution of finance is given. It’s fair to say that the VVP policy is complicated by other actions such as planning and access to land, et cetera, so that complicates, sometimes, some of the schemes that are thought to be a little easier than others. I am looking at authorities that bring to me alternative schemes that are able to be flexible, but certainly the schemes that the Member talked about, about the introduction of long-term opportunities in housing, not just affordable, but the transformation of their communities, is something I’m very keen to pursue.
Childcare
2. How long in advance would it be reasonable to expect a Welsh Government supported provider of childcare to notify working parents of their child’s start date? OAQ(5)0107(CC)
Parents are notified of when their entitlement to Flying Start childcare begins by a Flying Start health visitor soon after birth. Later in the process, local authorities will refer parents to local providers so that start dates can be agreed as far as possible in advance.
I was surprised, when starting my own three-year-old recently, not to receive advance notice. The process was to have meetings at the beginning of the term and then agree a date. I seek no intervention in my own case, which is resolved, but I just wondered, in having childcare to support working parents as well as the education of the child, would it not be appropriate, if both parents are working, perhaps have to give notice to a private nursery, to have at least a month’s advance notice of what date a child might actually start.
In regard to childcare outside of the Flying Start setting, there is no statutory issue regarding guidance around this, but I am conscious of the Member’s concerns and, as we develop the childcare policy as we move forward, it is something I will be looking at carefully to make sure that parents are aware and confident about how they can access these childcare facilities across Wales.
Cabinet Secretary, you alluded to the Welsh Government’s offer of childcare and that being unfolded now as we go forward in the Assembly. I believe this year the pilots are going to start in the various local authorities that you’ve identified as being fit for purpose for those pilots to take place. What type of public information, what type of information, are you going to make available to parents in the first instance in those pilot areas so that they are aware of what their rights are under the childcare scheme and what will be available to them?
We’ve got five pilot areas, which cover six local authorities, and we’ve already started to work with them on how they devise their schemes. It will be a matter for the local authority in terms of what area space they pick, whether that’s ward-based or school-based or private-sector solutions, but we are keen to make sure that, pre summer, we’re able to ensure that the message goes out to parents in that cohort of individuals where they can access childcare. It is a pilot scheme and we anticipate that some of those pilot schemes actually will not continue in that form. But what we are doing is learning from the way this complicated scheme, as the Member will be aware, is happening in England. Trying to get that out through the door is quite challenging, but we are learning from this and, hopefully, the information that is—the important bit is making sure parents know well in advance their ability to access this programme.
Questions Without Notice from Party Spokespeople
Questions now from the party spokespeople. Plaid Cymru spokesperson—Bethan Jenkins.
Thank you. My first question is something I’ve raised with you quite a lot now in the last few weeks. With regard to NSA Afan, I wondered whether we could have an update on the inquiry, specifically because I’m getting contacts from people in Bettws who have funding streams through the delivery of this service and they tell me they don’t have a clue as to what is happening. What isn’t clear to me is that, when problems were raised at Plas Madoc, the funding was continued until the investigation was completed. So, I want to understand, if you are treating this in a different way, why that is. You mentioned the police in previous answers to myself. Has it all been passed over to the police, or are you still investigating internally as Welsh Government?
I’m conscious of the Member’s interest in this and also that of Dai Rees, the other Member that’s raised this on several occasions with me. I’m very cautious of the ongoing police investigation and also our governance review of this. It is slightly different to the Plas Madoc event. I’m damned if I do and I’m damned if I don’t. If I remove funding people criticise me for not removing it early enough, or not leaving it run for the organisations. What I am conscious about is that the indirect consequence of NSA not having funding—how can we make sure that services provided to the local community are continued as best they can. My team have started discussions, advance discussions, with Neath Port Talbot council about stepping into that space for delivery.
That answers the question for Neath Port Talbot, but it doesn’t in terms of Bridgend. It wasn’t a criticism; I was trying to find out the differences between the operations and why you’ve made that decision, and I’m still not really that clear.
On the wider Communities First agenda, I’m hearing from those who have an interest in the future of Communities First that the consultation wasn’t really as strong as it could have been. I want to understand how you’re analysing the consultation responses. I hear you’ve got very comprehensive responses from children writing a little note to say how important the services have been for them personally. How are you going to analyse how important they are and then come up with a plan to try and deliver the future of whatever scheme you have in mind?
Of course, I’m grateful for the Member’s views on Communities First and those of many Members who’ve taken part in the consultation. The consultation phase 1 ended on 15 January. I’m surprised at the Member’s comments saying that it wasn’t very successful or delivered successfully from a third party—I assume that’s wrong. We received over 2,300 responses, primarily—80 per cent of them—from the workforce or people who are associated with the organisation in the first place. My team are analysing that programme response very closely—they will give me advice on that very issue and I’m hoping to make a statement about what resilient communities are within the next two or three weeks. I hope that the Member will allow me some time just to finalise details of what the Communities First programme looks like for the future, but I will come back to this Chamber to let Members know.
Thank you, and I look forward to that statement, because I think many people in the sector want to know exactly how any new scheme can be effective in targeting poverty. Many of the people I’ve talked to in the last few weeks have said that it’s about the economy and boosting the job market for the less well-off: for example, more jobs closer to disadvantaged areas, action to improve terms and conditions—for example, a living wage—and strategies to improve low-paid sectors, e.g. social care and tourism. Are these things that you are considering as key elements of any new programme, because, of course, many of the Communities First projects have been well run and effective, but many, we would say, haven’t achieved those aims of eradicating or tackling poverty in their respective areas?
I think the poverty figures speak for themselves—they’ve been very stubborn, bouncing along the bottom, and what we’ve done as a Government is looked at and reviewed all of our programmes. We’re flexing between some of our Flying Start and Families First programmes; Communities First is under review, looking at what that may look like; we’ve got a big focus, working with Ken Skates regarding employment opportunities—so, Parents, Childcare and Employment, Lift, and Communities for Work. I will come back to the Chamber with a commitment, a vision, around what we do and want to do with our communities to ensure that we can start to turn the crest of poverty in a positive direction.
Welsh Conservatives’ spokesperson, Mark Isherwood.
Diolch, Lywydd. Of course, Plas Madoc Communities First was a grant-recipient body that received funding direct. After the whistleblower was vindicated, with the support of, dare I say, Janet Ryder, Eleanor Burnham and myself, and there were convictions in court, we also had two Wales Audit Office reports, one into Plas Madoc specifically and one into Communities First generally, which I’d asked the then auditor general to commission. Those found, above all, a failure since the inception of Communities First by the Welsh Government to put in place effective corporate governance controls—financial controls, human resource, and audit.
In Higher Shotton, when the Communities First co-ordinator whistle-blew against Flintshire County Council, which was the grant-recipient body, she was subjected to what turned out to be false allegations. Now, in the context of NSA Afan, the lead delivery body for Communities First in Sandfields and Aberavon, you said last week, that, following an investigation that had provided strong evidence of financial irregularities, NSA Afan had had its funding terminated. Was this a grant-recipient body or not? Had heed been given to the Wales Audit Office findings all those years ago of the need to implement those corporate governance, finance, human resource, and audit controls, which had led to the problems of the past?
Thank you for the Member’s question. I prefer not to look in detail at NSA Afan because of the ongoing detailed discussions with South Wales Police and with my audit team. What I can tell the Member is that the decision to terminate funding from NSA Afan wasn’t taken lightly—it was taken following a thorough investigation into the financial governance arrangements with NSA Afan. Our investigation has commenced. The Welsh Government official leading the investigation team informed the Wales Audit Office of the case and has continued to update the Wales Audit Office as it’s been progressed.
There is a rigorous process in place to manage the funding that we provide to thousands of organisations every year. In this respect, the grants centre of excellence is now well established and works to ensure continuous improvements in the delivery of grant funding across all of Welsh Government. What we have to recognise is that this is a huge programme—£300 million-worth of investment in our communities. And of course, at some stages there will be people who will seek to take advantage of a system that they understand. We have to take that in our stride and understand how we can resolve those issues when they come about. I’m conscious of the Member’s interest in all of these activities and, as and when I can release more information about this particular case, I will do.
Well, of course, the particular concern was whether this was a grant recipient body, and whether the Welsh Government have acted on the recommendations of the Wales Audit Office all those years ago in terms of ensuring that effective controls were in place.
But, moving on to a related matter, as I’ve raised with you previously, the ONS figures published last July said Wales had higher numbers—one in eight children living in long-term workless households—than the UK average, and research showing that children living with long-term unemployed parents tend to do less well at school or are at higher risk of unemployment later in life.
Given the findings of the Social Mobility and Child Poverty Commission ‘State of the Nation’ report that more than 65,000 children whose families receive out-of-work benefits or tax credits in Wales were not living in Communities First programmes, how do you respond to the StatsWales workless households figures, which came out two months ago, that show that although the percentage of children living in workless households in Wales had slightly reduced, they had gone up in Wales’s most deprived communities, from Blaenau Gwent to Bridgend, from Denbighshire to Merthyr, and many more besides?
It really troubles me that we’ve got children living in workless households and living in poverty wherever they live, whether that be in a Communities First area or elsewhere. And it’s not always a class issue—this can happen to any communities and any individual.
It is an ambition of this Government to tackle the issue around poverty, and that’s why we are looking at reviewing all of our programmes and interventions, to make sure that we tackle the people that need, in a way that we can deliver with our programmes that we are investing in. It doesn’t given me any pleasure to say that those numbers are stubborn. But there’s nothing wrong with any Government with ambition seeking to make those changes.
I agree, because, sadly, as you know, Wales still has higher child poverty than Scotland, Northern Ireland and all but two of the nine English regions. At least we’ve pulled ahead of two of those regions—I think London and the East Midlands. But, last week, the royal college of paediatricians said that poverty was the biggest threat to children’s health in Wales. I welcome the news, given your previous comments, that your officials have now met the co-production network for Wales, re-named All in this Together, and I even heard you yesterday refer positively to co-production. How do you respond to the statement from the Well North Wales programme, with which you might be familiar, that the more deprived communities of north Wales have around a 25 per cent higher rate of emergency admission than the more affluent communities, and that there is, therefore, a requirement to tackle issues around deprivation and poverty at a local community level by meeting the principles of prudent health, particularly around co-production?
I’m glad the Member and I are clearly coming together on our policies in some areas. [Laughter.] Let’s not be too ambitious. I think the Member’s right to raise the issue of prudent healthcare. Mark Drakeford has been for a long time raising this in the Cabinet setting, and I share his views on this about prevention and early intervention. And that’s why we are tackling issues around adverse childhood experiences, wherever they exist in families and communities. It’s something that we have to make sure we invest in now, to protect for the future. It’s not just a moral issue, but this is a long-term fiscal issue for any Government in power.
UKIP spokesperson, Michelle Brown.
Thank you, Presiding Officer. According to the Fawcett Society, women will lose approximately £300,000 over their working lives because of unequal pay. As you know, enforcement of equal pay legislation is in the hands of the employee. Does the Cabinet Secretary agree with me that ensuring gender-equal pay should be the job of the employer, rather than the employee?
I agree.
Enforcing equal pay rights is made extremely difficult, if not impossible, by the lack of transparency regarding pay by employers. A worker can’t make a claim regarding equal pay unless they know what everyone else is being paid and have a comparator. Admittedly, the Welsh Government have no control over what private sector employers do. However, Welsh Government does have control over what happens in the public sector in Wales. Does the Cabinet Secretary agree with me that pay data at all levels should be made available to public sector workers to facilitate the enforcement of their equal pay rights?
I think the Member raises an important issue around making sure that we get equality in job evaluation. It’s something that many in this Chamber, in all parties, have championed for many years. Ensuring that that happens is another thing, but we’ve been blighted by the ambulance chasers on trying to stop equal pay on the basis of people wanting to stop the claims going ahead. And I think there are many local authorities that have acted very responsibly in terms of the way they operate. The trade unions have brought forward legislation and support for Government interventions in local authorities, and it’s something that I’m very keen that we pursue.
I’m sorry, I didn’t quite hear whether you’re prepared to actually introduce pay transparency in the public sector, because if you’re not, can you explain to women in the public sector how they’re going to enforce their equal pay rights if you won’t tell them what the relative pay rates in the rest of their organisation are?
I think there are lots of data out there around pay and pay scales. It is a matter for the employer in terms of how that is given to employees. But employers will not see any closed doors at Welsh Government level in terms of introduction of equal pay.
Children’s Zones in Mid and West Wales
3. Will the Cabinet Secretary make a statement on child zones in Mid and West Wales? OAQ(5)0100(CC)[W]
I thank the Member for Mid and West Wales for his question. A number of organisations have put forward proposals for pilot children’s zones in Wales. I will announce the pilot areas as soon as we have an opportunity to assess the bids received.
I thank the Cabinet Secretary for his reply. He knows that I’ve drawn to his attention in the past some examples of very good practice in Mid and West Wales that stand outside some of the Communities First and Government-supported things, and there are some good things happening in the third sector and in the voluntary sector. I met with Jig-So, which is a project in Cardigan, a couple of weeks ago. It’s a long-standing project that works across boundaries, which often means it falls between two stools in terms of support from local authorities, being in Carmarthenshire, north Pembrokeshire and Ceredigion. It works around a crèche provision, training for parents, parenting, cooking skills and young people’s support in general. Is the Cabinet Secretary prepared, or are his officials prepared, to look at projects like Jig-So? Because they feel they’ve got something different and special to offer the concept of children’s zones outside the one that the public sector tends to approach it upon?
Yes, I’m very happy to have engagement with my teams. As I said, we’ve had a number of applications for the opportunity to run children’s zones across Wales. But I will check with my team whether Jig-So is part of that, and if not, they can have a conversation, of course.
Cabinet Secretary, I appreciate that you’re still looking at the issue of children’s zones, and I welcome the fact that the Government is looking at programmes where it can actually work with the third sector much more closely. Now, giving that delivering children’s services in rural parts of Mid and West Wales can be very different to perhaps more urban areas, can you update us on what discussions you’ve had with the third sector on delivering a service that actually meets the needs of families in all parts of Mid and West Wales?
The Member is right, and what I don’t want to be in the space of is controlling the market. But I think that we do have to give enablement to organisations to be able to deliver schemes for Welsh Government and for the sector. I meet on a regular basis with the WCVA and I’ve also met with organisations such as Flying Start and Families First in various areas to make sure that we’ve got the synergies around that. I’ve recently made an investment with Kirsty Williams and Rebecca Evans around an adverse childhood experiences hub, which is about the development of a programme where we can get all of the expertise, whether that would be in a rural or urban setting, around how we make sure that practice gets out there for delivery. Children’s zones will be part of that, running in parallel to the scheme, to ensure that we get delivery. But the Member’s right to raise the issue of rural communities, and it’s something that we’re very aware of.
Cabinet Secretary, clearly, the deputy director of the children’s and families division has actually highlighted the key criteria for children’s zones, particularly multi-agency work, the anchor companies and the organisations, and the third sector play an important part in that. Now, you’ve received the bids. Will you ensure that the bids actually meet those criteria, to ensure that they are collaborative, that they will meet those criteria and that they will involve the third sector, so that they can go forward with the best strengths?
Indeed, and that’s the principle of this. This is not additional funding. This is about bringing together what we have and a better implementation of this. There are examples of these children’s zones working across the globe and that’s something that we should use in best practice here in Wales too.
Apologies, Cabinet Secretary, for my inappropriate intervention. I will learn how this process works in due course. I think, to a degree, you’ve probably answered my question, but you’ll be aware from discussions in correspondence that we’ve previously had that I’ve talked to you about a number of schemes within my constituency that are playing an important role in engaging young people in particular. I’m referring particularly to schemes like Forsythia Youth in the Gurnos and the Engine House in Dowlais, which you might be aware of. They provide opportunities for early intervention with a number of youths who probably, without that kind of support, would end up wandering the streets and unfortunately would go on to become young offenders. So, does the Cabinet Secretary agree with me that it’s vital that we don’t lose this type of early intervention scheme? Can he assure me that, under the children’s zones approach, it is envisaged that early intervention schemes will have a crucial role to play?
I thank the Member for her question. Both Dawn and Lynne and many other Members on the benches beside me have made many references to the future of communities and what that looks like, and rightly so, recognising the strengths within their own communities.
Children’s zones are about integration of services and bringing services together. What I can’t commit to is an open cheque book, because the finances are challenged, but I do recognise that intervention, prevention and well-being plans are critical to making sure that we understand how areas work in the future and making sure that, where we can make those clever interventions, we do. I recognise some of the areas that the Member has raised here today.
Accessible Play
4. How is the Welsh Government working with partners to improve opportunities for accessible play across Wales? OAQ(5)0096(CC)
I thank Vikki Howells for her question. We are the first nation to put play on a statutory footing. We require our local authorities, working with partners, to secure, where practicable, play opportunities that meet the needs of all children and young people in their areas. We also provide funding to support this aim.
Thank you, Cabinet Secretary, for your response. Sense, the national charity for those with sensory impairment, has found that 92 per cent of parents with disabled children feel their children do not have the same opportunities to play as their non-disabled peers. Current guidelines, as you so rightly say, state that local authorities must have due regard to making play accessible. I’ve seen good evidence of this in my own area from Rhondda Cynon Taf council, but how does the Welsh Government work with other providers of play areas, such as private housing developments or community councils, to ensure that they also make play areas as accessible as possible?
I think the Member is absolutely right to raise this issue and she champions the cause of disabled children at every opportunity she has. My officials work across policy areas to ensure that play opportunities are sympathetically and appropriately considered in policy development and delivery. On the back of the play sufficiency assessments, officials are examining how policy areas work with their partners, including local authorities, housing associations, and indeed how we operate. Town and country planners are encouraged to make good use of section 106 agreements to make links between stakeholders and partners. I will ask my colleague Lesley Griffiths also to have a look at this in terms of planning proposals and how they operate, particularly with private developers. It’s all right saying that we’ll put a park in place, but a park that’s accessible is a very different park.
Accessible play is of course very important, but using play as a therapy as well has a big contribution to make, particularly in terms of those with adverse childhood experiences. It is something that I believe we’re not sufficiently utilising, or certainly not in north Wales from my experience. So, could you tell me what plans the Welsh Government have to expand play therapy services in Wales, and also would you agree to meet with a group of practitioners in north Wales who would want to discuss their ideas about how they could play a stronger role in achieving some of the positive outcomes that we all want to see for children and young people in Wales?
I thank the Member for his question. Indeed, prior to questions today, I met with StreetGames, who told me about the work that’s going on in many communities around Wales where play is an important factor, not just about health benefits, but also about confidence and other aspects of mental health provision et cetera. There’s a huge benefit from play. We are seeking to use play as an alternative therapy—and social prescribing. I’m interested in the Member’s local connection in terms of the group that he talks about. If the Member would like to write to me with details, I’ll give that some consideration.
Cabinet Secretary, it’s often said that play is the work of children, but, in deprived areas, many children just do not have access to safe playing areas. A generation or so ago, they would often have played on the street. Even that is now not an option. And, you’re right—the Welsh Government has a really good record in this area. But I think one weakness is perhaps that it hasn’t got to the planning stage where we look at the provision of play areas, and particularly in those deprived areas, and, where they’re absent, we plan for them. There are ways of doing this, but they require innovation and determination.
I agree with the Member, and, as I said to Vikki Howells, I will be seeking a conversation with the Minister responsible for planning to see how we can have a holistic approach to development and estate and look at that for the future.
The Government’s focus on play is welcome. We now have a fairly weighty Government document on this. This document is geared up for schools, nurseries, social workers and local authorities. Surely, a major problem though is that so many parents are sedentary or even obese that we have to persuade them to get out of the house to the local park to play with their kids. So, I wondered what we can do to encourage this aspect.
Well, it’s all our job. Governments can do many things, but telling people to get out on their bike is one thing I’m certainly not about to do. One of the innovations of last year—and some people were highly critical of it—was the Pokémon Go app that was used on many phones. I know many kids didn’t look up from their phones and banged into walls et cetera, but it got people out and about. That was a really clever innovation about getting people back into their communities. So, there are programmes out there that we seek to do. Ken Skates is a champion of these proposals, and I have regular conversations with him about how we can get more people active in our communities.
Domestic Violence
5. What measures will the Cabinet Secretary take to help tackle domestic violence during the Six Nations rugby tournament and other major sporting events? OAQ(5)0102(CC)
I thank the Member for his question. The Welsh Government is committed to working with its partners to take every opportunity to tackle domestic violence. Our aim is a more coherent approach to publicity with sustained activity to as wide an audience as possible. As part of this approach, there will be an increased level of social media activity through the Live Fear Free campaign during the period of the six nations.
I welcome that response. As the Cabinet Secretary knows, there’s growing and damning empirical evidence and applied academic studies highlighting the increased domestic abuse and violence around major sporting events, not just the six nations but the Super Bowl final, the football World Cup and others. Hence, those efforts by the Welsh Government, by the Welsh Rugby Union, by players themselves and others to raise awareness of this deep cultural problem and putting forward measures to turn this around. When Wales played England in Cardiff during the six nations tournament in 2009, South Wales Police recorded a nearly 80 per cent increase in domestic abuse incidents compared to the previous weekend. In the 2012 tournament, there were over 4,300 calls to the all-Wales domestic abuse and sexual violence helpline. That was an increase of almost 10 per cent on the same period the previous year. And when Wales played England during the six nations that year South Wales Police recorded a 76 per cent increase in the numbers of domestic abuse incidents compared to the previous weekend. So, bringing this into the open, raising awareness of the increased threat of domestic abuse around the six nations and major sporting events is only the first stage. We’ve all got a role to play in highlighting this and rugby players themselves have spoken out previously, but what more can the Welsh Government, but also its partners, do to tackle the tough cultural and individual roots of this ongoing problem?
I thank the Member for his contribution. I think sporting events are one aspect of this. But what is absolutely clear is that there is a direct link between alcohol misuse and domestic violence, and that’s where the link is. Usually, this happens at sporting events, so it’s not exactly the rugby or the football, but it’s the cultural events around those that cause the problems. The reporting aspect of this is a positive one. The fact is that people are talking about this now and we are finding access and opportunities to deal with perpetrators and, more importantly, victims of domestic violence, and hopefully clamping down on that. But the Member’s questions was very specific to the six nation’s rugby tournament. I’m quite clear to my team that this message is a daily message, not for six weeks. This is about something we could talk about all of the time and making sure access to services is here and available in Wales.
Yesterday, when I knew I was coming in on this supplementary, I did a little question on Facebook to ask people what they thought of the fact that these campaigns have happened. Many people were aware, but there was quite a shocking amount of people who weren’t aware that these publicity campaigns even existed. I could find, via Women’s Aid, some analysis of what’s happened in the UK—England, predominantly—on these awareness campaigns, but nothing in relation to Wales. So, I’m not taking away from how important it is to carry out these campaigns, but I want to understand their effectiveness, I want to understand if they need to be more high profile and if they need to be happening over a longer period of time, because the message that came back to me yesterday was, yes, as you said, it can’t just be a one-time occasion, it has to be systematic and it has to be all year round.
And I said that in my previous response. I think there are peak times where sporting events have high pressure for service deliverers, and it’s important for us that we can get a message out to people to say there is a helpline number or a support mechanism in place. But it is something I’m very keen to look at, long term, and I’ve started a discussion with the police and crime commissioners across Wales to ensure that we can have a collective response here, across Wales, of a typical messaging programme that we can share all the year round. So, I’m hopeful that will give us some better outcomes in terms of delivery.
Some 10 years ago, my wife was a community midwife, and when I used to hear some of the stories that the community teams would have to pick up on the domestic violence front—from people they would have seen at the end of the week to what they were picking up at the beginning of the week, and the intervening thing that had happened was a major sporting event—it was truly horrific, to say the least. Hearing the opening remarks from the principal questioner here about the increase in percentages that have been identified with the six nations, but, indeed, many sporting events, the one underlying factor here is alcohol predominantly, and drugs, being an issue in driving people down this road of domestic violence. How confident are you, Minister—and I commend you for the work you’ve done on this particular aspect—how confident are you that community support teams, whether they be in health or social services, or in the charitable sector, are resilient enough to actually be able to be there to support people who do find themselves in this horrific predicament of domestic violence, and be able to offer a way out of what seems to be a downward spiral that ultimately can lead to catastrophic events within those families and, ultimately, suicide?
Domestic violence is an epidemic, and I’m not sure—. We’ve just uncovered the top of the iceberg of this, and service delivery is challenged. And I’ve asked my senior adviser, in terms of the domestic violence adviser, which is in the Act, to look at a sustainable funding model and to see if we can work with the sector to deliver better services, longer term. I would like to invest more finances into this proposal, because the more facilities we build, the more people will access those. What is true is that, when we signpost somebody through a helpline or through a connection through health visitors or otherwise, it is absolutely critical that we have a follow-up procedure to that. Rather than just telling people, ‘You’ve disclosed’, you’ve got to ensure that there’s a service pathway in place, and I’m very keen to make sure that happens. I’m confident at the moment we can deliver, and we do, but it will get even more challenging. The more people who present—and rightly so, that they present—we will be challenged in making sure that we can deliver for these people.
Voluntary Organisations
6. Will the Cabinet Secretary outline how the Welsh Government assists voluntary organisations that help support health services? OAQ(5)0099(CC)
I thank the Newport West Member for her question. I have provided £4.4 million of funding this year for county voluntary councils across Wales and to the Wales Council for Voluntary Action to ensure support is available to third sector organisations. This includes support with fundraising, good governance and placing volunteers.
Thank you, Cabinet Secretary. Like many Members, I’ve had the privilege of meeting voluntary groups and seeing the amazing work that they do. One fine example in my constituency are the Robins, who are volunteers from Age Cymru, working with Aneurin Bevan Local Health Board, who provide support for vulnerable patients at the Royal Gwent and St Woolos hospitals. They take time to talk and read to patients, do their hair and nails, and provide assistance at meal times, make visits to shops and many other things that can make a really big difference. Both staff at the hospital and the patients describe the Robins as invaluable. Will the Cabinet Secretary commend the work of the Robins, who are making a difference for the better in Newport, and commend the efforts of all those who give up their time to volunteer?
Thank you for your question. Almost 1 million people in Wales volunteer in some way every year, and their contribution to society is invaluable. I want to say a big thank you to them. I also want to give a big thumbs up to the Robins in your constituency. I’m sure if we could do three cheers, they’d have them here, but, indeed, Jayne, I’m grateful for your raising this with me today, recognising the good work that they do, and please pass on my congratulations to that organisation.
There are almost 80 charitable and voluntary groups working with patients and healthcare staff in north Wales alone, and if there are 80 organisations, then there are hundreds upon hundreds of volunteers and therefore thousands of voluntary hours donated to support their work. The return on quite a small investment is very substantial indeed. Can I ask you, therefore, given that you say that funding has been allocated to support much of this work, do you recognise that the statutory services in place at present are under more pressure than ever and that, as a result of that, the voluntary organisations and volunteers are also under pressure to meet the additional needs that fall on them? Can you tell us what more you as a Government hope to do to support them?
The conversations I have with the Wales Council for Voluntary Action and CVCs are important ones on the basis that I know that if we didn’t have volunteers in our communities, statutory services would collapse; we wouldn’t be able to deliver the things that we want to do together. That’s why I value the work that these organisations do. But I’m under no illusion that what we have to do is take out some of the duplication and make sure we’ve got good, efficient services, and that accounts for both the voluntary sector and the third sector, and also the public sector response as well. Working together, we can get through this. But, as I’ve said in the past, I’ve made £4.4 million of funding available this year, and I will look carefully at how that develops over the next coming years.
Cabinet Secretary, the Red Cross offers regular support to ambulance services in Wales during routine work and major incidents. What assistance does the Welsh Government provide to the Red Cross to enable them to continue providing the most valuable support to Welsh ambulance services?
Indeed. I thank the Member for his question. The Red Cross and St John Ambulance both do some terrific work across Wales, and I would say—I don’t have the details of numbers for the Red Cross, specifically, in Wales—a big thank you to them. And the UK Government should be saying a big thank you to the Red Cross too. During the crisis that appeared over the border in a health setting, the Red Cross stepped in to help the statutory services in the delivery of services. So, we shouldn’t ever take away from the fact that these worthy volunteers are doing a great job in all of our communities.
Cabinet Secretary, having attended the recent AGM of the Swansea Council for Voluntary Service, I was amazed by the sheer number of voluntary organisations offering health-related support operating in my region. I was already aware of the excellent work undertaken by the likes of Tŷ Elis in Porthcawl and the Sandville Self Help Centre in Ton Kenfig, but, at the SCVS meeting, I met people from the Interact scheme, Caer Las and the mental health and well-being volunteer project to name but a few. All of these projects offer vital support to our NHS, yet very few receive any direct financial support from the Welsh Government. Cabinet Secretary, given that these voluntary organisations save the health and social care sector many millions of pounds, what additional support can the Welsh Government offer to them?
I can offer warm words; I can’t offer finances, unfortunately. It would be dishonest of me to say that, but I thank all of these organisations that step into the void sometimes where people are in need, and the third sector organisations are in the right place to deliver that; they understand communities very well. So, as much as I’d like to support all of the organisations in Wales, it would just be fiscally impossible. But I do recognise the work that goes on in all of our communities.
Strengthening Communities
7. Will the Cabinet Secretary outline his priorities for strengthening communities in Wales? OAQ(5)0098(CC)
I thank the Member for Monmouth for his question. My priorities for strengthening communities focus on three key areas: early years, employment and empowerment. I am currently considering views from a broad programme of engagement on a new approach to building resilient communities. I will make a further statement in due course.
Thank you, Cabinet Secretary. As I’m sure you’re aware, I have a short debate later today on the Cardiff capital city region deal. It won’t be you who will be responding; that will be the Cabinet Secretary for finance. In that debate, I’ll be raising the fact that it’s a deal with much potential for the future, and clearly, about growing connections between communities that will strengthen those communities—that’s urban and rural communities. What discussions have you had with the finance Cabinet Secretary about utilising the substantial city deal funding coming not just from this place, but also coming from Westminster to make sure that that funding does go into strengthening our rural communities and strengthening projects such as the south Wales metro, which will ensure that people living out in some of those more distant parts of the South Wales East region are able to get to areas like Cardiff and Newport as quickly and as easily as possible to ensure that they’re economically better off?
I think the Member is absolutely right to raise this issue. The principles that the Government is working on are based on the Well-being of Future Generations (Wales) Act 2015, about making sure that we can build this jigsaw together, but also put a picture on it so that we know and understand what the future looks like for our communities and our families across where we represent. The metro or the city deal is just one aspect of making sure that we’ve got the well-being of individuals at the forefront of our decision-making processes.
Cabinet Secretary, obviously resilient communities also depend upon not just the three factors you mentioned but also the health and well-being of those communities to ensure they’re in a position to take advantage of all the other aspects. To that end, Communities First at the moment has an element of health and well-being within it, and you’ve said in a previous statement that you’re minded to look at the other three. What discussions have you had with the Cabinet Secretary for Health, Well-being and Sport to ensure that the health boards can actually get involved in this process but also have sufficient funding to do so, because it’s important that we get those health and well-being areas of those communities strong?
Of course, and I said earlier on to a previous question what our vision is in terms of building resilient communities, and what is about economic regeneration, jobs and growth and what is about well-being. I’ve already had discussions with the Cabinet Secretary for health and other Ministers across the department about how we look at our funding streams and move into a prevention and early intervention process while doing the day job as well, because we’ve got to get a well nation, a well-being service rather than a health service, and I’m sure that my colleagues across Cabinet are responding to that in the way that we develop our policies for the future.
Thank you, Cabinet Secretary—I do apologise. Simon Thomas.
Roeddwn ychydig yn rhyfygus. Simon Thomas.
Thank you, Llywydd. Thank you very much.
Ysgrifennydd y Cabinet, fe sonioch am rymuso fel un o’ch themâu, ac os yw hynny’n mynd i olygu unrhyw beth o gwbl, rhaid iddo gynnwys grymuso’r bobl sydd fwyaf ar y cyrion yn ein cymunedau. Hoffwn dynnu eich sylw at brosiect o’r enw Prosiect Undod yng Nghil-maen yn Sir Benfro, sy’n brosiect ymhlith y gymuned Sipsiwn a Theithwyr yno. Daeth aelod o’r gymuned honno i gysylltiad â mi, unigolyn sydd wedi defnyddio’r prosiect i ddatblygu ei sgiliau ac i hyfforddi i lefel gradd, ond mae’n bryderus iawn fod y prosiect yn dod i ben bellach ac na fydd pobl eraill tebyg iddi hi o gymuned y Sipsiwn a Theithwyr yn cael y cyfle hwnnw. Rwy’n deall mai Achub y Plant sy’n darparu’r prosiect, o bosibl, a Chyngor Sir Penfro, ond rwy’n gofyn i chi: a ydych yn ymwybodol o’r prosiect hwn a pha drafodaethau yr ydych yn eu cael gyda Chyngor Sir Penfro, gan fod nifer o gymunedau Sipsiwn a Theithwyr yn yr ardal honno, ynglŷn â sicrhau bod y cymunedau hynny’n cael eu grymuso hefyd?
Indeed, and the Member’s right to raise the issue. Empowerment isn’t about restricting it to class or culture; this is about all-inclusiveness. Interestingly, the Member Julie Morgan raised this very issue with me yesterday about the Unity Project. I understand it’s a project that was funded by the Big Lottery Fund. I think it came to an end yesterday, if I’m right in thinking, but I will ask my officials to look at the detail of that, because the Gypsy/Traveller community are one of the most vulnerable communities in the UK. The life chances of this community are very poor. It’s something that we should take responsibility for.
Thank you, Cabinet Secretary.
[R] signifies the Member has declared an interest. [W] signifies that the question was tabled in Welsh.
I have accepted one urgent question under Standing Order 12.66. I call on Rhun ap Iorwerth to ask the urgent question.
Will the Cabinet Secretary make a statement on the Welsh Government’s response to the Healthcare Inspectorate Wales report on ophthalmology services in Wales? EAQ(5)0116(HWS)
Thank you for the question. We have action in place to improve our healthcare in Wales through the eye care delivery plan, together with the planned care ophthalmology improvement plan. The HIW report underscores the need for further improvement across Wales. I expect health boards to implement the required actions to ensure better outcomes for all patients.
Thank you for that answer. In a recent audit of health issues brought to my attention by constituents, ophthalmology actually was near the top of the list, making me think that there is a particular issue here. Of course, with ophthalmology, a long waiting time is more than just an inconvenience or a longer time than necessary in pain, because we know that long waiting times for some patients are causing harm, including sight loss, and the report does show that. It also says that management in two health boards are prioritising lower-risk patients who are more straightforward to treat over those with greater clinical need so they can avoid failing to meet referral-to-treatment time targets. Will the Government investigate, as a matter of urgency, that very serious allegation, and will action be taken against managers who are found to have acted in this way, and will there be a review of the targets, with clinicians and with patients also, to ensure a more robust system designed to prevent sight loss?
Thank you for the series of points and questions there. It’s worth reminding us all that there is, of course, increasing demand for eye healthcare. So, it’s part of the ability to detect more conditions, but also the success story of more of us living longer. Of course, not all waits cause harm, but some potentially do, and there’s the point about clinical need.
I take a slight issue with just some of the language but not the thrust, as it were, of your question, in that managers may not have done this, because HIW recognise in their report, in the language, that it does not know if the allegations are true, or represent a systemic policy by the health board. But I have been clear, on several occasions in the past, that patients should be seen in order of clinical need. I’ve already asked my officials to contact the health board mentioned to go through the allegations that are made.
On your broader point about outcome measures, it’s fair to say the Royal National Institute of Blind People, for example, support our agenda and the moves that we’re making to improve eye healthcare, with more care in the community, and they, as do I, want to see more pace and consistency. I’ve had a very constructive conversation with them about both what we are doing and the areas of challenge, and that includes our targets and outcome measures, because I think there is a powerful case that our current RTT targets in this area do not promote the best interests of patients, or help to support the service to make sure that clinical need is the prioritisation. So, there is an ongoing conversation between the RNIB and clinicians about how we reform and revise those targets, and I’m expecting to have a report come to me this spring. So, there’s work already in train, because I’ve already recognised that we could and should make improvements to not just service, but how we measure and understand what success looks like in the service to support and underpin best clinical practice.
Cabinet Secretary, the HIW report focused primarily on wet age-related macular degeneration services, but the problems highlighted reflect wider problems with ophthalmology services in Wales. Waiting lists for ophthalmology are excessively high. RNIB Cymru have repeatedly highlighted that patients are going blind whilst waiting for treatment. Every time the RNIB raise this issue, they’re told that the RNIB’s views do not reflect the current position of services in Wales.
The latest waiting times figures show that the average waiting time for cataract surgery is 115 days—twice as long as in England. That’s the current situation, and when you combine this with the fact that many ophthalmologists are having to rely on posting photos of retinopathy because the IT systems are not up to scratch, you can see why the RNIB make such claims.
Cabinet Secretary, what is your Government going to do to ensure ophthalmology services in Wales meet the needs of the constituents?
Thank you for the comments. I think in my supplementary response to Rhun ap Iorwerth’s first two questions, I tried to set out that we recognise that we are actually saving the sight of more and more people. The challenge is that more and more people need to have the service. There are more and more people coming into our services—it’s about meeting the demand that we have. That’s why we do need to have the sort of system reform that is set out in the Government plans, which has been put together with clinicians. There is no hiding away from that, and I’ve never tried to do that, but I don’t think people should take the view that every single thing said by the questioner necessarily accurately represents the RNIB’s view. For example, on cataract waits, it’s an area where you can wait for a longer period of time without there being clinical harm. If we get lost into saying, ‘Cataract waits must come down as the priority’, we’re potentially then skewing our system in a direction that does not meet clinical need.
Our RTT times are actually falling in ophthalmology, but our challenge is not just are our current RTT measures falling, but actually whether they’re the right and the sort of intelligent measures that we should have to tell us about how successful our service is, and I think there’s a powerful case that they don’t. That’s why I’ve told the service, with the RNIB, that I want to see us having a different approach, to try and have a more intelligent approach to this. We’re already investing in IT to make sure that images are able to be swapped digitally between secondary and primary care, and we’re giving out messages for people to go to their high-street optometrist for eye health care, not to a GP. So, we’re doing much of what the question suggests we should do. The challenges are the pace, the consistency and an intelligent set of performance measures.
Thank you, Cabinet Secretary.
There were no requests to make 90-second statements this week.
The next item on our agenda is a statement by the Chair of the Public Accounts Committee on committee-led inquiries, and I call on the Chair, Nick Ramsay.
Diolch, Lywydd. Can I thank you for the opportunity to speak today and to inform my fellow Assembly Members about the work of the Public Accounts Committee? As Members will be aware, the Public Accounts Committee is responsible for considering and investigating the value-for-money reports produced by the Auditor General for Wales. To date in this Assembly, we have already undertaken a number of inquiries based on these reports, including Kancoat and coastal flood and erosion, and we have a number of other inquiries scheduled, including income generation and charging and medicine management.
To complement this work, at the start of this Assembly, the committee decided to build on the innovative work of the Public Accounts Committee during the last Assembly, who introduced the concept of committee-led inquiries in the field of public accounts. So, as a committee, we agreed to develop an ambitious programme of inquiries to undertake during this Assembly, and we intend to place people firmly at the heart of each of our committee-led inquiries. This is, hopefully, a positive innovation, which will make the vital work of the Public Accounts Committee more comprehensible to everyone in Wales.
Firstly, we’ve agreed to undertake a thematic approach to our annual scrutiny of accounts, so, for example, for the 2015-16 accounts, we focused on educational bodies, which we found, in the main, to be in good order. We believe that taking a different theme for each year will add clarity for the public on this work. Although, in doing this, we may not always unearth any skeletons in the closets of organisations, but it has had a deterrent effect in ensuring that publicly funded organisations in Wales feel pressure at all levels to ensure taxpayers’ money is being spent in the most effective way possible. And, indeed, just this week, the committee agreed to call the National Library of Wales back in for account scrutiny in September, having considered the recent auditor general’s report on governance at the national library—particularly pertinent given the concerns the previous Public Accounts Committee raised about governance arrangements.
Our significant piece of committee-led work for the spring term is to consider the regulatory oversight of housing associations. We’re interested in this issue because housing associations receive significant amounts of public money, play an important role in combatting homelessness and contribute to the wider economy. The committee wants to make sure that the current regulatory arrangements are effective and efficient and that governance arrangements within the sector are robust. This is a timely piece of work, given the discussions around the classification of these important bodies by the Office for National Statistics. As a piece of work that has been driven by the committee, we’ve been able to put tenants at the heart of this inquiry, which is something the Welsh Government regulations aim to achieve. We have already held an engaging and informative stakeholder event with a range of tenants and will be issuing a survey tomorrow aimed at reaching as diverse an audience as possible. We have proactively engaged with relevant organisations to cascade the work of the committee and to establish an open dialogue with those stakeholders at all levels.
The committee has also begun to scope out our next piece of work looking at regional education consortia. Members may already have seen the useful memorandum prepared by the auditor general for the committee setting out the current position with the consortia. The committee have started to gather evidence for this and have just issued a joint survey with the Children, Young People and Education Committee—which is an innovative step in the hope of reducing consultation fatigue—to hear from teachers and professionals who’ve been impacted by the changes.
Finally, on the horizon, we are intending to do a substantial piece of work looking at the governance arrangements and support for looked-after children. We’ve identified four strands for this: expenditure and value for money of public services for looked-after children; value for money of the pupil deprivation grant for looked-after children; value for money and the effectiveness of current arrangements for foster placements; and the effectiveness of local authority corporate parenting arrangements. We will be approaching this as a rolling programme of work, playing on the power of persistence that we will not go away until we see some substantial improvements in how public money is spent in this area.
Although much of what I have outlined today about aiming to make our work more citizen focused may not be hugely innovative for the wider policy-based committees of the Assembly, it is a big step for a public accounts committee, and hopefully will help to engage people and increase understanding and awareness around our role as stewards of the public purse. I would like to take this opportunity to encourage all Members to promote this work, in particular our surveys, and bring forward any areas you think the committee should consider in the future. Diolch yn fawr.
I very much welcome the statement by Nick Ramsay, and I congratulate him on the way he has chaired the committee over the last few months. Sometimes, though, the Public Accounts Committee feels a bit like a treadmill: the auditor general produces a report, we get a presentation, the Government civil servants and other witnesses come in, we produce a report, which is then sent off to the Government, which responds, and then we start again like some form of infinite computer loop. The opportunity for committee-led inquiries is a good one, and a very important one. I think the one thing that really is important is that we don’t duplicate what is being done by other committees. That is one of the problems of public accounts because it is so far ranging and can cover anything done by the Government, or by the Assembly. It can be able to do things, only to find that, at some later stage, another committee has started off doing exactly the same thing, or has planned to do such a thing. I think that it really is important that we have a system by which we ensure that, if some other committee is doing it, either the Public Accounts Committee takes the lead on it or the other committee takes the lead on it. But I don’t think we’ve got enough time or people in order to do something twice.
I know that we all have our own interests, and we all have our own past experiences, and I think it really is important that we give other Members, not on the committee, an opportunity to suggest committee-led inquiries. Perhaps the Chair can say how people can do that. I could probably keep it going with my own suggestions over the next five years, but I don’t think that I, or any other Member, no matter who they are or where they serve, have all the knowledge and experience or a monopoly on good ideas. I think that there should be an opportunity for any Member here to be able to suggest to the Public Accounts Committee an area where it would be beneficial for them to do a committee-led inquiry. We may, Chair—under your direction—not take it up, but I think Members throughout the Chamber should have the opportunity to be able to put forward suggestions, because they may well have a better suggestion than those of us on the committee. So, can you say how that can be carried out, so that Members can have an opportunity to put ideas forward for what we could look at?
Can I thank Mike Hedges for his warm words there? You are right; it does often feel like we are on a treadmill. I know that all of the committees of this Assembly have their work cut out, but I think it’s unusual for committees to change gear as much as we do, from area to area, and sometimes within the committee meeting; whether we’re looking at a health issue or looked-after children, as we will be doing, we are changing constantly. It’s been some years since I’ve been on the Public Accounts Committee as a normal member—if I can use that expression—back in 2008-09. Not that I’m abnormal now, of course, being the Chair, but, well, that’s for you to consider. It was 2008-09 and the committee has changed significantly since then. What’s still the same, of course, is that we’re an unusual committee because we do have the auditor general on board. We do have his advice, we do have his reports, but we do differ from public accounts committees elsewhere—and increasingly so—because we are looking to diversify our work, and not just to take forward the work of the auditor general, but also to take forward our own committee reports as well. On that point, Mike Hedges, I think you’re quite right: it’s not just for us within the committee to suggest that work; it is for other Assembly Members too. This is a forum today. I’m sure that when we bring forward other work, Members would like to bring forward their suggestions, even if it’s just by word of mouth. We are a listening and open committee, and we aim to be increasingly so.
I would thank you, Mike. I know that you’ve been on the committee for some time before me over recent years. I’m also on the Finance Committee with you, so I don’t get that much chance away from you, but you are always there for advice and support. At the start of this Assembly session, when the committee was re-established, we were dealing with lots of inquiries from the previous Public Accounts Committee, which I know did cause confusion, not just with me, but with newer members of the committee as well. We’re moving beyond that now. We are moving towards looking at new work brought forward by the auditor general and new work brought forward by Members as well. But I’m open to suggestions, so please feel free to approach me or other members of the committee at any point to suggest how you would like the Public Accounts Committee to move forward in future.
I’m really glad the Member has just said what he said. I’d like to pay tribute to Nick Ramsay that he chairs the committee in such an equitable way. I’d like to pay tribute to Mike as well, who does a great job on Petitions Committee—the quickest committee in the Senedd, I think. Very well chaired.
Moving on, if we look at what the Public Accounts Committee has been looking at with Kancoat, then we’re talking about very serious matters. I’d like the Senedd just to listen to the following in terms of questionable Government expenditure: Kancoat, £3.4 million; the Lisvane land deal, the taxpayer lost £39 million; Rhoose, the land there, we lost £7 million; OysterWorld, the games company, £1.4 million; two shops in Pontypridd, £1 million; Cardiff Aviation, it’s alleged that £1.5 million is owed in rent; and Kukd.com, well, all the payments from the Government have been suspended because the parent company is being investigated by HMRC for irregularities in its tax affairs. We had thousands of pounds spent on David Goldstone, the millionaire, to stay in the Hilton in Cardiff, and Ministers, when you answer questions about use of the ministerial car, this all adds up to just over £53 million. I think the former Minister should be brought before the Public Accounts Committee to answer for decisions made. And if the former Minister won’t come along, we should call the First Minister, who is ultimately responsible.
We need to get serious about ending financial waste in Wales, and I think the Public Accounts Committee is the perfect place to do that. So, I’d ask the Chair if he would accept my call to put to the committee the suggestion of a forensic—a forensic—investigation into all these matters, because Labour incompetence is endangering devolution, and we have to shed light on these matters and bring transparency. Thank you. Diolch.
I would agree with the opening of the Member’s comments there. We are an eclectic mix on the Public Accounts Committee. I chose my words carefully there. We do have a robust exchange of views. We work together where necessary, but also individuals have their own views. You are right as well, Neil, that this is a committee with an incredibly serious workload, a huge workload, looking at the value for money of public spend across a wide range of areas in Wales. We could probably meet—I’m not suggesting this, by the way—every day and still not have enough time to get through the workload involved.
Okay, going back to your basic points there, you’ve mentioned Kancoat, and I mentioned it in my opening statement. We know there have been issues there. What I would say, as you know, is that the Public Accounts Committee, in terms of its operation, is primarily concerned with the operational decisions of Government, which is why we take evidence from a wide range of officials, right up to and including the Permanent Secretary—the last Permanent Secretary, and the new Permanent Secretary will be coming in in the near future. That’s our standard practice. Now, we can of course call anyone, but I would have to say that we would have to be clear, there would have to be a clear indication in the evidence we receive from the officials, operationally, that calling particularly an ex-Minister would be beneficial to our inquiries. You clearly believe that evidence we’ve taken to date does warrant that. Witnesses are, of course, a matter for the committee as a whole to consider, and I think it would be breaking with precedent for me or any other Member in this Plenary to say that that should happen. So, this is a matter for the Public Accounts Committee, and you know that, Neil McEvoy. If you want to bring that request to the committee, we will all consider it and I’m sure we will make a considered response. But I would say that, in the first instance, we are responsible for scrutinising the officials. We’re not a subject committee, we’re not looking at policy; we’re looking at operational activity. In that sense, you would have to have very clear evidence that we were calling in witnesses for the right reasons. But, as I say, it’s a matter for the committee to consider and not a matter for this Plenary.
As one of the longest serving members of this committee, for the last 10 years to be precise, and after 45 years as an accountant in public practice, I know a little bit about figure work. Neil McEvoy just wanted to know about financial irregularity. We’ve got to look into the Wales Audit Office’s reports. I agree with you that a forensic examination should be done by that department, and then they could give us the report. There is no reason why not, if anybody does a bad job, either political or financial. If Tony Blair can go to the House of Commons accounts committee to explain to the MPs why he went to Iraq, why can’t some Assembly Members who made some wrong financial decisions come to our committee to give answers?
I would like to thank Nick Ramsay for his statement and congratulate him on his distinguished chairmanship of the committee. One of the strengths of the Public Accounts Committee is that we are able to initiate our own inquiries, alongside the work of the Wales Audit Office. So, may I ask how you see the work of the Public Accounts Committee developing in future, with particular reference to the relationship between the committee and the audit office? That’s what I’m interested to know.
Thank you, Oscar, and thank you for your warm words. It’s been a pleasure working with you on the committee over the last few months as well. I don’t think that was a request for us to call Tony Blair to the Welsh Public Accounts Committee—at least I’m not taking it as such—but I take your point. The point is, as a committee, we are free to make requests to any members of the public to come and speak to the committee if we believe that the evidence justifies it. It is a big workload and often the evidence that we receive does lead us to take evidence from witnesses we didn’t consider initially. But as I say, we have to be evidence based in that respect.
In terms of your key question, you kind of answered it yourself in the question. We have a balance to be struck between considering the Wales Audit Office’s work on the one hand and now conducting our own Member-led inquiries. I know that, in this Assembly certainly, many members of the committee are eager for us to carry out our own inquiries, and not just short, sharp inquiries. In terms of looked-after children, which I know Lee Waters has been particularly interested in, in making sure that we do a medium- or long-term piece of work that doesn’t just get forgotten on a dusty shelf a year or two years afterwards, but that we do mean business and we are going to revisit that issue in the future to make sure that things have improved, because that’s too important an area. It’s one example of an area that’s too important for us not to revisit and make sure that they are listening to our requests.
I would say, finally, in terms of your question, it’s for me as the Chair, with your assistance of course as members, to make sure that I do get that balance right. And I’m sure that if I don’t get it right at any point you’ll be the first—well, you are the first to tell me, I know that, so I probably don’t need to mention that. Or I shouldn’t remind him. So, I will continue to endeavour to do that. But do not be afraid to tell me if you feel I’m getting the balance wrong, because I’m only human.
I declare my interest as the Chair of the ministerial advisory group on outcomes for children. Can I welcome the decision of the Public Accounts Committee to carry out a comprehensive piece of work on services for looked-after children? I think this will help the ministerial advisory group in its work to advise on how a national plan and programme can be developed, with the aim of producing the best quality services for looked-after children anywhere in the UK or even further afield. So, I do look forward to following your deliberations.
Just as you were saying on the work you’ve done on housing—that you wanted tenants to be key to the inquiry—I think it’s very important that you are able to engage with looked-after children and care leavers in particular, either through direct evidence or outreach methods in terms of gathering evidence. There are organisations like Voices from Care and Children in Wales that can advise on this, because I think it would be an outstanding opportunity for their voice to be heard directly.
I know you have a long-standing interest in terms of looked-after children. I thought that that would come up, so I brought down some of the figures for that, and just looking through them, we intend to scrutinise the overall cost and the value for money of the range of services aimed at improving outcomes for looked-after children. But this is such a huge area that, over, I would say years, not even months, but over that period, we’re going to return to this. We’re going to look at all aspects of this, from the value for money aspect to corporate parenting. As a former county councillor, I know very well the important role that county councillors across Wales have played, and will play, in the role of corporate parenting.
But, always, all of this, we are not—. I must stress, we are not a subject committee; we are always looking at this from a value for money for the taxpayer viewpoint. That doesn’t mean that we do not have an interest in the policies that are being employed, because sometimes it is very difficult to separate the policy aspect from the value for money aspect. So, all that comes into it, but we are, first and foremost, looking at are we getting value for money. And is the system transparent? Are people getting what they deserve? Are looked-after children in Wales really getting the sort of service that they deserve?
The evidence to date—. I think the auditor general looked at this in early 2015, I think it was—the evidence then was that a lot of progress had been made, but, as is often the case, more could be done, and particularly in the area of mental health issues for looked-after children. And more than 8 per cent of looked-after children were diagnosed as having a mental health problem, nearly 6 per cent of looked-after children had substance misuse problems, nearly 13 per cent of LACs had a disability. Now, of course, there are proportions of people in the general population who have that, but they don’t often reach those figures across the board so consistently. So, there is a lot of work to be done here, and I look forward to working with my members on the committee to ensure that we do that as speedily and as efficiently as a committee as possible. Because, at the end of the day, that’s what we’re all about.
I take being a member of the Public Accounts Committee very seriously. I think it is one of the key committees in any parliament, and I think it’s imperative it doesn’t become a circus. I have no problem following any evidence and in holding Governments to account with rigour. But that requires all Members to take the committee seriously, to engage in its work, to read the voluminous papers in advance, to engage with the evidence—not to spend the whole committee meeting tapping away at their iPhones and then lobbing in some partisan-fuelled conspiracy theory. Because that, I think, brings the work of the committee into disrepute. When there is evidence, we must follow it, and we should be ruthless about pursuing it, and all members of the committee are prepared to do that.
The litany of allegations Neil McEvoy mentioned earlier—which is not the first time he’s mentioned them—are issues being looked at by the committee, and will be looked at by the committee. There’s nobody on that committee who is not of the same mind and wants to get to the root of it. But constantly suggesting there’s some great party-political conspiracy theory behind every poor judgment or questionable case isn’t particularly helpful, nor is conducting themselves during meetings by tweeting every time they see something they think will get them a headline, or taking photographs of restricted papers and putting them on Twitter—it doesn’t help the cause and the integrity of the Public Accounts Committee.
I echo the comments of David Melding and Nick Ramsay that one of the key issues we want to look at over the coming months is outcomes for looked-after children. I’m hoping that we will be innovative in following the example set by the culture committee, in consulting the public on our terms of reference to make sure we are shining the light in the correct places, and that we show some consistency in coming back to this issue. Because the data, as David Melding and Nick Ramsay have intimated, are stubborn—stubbornly poor. And that’s the sort of work I think the public accounts should be doing, rather than chasing cheap headlines. Thank you.
I’m about to. As you can see, Members, we are a committee of robust members, and robust views, and when we agree and when we work as a team, actually, I think we’re at our best, because, believe me, the Members on the Public Accounts Committee in this Assembly really do know their own minds. I would say in terms of—. I quite agree with you about tweeting, and in fact we did have that discussion, and I think probably other committees have had that discussion as well during this Assembly. I don’t think it’s helpful that, during a committee, whether that’s in the private or the public session, tweets go out before the committee as a whole has had an ability to consider the evidence. Often, in this Chamber, as the Presiding Officer knows from her experience, we can have robust debates, and you do get partisanness, or however you call it; of course you do. But the committee is not there for the same purpose entirely that this Chamber is. It isn’t there purely for us to make party-political points. Of course, Neil McEvoy can make party-political points, you can make party-political points, I can as well, but, at the end of the day, does that help the operation of that committee? Does that help us within the remit of that committee to hold those organisations to account? I don’t think it does. And I think that we need to remember what this Assembly is all about, why we got elected to it. There is a time for us to take each other on, but there’s also a time for us to work together to take on vested interests wherever they might be, in whatever sector they might be. And that’s the job I mean to get on with.
So, I have no problem with Members tweeting their thoughts once committee meetings have finished, and they wouldn’t listen to me if I told them not to. I don’t tweet as much as most. But I think, yes, this is a really serious job, this is a really serious committee. I’m delighted to have every member of the committee working with me. Let’s move this forward. We are a team. Let’s just get to where we want to go. We all want to go to a place where we are ensuring value for money and efficiency for the taxpayer. Many of us choose different roads to get there, but, at the end of the day, we’re going to get there, and, before Mark Isherwood starts going on about co-production, I will finish my comments.
Thank you very much to the committee Chair for his words and his statement.
The next item on our agenda this afternoon is a debate on the Health, Social Care and Sport Committee’s report on its inquiry into winter preparedness and I call on the committee Chair to move the motion—Dai Lloyd.
Motion NDM6220 Dai Lloyd
To propose that the National Assembly for Wales:
Notes the report of the Health, Social Care and Sport Committee on the inquiry into winter preparedness 2016-17, which was laid in the Table Office on 9 December 2016.
Motion moved.
Thank you, Llywydd. I’m very pleased to open this debate today on the Health, Social Care and Sport Committee’s report on winter preparedness 2016-17, which we’re in the middle of now. Of course, winter is a hugely challenging period for our health and social care services. It’s a time when the year-round pressures of an ageing population, increasing demand for services, and workforce challenges, are thrown into sharp relief. Just two weeks ago the chief executive of the Welsh NHS remarked that the NHS has already faced exceptional challenges this winter, experiencing some of the busiest days ever faced by hospital emergency units and the Welsh ambulance service.
That’s the week the Cabinet Secretary for Health, Well-being and Sport announced that certain targets for GPs are to be suspended temporarily to help free up appointments in their practices, such is the pressure on primary care over this winter. Assembly Members will almost certainly be aware also of the coverage relating to similar pressure on health and social care services elsewhere in the UK and in England in particular.
We as a committee felt it was important to examine how prepared the Welsh NHS and social care services are to deal with pressures on unscheduled care services during what is now the current winter period. As part of this work, we wanted to look at the progress that has been made in this area over the past few years, particularly since the work done by our predecessor committee in 2013-14. Our terms of reference also included a focus on patient flow, including primary care out of hours, emergency ambulance services, emergency departments, and delayed transfers of care.
We spent the 2016 summer period asking stakeholders to tell us their views on whether the Welsh NHS was equipped to deal with pressures on unscheduled care services during the coming winter. We had a really good response to this and we’re grateful to everyone who took the time to write to us and present evidence to us in our formal meetings.
That’s the evidence that’s helped us to come to some very clear conclusions and has enabled us to make what we believe are robust recommendations to the Cabinet Secretary and Minister. Although many of our recommendations are important in terms of managing additional winter pressures, they need to be considered as part of a much wider review of health and social care services in Wales. Indeed, our overriding conclusion is that a more resilient NHS and social care service would be better equipped to cope with the considerable spikes in demand over the winter period. Without that greater resilience all year round, efforts to manage winter-specific pressures will be more about trying to limit their effects than achieving the whole-system change that is so greatly needed. Regular readers of our report will know that paragraphs 71 to 75 tell us this.
I note that the Cabinet Secretary has partially accepted our first recommendation. We are all aware that statutory regional partnership boards were established under the Social Services and Well-Being (Wales) Act 2014 as a way of taking forward the agenda to deliver integrated health and social care. However, I’m glad the Cabinet Secretary recognises there is more to do and that his Government will be supporting further improvements.
Overall, we concluded there is a need for greater integration between the health and social care sectors, both in the planning and delivery of services, and there is a need to include the independent sector, both care home and domiciliary services, in this work. In light of this, I am disappointed the Cabinet Secretary has rejected our recommendation that he should commission or possibly review any available research into the effectiveness of the co-location of primary care services in A&E departments, especially as he acknowledged the evidence from across the United Kingdom outlining the effectiveness of co-location. The information he has provided relating to out-of-hours services working alongside emergency departments is welcome, despite that.
The Deputy Presiding Officer (Ann Jones) took the Chair.
There was a difference of opinion amongst those who gave evidence to the committee about the levels of preparedness—this, in itself, is cause for some concern. There should be more confidence across the entire sector that the problem is under control and manageable. That this is not the case may be due, in part, to a need to improve communication between all the relevant parties, despite arrangements, such as integrated plans, being in place.
Linked to this, we have some concerns about the Welsh Government’s flu vaccination campaign, especially in relation to the relatively low uptake amongst NHS and social care staff. Recent figures provided by Public Health Wales show that only 48.4 per cent of NHS staff who have direct patient contact have, so far, taken part in the influenza immunisation programme. Vaccinating front-line staff is a key preventative measure, and we believe the Welsh Government and the sector should be more ambitious when setting targets in this area. We also have some concerns about the structure, visibility and targeting of the campaign this year. There is a need for clarity about the respective roles of GPs and pharmacists in the campaign and the strength and visibility of national messages to target groups. We recommended that arrangements are put in place to undertake whole-system learning based on an evaluation of the effectiveness of all Welsh Government campaigns relating to winter health. That’s recommendation 3.
I welcome the fact that the Cabinet Secretary has accepted our recommendation on this matter. I am pleased to note—and I’m sure that other committee members will feel the same way—that learning from the evaluation will be incorporated into future all-year planning, including the campaign for next winter. There is no doubt that there have been some clear improvements within the system. The Welsh ambulance services trust is an obvious example, and they should be congratulated for this. However, a number of matters reported on by our predecessor committee in 2013 have been identified in the course of this inquiry as continuing to need attention as a matter of priority, including inappropriate A&E admissions, patient flow through hospitals and delayed transfers of care. We had a lot of evidence about beds, the need for more beds and the great pressure on social care. More from other committee members on that, evidently.
As a committee, we recognise that planning for this winter has required a great many resources. We welcome the fact that the work on planning for the winter started early. It’s important that the lessons of previous years are learnt. Now, despite this, we are concerned about the ability of the system to cope with the additional seasonal pressures, and the damage that one serious incident such as a flu outbreak or the closure of a care home could cause. We welcome the additional investment of £50 million by the Welsh Government for winter preparedness this year. The Cabinet Secretary said that he expected to see specific outcomes as a result of this additional investment: dealing with the additional demands of unscheduled care and maintaining elective surgery over the winter period. We recognise that these are ambitious targets for this level of investment. That’s recommendation 4. We look forward to hearing from the Cabinet Secretary in May regarding the progress made against those ambitious targets. Thank you very much.
I don’t want to rehearse what Dai Lloyd, the committee Chair, has already said, but I certainly want to put on record that I agree with the comments that we’ve just heard and agree with the conclusions of this report. Of course, there are additional demands arising during the winter months, particularly, as we heard during our inquiry, in terms of the kind of health problems arising with elderly people, and children too. But what struck me more than anything during this inquiry, and in the conclusions of the report, is the degree to which winter pressures are pressures that aren’t necessarily caused by factors that are beyond the control of Government—for example the weather, or cold weather particularly—but they are pressures caused by factors that should be within the Government’s control. That’s what causes many of the problems that we see within the service. We know how important flu vaccination is, and we know that front-line staff in the health service should receive that vaccination. It’s not expensive to ensure that that happens, but we did receive clear evidence suggesting that staff in our hospitals weren’t taking up that vaccination. That’s the kind of thing that should be relatively fundamental in this area.
We also heard that preparations within the social care sector for the winter weren’t as detailed as, perhaps, they should be. I know that these benches often refer critically to the Westminster Government for failing, in the English context, to realise the value of social care within the health and social care service as a whole. But here, I think, we have an example of the Welsh Government also making a similar error of planning—yes, as is required for the NHS—but failing to simultaneously give due attention to the care system more broadly. The evidence that we as a committee heard certainly reinforces our view that there is, perhaps, a crisis facing social care, and we will be focusing on that in the Plaid Cymru debate later this afternoon.
I will quickly turn to the number of beds in our hospitals used at any particular time. Over the last two decades, there’s been a reduction in the number of beds available within the health service in Wales, and that is driven largely by ideology more than funding, if truth be told. But we as a committee heard evidence that the bed shortages have now reached a point that is causing a problem within the health service. We know that occupancy should be no more than 85 per cent or it creates problems in terms of flexibility within the system. Many have suggested to me that those who refuse to accept that concept of not going over 85 per cent are those who have supported an ideological shift towards reducing the number of beds within the health service. I do think that we need to commence a programme of ensuring that the beds are in place, and we will also cover that issue later on this afternoon in our debate.
But, as I say, I think the greatest lesson we can learn from our inquiry as a committee is that the health service is facing pressures throughout the year, and that the pressure and what happens in the winter months—the additional demands from older people and children—is something that’s going to happen next year too, and it will happen the following year. So, we should be able to make preparations, particularly given the demographic changes and the increase in chronic illness and so on. So, we know what the pressures are, we have some forewarning of that and, quite simply, we should be doing more about it.
I very much enjoyed being part of this committee and I’d like to thank everyone who came as witnesses before it. They were very detailed, they were very knowledgeable and, in the main, they were incredibly passionate about the different areas that they represented. I’d also like to thank the clerking team and the staff for turning around and marshalling us all so well.
The report, I think, speaks for itself. There’s an awful amount of detail in the report, and when you read the Record of Proceedings there is even more detail there. But, for me, coming to this in a brand-new way—it’s the first time I’ve sat on the health and social care committee—there were two main areas that really came forward—two big issues. The first issue is that whilst the pressure on the NHS remains constant 365 days of the year, there’s no doubt about it that in the winter it changes shape. We know that it changes shape, and every winter we know that it’s going to change shape because it’s a different type of patient that mainly gets admitted, it’s a different type of patient that needs the ambulance service and a different type of patient that needs the social care services.
Therefore, it should not be beyond the wit of us all here—but particularly the Welsh Government, as it is your responsibility, Cabinet Secretary—to ensure that the health boards really reflect not so much the pressure but that change in pressure, so that we make sure that we do have good collaboration in place and good integration in place, and that we make sure that we have specific types of bed, because we know, for example, that we’re going to have an awful lot more young children and we’re going to have an awful lot more elderly people; that we think about things like co-location and we think about how we can make people’s journey through A&E and through clinical decisions units into hospital and back out of hospital much more quick and efficient.
No-one’s taking away from the fact that that pressure is there all of the time, but we know that as winter turns—and winter turns year after year—that pressure will change shape. We had, as the Chair has already referred to, a committee report in 2013 that raised these very issues, and we’re not learning the lessons. So, my first question to you, Cabinet Secretary, would be to really emphasise to you about the fact that we need to be ahead of the game and understand that pressure is not always the same, no matter how we describe it.
The second area that really came up for me in this committee was the whole story around integration and collaboration. In your Government response to the committee report, you state, Cabinet Secretary, that
‘Health boards are expected to routinely engage with social care and independent sectors as part of the development of their IMTPs’.
I walked away from that committee with a very sure feeling that general practitioners did not feel that they’d been really consulted with and involved in the collaborative delivery of winter pressures and healthcare plans for the winter period, and I also walked away from that committee feeling that the care sector hadn’t been, really, overly involved. And that’s why I was very disappointed to see your comments on recommendation 6 and your refusal to actually accept that recommendation, because I think that market oversight, Cabinet Secretary, is absolutely vital, and I would like clarification of the timings and the depth of the work that’s going to be undertaken by CSSIW and the national commissioning board, because there’s no doubt that the market in social care is extremely fragile at present.
There are a great number of barriers to the further growth of the social care market: there are dwindling care home beds, there is ageing building stock, and regulations and financial constraints are kicking in. If we’re going to accept your response to recommendation 1, which is you believe that we need to go ahead and do more integration, more collaboration, build these IMTPs, which look at the whole sector—all the way from primary care, when somebody might first walk out of their door with an issue, all the way through to going in to hospital and then perhaps back out into a care home—we’ve got to involve all of those elements in those IMTPs. I did not have any sense—no true sense—that any of the health boards that we interviewed or the witnesses that we saw believed that that pan-sector collaboration had really been successfully undertaken. I think that, unless we can ensure we have a robust social care sector ahead of us, then with the best will in the world, with all the planning with GPs, with any planning in hospitals, if we cannot take people who are well out of hospital and put them into a social care setting, then we’re going to end up with this constant jamming of our beds in our hospitals, and that brings all those other problems all the way through to the very front door of the hospital and then the back door of GP surgeries. So, those are my two points, Cabinet Secretary, and I really would urge you to look at a way of getting to grips with the state of the market in social care, ensuring collaboration and integration, and accepting that pressure is always there, but pressure looks different at different times of the year. Thank you very much indeed.
I’d like to thank the clerks, the health committee and the Research Service for their assistance during our inquiry. I would also like to thank all those who gave evidence to us during the course of our inquiry. Over the course of our inquiry, the majority of stakeholders told us that, while things were slightly better this year, they were still unprepared for the winter period and facing year-round pressures. The Royal College of Paediatrics and Child Health told us that services were not quite ready. It is abundantly clear that we need to make substantial changes in order to cope with this additional pressure.
As a committee, we carefully considered the evidence put before us and cross-examined the witnesses before coming up with just nine recommendations. It is therefore disappointing that the Welsh Government were able to fully accept just three of our recommendations. I’m particularly disappointed that the Cabinet Secretary has rejected recommendation 5. Many of the witnesses to our inquiry highlighted the fact that the current service model for unscheduled care is unsustainable. While the Choose Well campaign is a step in the right direction, it is going to take much longer to totally re-educate the Welsh public. It is so ingrained in the public’s mindset that when we get ill we need to see a doctor that convincing people that sometimes a community pharmacy is a much better option is going to take a long time.
When you couple this mindset with the fact that it is getting harder to see a GP because of underfunding and overwork, it is no wonder that people inappropriately turn up at A&E. While this is shouldn’t be the case, we have to face reality. Until we employ more GPs and have better integrated primary care teams, our hospitals are faced with picking up the slack in the system. It was pressures on A&E that led to the creation of minor injury units, and therefore the co-location of primary care services would seem to be a natural progression. Both the BMA and the Royal College of Emergency Medicine suggested that we look at co-location of primary care services and the use of front-door physicians. We should listen to them.
We learnt that up to 30 per cent of those attending A&E would be more appropriately dealt with elsewhere in the health system. We need a better way of dealing with these people. Having a single-point gateway service that can funnel people to the appropriate service is a much better solution than what we currently have and warrants proper investigation.
Cabinet Secretary, I urge you to reconsider. You say that this a matter for health boards, but with the majority of our health boards requiring some form of Government intervention, you need to show leadership. This issue is not going away. We can’t just sit back and hope that we can solve winter pressures with an ad campaign. Our committee carefully considered the evidence put before us and we have suggested solutions based upon that evidence. I would hope that the Welsh Government will heed our report. Diolch yn fawr.
I, too, welcome this report from the Health, Social Care and Sport Committee. When considering the challenges facing our healthcare system, we must do so in a way that fundamentally incorporates health and social care, as a complete circle, as noted in this report. No-one is denying the many pressures facing health and social care, and we are fully aware that, during the colder months, it is obvious there is going to be a seasonal spike. The report highlighted a number of serious causes for concern in terms of the level of preparedness and the ability of both sectors to cope: individuals living longer; respiratory complications over the winter months; hospital infection rates peaking at various times of the year; and, of course, delayed transfers of care and readmissions are all pressures at this time of the year.
Readmission into hospital is costly and often avoidable. Latest figures from Age Cymru show that over 15,000 over-75s in Wales were readmitted to hospital within just 30 days of discharge. Having adopted a care in the community model is applaudable, but, in my view, there has been a tendency to cut down the number of beds in our hospital wards with a natural assumption that these beds will then simply be occupied at home and with a complete package of care available to the patient on arrival home.
Reablement support across Wales, certainly in north Wales, is inconsistent and patchy. Where it works well, we know that 70 per cent of people then go on to no longer require support or need further hospitalisation. That has to be the ambition of this Government and also anyone working in the health and social care sector.
The Royal Voluntary Service highlights the inconsistency and complexity of reablement services delivered by local authorities and health boards. There is no definite standard of reablement across Wales. The spend per head by local authorities on reablement services can be up to 10 times more in some areas than others. Good care in the community for an individual often requires a fully integrated care package tailored to that person’s own particular and complex needs, and can often also require the input of a social worker, care providers, district nurses, occupational therapists, physiotherapists, GP provision and sometimes even a dietician. The latter, of course, to address any nutritional or hydration issues. Again, all agencies working in a consistent and well-communicated manner is vital in order to ward off, for instance, any potential infections, to maintain good skin integrity, and generally to support the overall well-being of those receiving their care out of the hospital setting, but inside their own home.
Further evidence taken at committee stage noted that social care is now at tipping point, and we all know the loss in our constituencies of many of our nursing homes and a shortage of care provider agencies. Indeed, Care Forum Wales state that we are only one significant nursing home failure from complete calamity in any part of Wales. They go on to say that there isn’t anywhere in any health board in Wales where they could sustain 60 individuals quickly, following the closure of a home. Can Wales’s policy adjustments such as the introduction of stay-at-home assessments, called for by Altaf Hussain here as a Welsh Conservative, could provide a key early intervention measure, preventing hospitalisation, avoiding delayed transfers of care upon leaving hospital, and easing the pressures for our hospital wards at peak intervals. The report recommends the co-location of primary care services into A&E departments, and I just ask myself why this isn’t happening and why you reject the recommendation. As they say, it is a no-brainer. The whole purpose of taking evidence in committees I thought was to better inform Welsh Government as to how concerns raised by our professionals—those actually carrying out health and social care—and to educate on what is needed. That is the whole purpose of why we’re here and why it’s called scrutiny. I would urge the Welsh Government to accept the recommendations made, all of them, and to implement them, and I would like to thank Dai Lloyd, Assembly Member, and all the members of this committee for such an excellent report. Thank you.
Thanks to the health committee for bringing today’s debate. Health issues are frequently discussed here in the Chamber, and that merely reflects the fact that they’re one of the major concerns of our electorate. As a newcomer to this place, I’m interested in the process whereby a committee, 50 per cent of whose members belong to the governing party, produce a report with concrete recommendations and the Government then decides which ones, if any, it will choose to implement. Clearly, the Government has to be able to govern, but if it ignores a lot of recommendations after a committee has conducted a rigorous evidence-based inquiry, then that Government does leave itself open to an awful lot of criticism if things do subsequently appear to go wrong.
At the moment, a lot of time is being wasted with patients being stuck in ambulances parked outside A&E departments, sometimes for hours at a time, attended all the while by paramedics. This is a real waste of resources, as well as being an unpleasant experience for patients. I appreciate that the Government is awaiting a report from the Wales Audit Office on out-of-hours services, and that that will affect what it decides to do about co-location of GP services in A&E departments. All I can say is, the sooner the Government gets this report, digests it and then takes some meaningful action, the better. It seems to me that co-location may well be a sensible option to relieve the strain on A&E. Thank you.
Thank you. I call the Cabinet Secretary for Health, Well-being and Sport, Vaughan Gething.
Thank you, Deputy Presiding Officer. I want to start by saying that I do welcome the committee’s report and the range of comments that were made in today’s debate, even though I won’t agree with all of them. But I’m really pleased that the report acknowledges improvements that we have already made in planning for winter, and the continuing challenges that we still face.
The committee make, of course, a number of recommendations right across health and social care that reflect not only the importance of managing winter pressures, but also the year-round challenges that face our services. At the outset, I do want to acknowledge again that our health and care system is under very real and significant pressure. I said before Christmas, when I appeared before the committee, that we are better prepared than before for winter but that there will, of course, be difficult days, and there have been. Our hospitals and social services have seen surges in demand, especially from patients with increasingly complex needs. And I say again: there will be more difficult days to come before winter is over, and each of us should be very grateful that we’re here in this Chamber, not facing those pressures on the front line. Because it is a testament to the commitment and skill of our staff that despite the pressures they face, the vast majority of patients and citizens continue to receive high-quality care in a professional and timely manner.
That does not mean that, as a Government, we’re complacent or ignore the scale of the challenges that our whole system faces. We rely upon our staff, and we’re proud in this Government to see them as partners. That is why I have not and will not pick a fight with junior doctors. That is why I have not and will not blame GPs for winter pressures. And that is why I’m proud to be a member of a Government that is investing in our social care workforce.
We have deliberately taken a whole-system approach to planning, and I don’t accept the criticism of Rhun ap Iorwerth that the social care system is somehow being forgotten or overlooked. We continue to fund social care at a much better level than in England, but that does not mean that social care here in Wales is pressure free; it certainly is not. Social care is very much part of the planning and delivery in winter, and social care is also very much part of the market analysis work that is ongoing. We work, and we’ll continue to work, right across health, local government, in partnership with the third sector and our emergency services. Now, that doesn’t mean to say our system is currently perfect, but progress really is being made and will continue to be further strengthened in an integrated way, working between those services.
Now, I recognise, of course, that designing services that can anticipate and respond to the changing nature of demand can take time to get right. However, we’re determined to drive forward further improvements, and I was pleased to see the committee’s recommendations reflect much of this work. Organisations have been encouraged to build upon their plans and experience of previous years to prepare for this winter and beyond. I’m encouraged that delayed transfers fell again in December—that’s unusual; it’s not the case we see across our border—ambulance response times are better than last winter and holding up; and 111 has been a success to date in its pilot area of Abertawe Bro Morgannwg, and that was not the case when it was rolled out right across England. So, we are getting a range of things right, and we’re getting a range of things that are improving year on year. The challenge is: do they improve at a fast enough rate to keep up with the ever-changing and ever-increasing nature of demand? And actually, we are seeing more people at home this winter; that’s part of the reason we are continuing to cope. There’s lots of evidence about the approach that we are taking being in the right direction, but there’s always the question: is it enough and can we do more?
There has been a great deal of focus, of course, on hospitals, but I’m pleased that the committee recognises the critical role of GPs, social care, the intermediate care fund, out-of-hours and ambulance staff in treating and caring for people. Recommendations 1 to 5, 8 and 9 in particular focus on the planning, delivery and learning across our whole system, and I should say, as comment has been made on it, that recommendation 5 was rejected because we’re essentially doing what is being asked of us, and I’m keen not to duplicate our efforts or to restart. But I think there’s much learning to take place about how we design, deliver and co-locate our various services, and there will be those in favour of co-locating in an A&E and those who say, ‘Actually, you shouldn’t co-locate everything within a hospital setting.’ We’ve got to think about how we deliver that care in different settings around our whole community.
We recognise, of course, that the report makes mention of this as well: that health boards have to manage both scheduled and unscheduled care over the winter. This winter, health boards have changed their focus of their activity, with more out-patient and day-case activity, which is not reliant on in-patient beds. And we have provided that additional £50 million to the NHS this winter to help manage demand, and I expect that at the end of this year we’ll see further improvements made in both RTT and diagnostics, and we’ll see further increase in elective activity through winter. And I expect the end of March position for this year to improve again upon last year.
We will, of course, evaluate how our whole system has managed through winter. I’ve made it very clear that we can expect to have lessons to learn and to improve. That includes, though, the success, or otherwise, of Choose Well, and the impact of the public and their use of the whole system. We ought to educate and inform our public, not blame them. But, actually, the public are part of helping us to make the very best use of the whole system. I’m pleased to say that the views of both clinicians and the public will be sought as part of the evaluation of our response to and delivery within winter.
I recognise what Angela Burns has said because it’s a point that I’ve made on many occasions in the past. We regularly get told throughout the year in health that, actually, there’s no such thing as winter pressure because there’s pressure year-round across our system, and it’s true, there is pressure year-round across our system, in both elective care and in emergency care as well. But then every single winter, we talk about the particular and heightened challenges of winter, and it is because we have a different sort of patient and a different need coming through our doors in different numbers in winter. The overall numbers actually go down, but the nature of the demand changes significantly. That’s why we plan to deliver, and we are delivering, extra bed capacity in winter. That’s why I listen to GPs, as Dai Lloyd acknowledged, and I relax quality and outcomes frameworks through the rest of this winter to give more time for GPs to actually take care of their patients.
We should, though, acknowledge the year-round context of our health and care system, and the choice that we have to make—not just in the winter, but in planning and delivering our system throughout the year. We all know the well-rehearsed pressures of public expectation and ageing population, the impact of poverty, our long-standing public health challenges, and, of course, the unavoidable impact of UK Government austerity. It’s a regular and understandable feature of politics that people call for more money, and resources where there are challenges, and that is every bit as much the case in health and social care as in any other activity. But calling for increases in health, local government and third sector spending is a demand for the impossible, whilst we face the reality of austerity.
Angela Burns rose—
We can’t fund all of those areas to an increased level when we all know that our overall budget is reduced. And I’ll take the intervention.
Thank you. I think this report was quite clear, though. We understand the financial constraints that we live within, but if I could just bring us back to recommendation 6, one of our real concerns is that those financial constraints are having an adverse effect on the care home sector, which is why we believe it is so important for the Welsh Government to have a really good, clear understanding of where the care home sector is now and where it is likely to be in the next five, 10 or 15 years, because without that sector, we are completely lost in the NHS, because we need to be able to bounce people into the care sector.
Well, that work is ongoing with the care sector. They are partners that come around the table, and I have heard the comments by Care Forum Wales, for example, but, actually, whenever there have been home closures, and there have been, each time, health and social care have managed to actually help people to move into different accommodation. We want more stability in the care sector, particularly that part that we pay lots of money for, to commission, with public funds, and that’s work that the Minister is leading with officials. So, this is not an area that is being ignored.
But, whilst we face the reality of austerity, and it’s part of the context—these are comments made in today’s debate around this area—I can’t and I won’t pretend to take seriously the voice of those who demand what they know to be impossible when it comes to funding, and funding every single part of our system to an increased level. It isn’t possible. I will, though, take seriously every voice in this debate and those to come that follow the serious, honest and mature approach of the committee in this report. We’re privileged to be served by staff who work under tremendous pressure in our health and care system. They deserve our support, but, more than that, they deserve honesty from us about the challenges we face, what we are doing to meet those challenges and what we can and will do within our financial resources.
I’ll finish here, Deputy Presiding Officer, but I know that much of what we can do is not about money, but how we use the advantages of our whole-system approach as we continue to integrate services around the needs of the citizen, and I look forward to working with the committee as we continue to learn and to improve right across the health and care system.
Thank you. I call the Chair of the Health, Social Care and Sport Committee to reply to the debate.
Thank you, Deputy Presiding Officer. I’d like to thank the Cabinet Secretary for his contribution, and also other members of the committee, and Members who are not members of the committee as well, for their contributions this afternoon.Rhun ap Iorwerth started by referring to the importance of acknowledging that we have to do something about flu and the pressure on social care, the pressure on our beds, and the need to tackle that situation.
Angela Burns, then, also discussing in her own mature, inimitable way, and making very valuable points in terms of the fact that’s recognised by everyone: that different patients appear in the winter and that we should be able to plan for that because the same kind of thing happens winter after winter. We are expecting another winter at the end of this year as well. She also made the point about integrated care.
I’m very grateful for the contributions of Caroline Jones, Janet Finch-Saunders and Gareth Bennett to this debate, because this was a very important report on the NHS’s preparedness for winter pressure. It was a result, of course—a report had been issued previously in 2013-14, and therefore building on those recommendations was the intention, and seeing what kind of improvement there had been in terms of the work that’s being done in this area.
Of course, the overriding conclusion of the committee is that the entire system that we’ve been mentioning—not just the health service, but also the social care system—should be more resilient throughout the year, and therefore in a much better position when additional pressures are applied at those very busy times in the middle of winter, so that the system in its entirety can deal with that in terms of capacity when a great number of patients appear on certain days, as we’ve heard about recently. Of course, we know that the arrangements in place for this winter will be evaluated soon and we look forward eagerly to the findings of that evaluation.
And just to close, and just to echo the thanks of those who have contributed this afternoon in terms of recognising the heroic contribution of the staff in the health service. Naturally, I meet them very often in the workplace, and I felt the emotion and that passion in the different contributions made to the committee inquiry. There is a passionate love towards our health service—yes, from the patients’ side, but also particularly from the staff as well. You can’t put a price on that passion and that commitment to a system that is vital so that we can keep it and develop it to be even more innovative than it is at present.
We’ve been looking at new ways of working, but to do that we have to get over the difference between primary care out there, compared with hospital care. We have to bring those sectors together. We like to see that aspiration that doctors and nurses can work in those hospitals, but also in our communities—a dual approach for the way ahead. We expect to see exciting developments of that nature in the future, not just GPs working in the hospitals, but also hospital specialists increasingly working in our communities. We have to tackle ensuring that every specialist can look at the patient in more general terms—not just at one system that is struggling. We have enough specialists now that just look at the thyroid, diabetes, or the heart, but increasingly we need specialists who can look after the patient as a whole, because we have a growth in the number of older people. The way to cope with that is to have specialists who can look at the patient as a whole, as we used to have. Now, it is only GPs, basically, aside from certain specialists who look after older people, who have the necessary skills to do that. So, we need to look again at that system as well.
So, can I thank from the bottom of my heart the staff in the health service for their contributions—our doctors and nurses, physiotherapists, OTs and so forth? And also, in closing, could I thank the clerks and all the officials who support my work as Chair of the Health, Social Care and Sport Committee for all the support, and for their hard work in ensuring that this inquiry and this significant contribution that you see before you in this report could see the light of day? It means a lot of work behind the scenes to bring this to life in the first place, but I thank everyone for their contributions this afternoon and for their attention. Thank you very much.
Thank you. The proposal is to note the committee’s report. Does any Member object? No. Therefore, that motion is therefore agreed in accordance with Standing Order 12.36.
Motion agreed in accordance with Standing Order 12.36.
The following amendments have been selected: amendment 1 in the name of Jane Hutt, and amendments 2 and 3 in the name of Paul Davies.
We now move on to the Plaid Cymru debate on social care. I call on Rhun ap Iorwerth to move the motion.
Motion NDM6223 Rhun ap Iorwerth
To propose that the National Assembly for Wales:
1. Believes that good social care services play an essential role in keeping the NHS sustainable.
2. Notes that unpaid carers make a critical and unappreciated contribution towards ensuring the sustainability of health and social care and regrets the fall in the number of nights of respite care provided since 2011.
3. Believes that community hospitals could play a vital role in providing respite care, and in easing the transition back to community health settings for those who have required hospital settings.
4. Calls on the Welsh Government to reverse the practice of closing community hospitals and explore ways of restoring the availability of beds for use by both health and social care services.
Motion moved.
Thank you very much, Deputy Presiding Officer. I am pleased to open this debate on social care, carers and community hospitals. We often discuss, as we should do in this Chamber, the health service—the NHS—but it is extremely important that we always bear in mind that, behind the NHS, there is an ecosystem of support of social care, third sector groups and unpaid carers—all of them contributing to what is needed by people the length and breadth of Wales. We’ve often referred to the mistaken policy of the Conservative Government in London of safeguarding the NHS budget at the expense of local authority budgets, including social care. I’m not going to spend too much time on that issue. I do think, however, that it is fair to say that the Welsh Conservatives have a different view to their fellow Conservatives in Westminster. I think that the Member for Carmarthen west deserves praise for that. I don’t think that we could have said the same a year ago.
The Welsh Government often reminds us about the fact—and it is a fact—that expenditure on social care here hasn’t been cut to the same extent here as it has in England. It is true: if you compare with the financial year 2011-12, expenditure on social services for adults is around £100 million more in cash terms in the most recent year, and this also translates into a real terms increase, too. So, we should be seeing improvements, and I want you to bear that in mind during this debate. But I am more interested, as I hope others are, in outputs rather than budgets. So, I have been looking at the trends over this period of time in order to have an overview of how social care is performing, whilst acknowledging that the pressures are increasing because of an ageing population.
There was an increase in the number of hours of homecare provided until 2014-15, but there has been a reduction in the past year. That is something that we should be concerned about, and we should certainly be keeping an eye on in terms of the trend. It’s also worth noting that the hours of care provided directly by local authorities have decreased, whilst the hours of care provided by independent contractors on behalf of local authorities have increased. There are excellent companies providing care, of course, but we do need to be guarded in safeguarding staff and service users in a climate where zero-hours contracts and low wages are commonplace.
I will move to adaptation and personal equipment. Here, we see a reduction of 21 per cent in home adaptations, and a reduction of 15 per cent in equipment. What the Minister said in response to a question from me last week was that we need to bear in mind that everyone’s needs are different, and that we shouldn’t be jumping to conclusions, but seeing a reduction of 21 per cent at a time when the population is ageing and demands on the service are increasing is quite surprising to me, certainly.
I will now turn to delayed transfers of care, which is a very important measure of the way in which the NHS and social care interact and collaborate. The Government has highlighted this performance as an example of success, and if we look at the annual numbers of cases of delayed transfers of care for reasons of social care, then there has been excellent attainment. One has to say that in that period between 2000 and 2013, when we saw a reduction from some 5,000 cases a year down to 1,200 a year, there’s no question that that was a significant improvement, but since 2013, the figures have been creeping up slowly. Last year, there were 1,343 cases of delayed transfers of care for social care reasons, and therefore, I would warn Government—and I hope that they don’t do this—that they shouldn’t become complacent. Things at present are moving in the wrong direction, with more than 100 cases of delayed transfers of care every month, because of issues related to social care. This is a problem for the NHS, of course, but it is also something that causes anguish to patients who find themselves caught in these kinds of situations.
Thank you, Rhun. The Health Foundation report recently stated that the need for social care funding was going to double in the next 13 years. Don’t you think we should be planning now, not waiting for the next few years and then suddenly having to find all this funding? I do appreciate that £50 million has been put in to help us with winter preparedness, but the fundamental basis is, if this was a business, you wouldn’t allow it to go that length of time—you would start to plan, and you would start to fund it now. Would you agree?
I will point out, and I’m sure you’ll forgive me, the irony of a Conservative Member talking about the need to invest in social care at a time when we have seen so many cuts. Although, of course, I have noted that the party here in the Assembly perhaps takes a different approach. There are finite budgets, of course, and I’ll help the Government out in those terms, but one of the things that, hopefully, we’ll be able to do in this debate today is say that it’s not just about how much money that goes in, it’s what we do with that money in order to achieve better outcomes. But, of course, I agree, the more money that can be found to deal with increasing demand is something that is going to have to be addressed as we move forward.
Rwy’n mynd i ganolbwyntio rŵan ar ofalwyr. Mae gofalwyr, rydw i’n meddwl, wedi dioddef mewn dwy ffordd yn y blynyddoedd diwethaf. Maen nhw wedi dioddef oherwydd y newidiadau lles ar lefel y Deyrnas Unedig—ac mae’n ddrwg iawn gen i, Janet Finch-Saunders, am dynnu sylw unwaith eto at ffaeleddau’r Llywodraeth Geidwadol yn San Steffan. Mae’r effaith y mae’r cwtogiadau wedi’u cael, rydym ni’n gwybod, yn rhywbeth y mae’r Aelodau yn fan hyn yn ymwybodol iawn ohonyn nhw. Ond maen nhw hefyd wedi dioddef oherwydd perfformiad gwael mewn nifer o feysydd yma. Mae gofal ysbaid yn un penodol. Mae yna ostyngiad wedi bod o 24 y cant yn nifer y nosweithiau o ofal ysbaid sydd ar gael, ac mae’r gofal ysbaid yma yn bwysig iawn. Yn aml iawn, dyna ydy’r gwahaniaeth rhwng rhywun yn gallu cynnal cyfrifoldebau gofalu neu beidio.
Rydym ni’n gwybod o arolwg diweddar fod dwy ran o dair o ofalwyr wedi rhoi’r gorau i weithio neu wedi lleihau eu horiau er mwyn gofalu, a bod hanner y gofalwyr wedi cael trafferthion ariannol o ganlyniad i hynny. Mae 55 y cant yn dweud bod eu hiechyd corfforol nhw wedi gwaethygu a bron i hanner y gofalwyr yn dweud bod eu hiechyd meddwl nhw wedi gwaethygu—y ganran uchaf yn unrhyw le yn y Deyrnas Unedig, ac rydw i’n gobeithio y byddwn ni i gyd yn bryderus ynglŷn â hynny. Mae hanner y gofalwyr hefyd—mae hwn yn ystadegyn—wedi gadael i’w problemau iechyd eu hunain fynd heb gael eu trin oherwydd y pwysau sydd arnyn nhw fel darparwyr gofal eu hunain. Felly, mae’r ysbaid yma’n hanfodol. Nid yw, yn sicr, ddim yn help bod llai o welyau mewn ysbytai cymunedol ar gael rŵan, fel un opsiwn ar gyfer cynnig y math yna o ysbaid. Fe rown ni ragor o sylw i hynny yn nes ymlaen.
Mae’n mynd yn waeth. Mae Gofalwyr Cymru wedi cyhoeddi eu monitor nhw o berfformiad ers y Bil gwasanaethau cymdeithasol. Dyma maen nhw wedi’i ganfod: nid yw 17 o’r 22 awdurdod lleol yng Nghymru yn gallu rhoi unrhyw ddata ar faint o ofalwyr sy’n cysylltu efo nhw dros y ffôn, y rhyngrwyd, neu yn bersonol, am wybodaeth, cyngor neu gymorth. Nid yw’r rhan fwyaf o awdurdodau lleol yng Nghymru yn gwybod faint o ofalwyr maen nhw wedi’u cyfeirio at sefydliadau eraill. Fe wnaeth Gofalwyr Cymru, Carers Wales, ddarganfod nad yw 16 allan o’r 22 awdurdod yn gallu dweud faint o bobl roedden nhw wedi’u cyfeirio ymlaen at sefydliadau eraill. Mae angen i ni gael y math yma o ddata. Nid yw anghenion gofalwyr o leiafrifoedd ethnig yn cael eu hystyried o hyd ac nid oes ganddyn nhw gynrychiolaeth ar fyrddau lleol, grwpiau llywio, pwyllgorau na fforymau. Mi oedd yna amrywiaeth sylweddol yn faint o asesiadau gofalwyr yr oedd pob awdurdod lleol wedi’u cynnal, rhywbeth a oedd yn bwysig iawn fel rhan o’r Bil. Ac, o’r bobl a wnaeth gwblhau’r arolwg, nid oedd 80 y cant wedi cael cynnig asesiad anghenion gofalwyr—tipyn o syndod o ystyried y ffaith fod y bobl hynny a wnaeth gwblhau’r arolwg eisoes wedi nodi eu bod nhw yn ofalwyr, ac rydym ni’n gwybod beth mae’r Ddeddf yna yn ei ddweud.
Felly, mae’n rhaid i ni gryfhau gofal cymdeithasol yng Nghymru. Mi fydd fy nghyd-Aelodau fi yn siarad y prynhawn yma am rai o’r camau rydym ni’n credu y dylai gael eu cymryd, gan gynnwys, fel y dywedais i yn gynharach, yr angen i ddadwneud y broses yma o golli gwelyau mewn ysbytai cymunedol. Ond mae cymaint o wahanol elfennau i’r darlun cyflawn o ofal cymdeithasol mae’n rhaid sicrhau nad oes yr un ohonyn nhw’n cael eu gadael ar ôl. Rydw i’n edrych ymlaen at y ddadl ac ymateb y Gweinidog. Rywsut, mae angen cyfundrefn gofal cymdeithasol arnom ni sy’n fwy gwydn ac yn fwy cynaliadwy at y dyfodol, lle bydd yna fwy o bwysau a mwy o alw amdano fo.
Thank you. I have selected the three amendments to the motion and I call on the Minister for Social Services and Public Health to move amendment 1 formally, in the name of Jane Hutt.
Amendment 1—Jane Hutt
Delete all after point 1 and replace with:
Recognises and appreciates the contribution unpaid carers make to the health and social care system.
Believes respite care should be flexible and can take place in a wide variety of settings, including at home and in the wider community.
Notes that community hospitals are one of several settings which can play a role in providing both respite care and step up/step down care.
Welcomes:
a) the Welsh Government’s commitment to develop a national approach to respite to ensure that respite is responsive to individuals’ needs in a consistent manner across Wales;
b) the investment in extra care services made possible through the £60m Intermediate Care Fund in 2017-18; and
c) the new £40m fund announced in the 2017-18 Budget to develop new integrated health and social care centres across Wales.
Amendment 1 moved.
Formally.
Thank you. I call on Suzy Davies to move amendments 2 and 3, tabled in the name of Paul Davies.
Amendment 2—Paul Davies
Add at end of point 1:
and recognises the role of allied healthcare professionals in reducing avoidable demand for social care.’
Amendment 3—Paul Davies
Add as new point at end of the motion:
Calls on the Welsh Government to update the Assembly on the operation of S35 of the Social Services and Well-being (Wales) Act 2014, with regard to meeting carers’ respite needs.
Amendments 2 and 3 moved.
Diolch, Ddirprwy Lywydd. I welcome this debate and move our amendments. Perhaps I might also mention that Members will have the opportunity to develop the positions put forward today in a debate that the Welsh Conservatives will be tabling in the next few weeks. I think we should really keep this in our line of sight. It is something we should be discussing often, particularly with the Cabinet Secretary’s parliamentary review ongoing.
Good social care is affected by a number of complex concerns because our constituents have complex needs. It isn’t open to a homogenous solution because we’re not a homogenous Wales. Labels like ‘integration’ can’t be seen as a silver bullet any more than Welsh Government can be seen as a golden goose. Integrating systems that are themselves imperfect and unequal in status presents its own dangers as well as some really, really exciting and good examples. But, why so narrow a path to a fundamental systemic change, which is what we may actually need?
I certainly don’t want you to think that I don’t believe that integration is the wrong way to go—isn’t the wrong way to go—but how far and how broad? Do we really want everything co-located in hospitals? Are we talking about a national care service that effectively disconnects the district general hospital space from a new leviathan responsible for primary, secondary and social care, maybe even removing strategic responsibility from local authorities altogether? Do we want a network of Builth models or Prestatyn models? Do we transfer all social workers into the NHS or all occupational therapists out into local authorities? How much responsibility do we place on the individual or their family or their bank account or the public purse?
I don’t think that the Government’s parliamentary review can blink when faced with transformational visionary change, and I hope that it really uses this period of experimentation, if you like, with the intermediate care fund as evidential but not the final answer. Revolution or evolution—I’m actually quite open-minded to either course there, as long as there is resolution in both senses of the word, but we won’t get that unless we look beyond the NHS and social services.
To the motion—points 3 and 4 first. Opposition of all colours, or parties of all colours, made the case in the last Assembly, as they already have in this Assembly, that the closure of community hospitals has gone too far—manifesto commitments all round. Yes, some buildings needed modernising or replacing, but what we really mourn is not the buildings but the beds. It is the closure of community hospitals and the loss of their beds that the Welsh NHS Confederation, in their meeting with me last week, called the ‘turning point’.
Every one of us will say that an individual’s better off at home with an appropriate enabling or reabling care package, but there’s no plan B, is there? Keeping people in acute beds or commissioning step-down places in residential homes is not the flexible or wide range of settings referred to in the Government amendment. We now need the community beds to protect people from a new institutionalisation in acute beds created by delayed transfers of care. These community beds are no longer the cause of institutionalisation.
Allied healthcare professionals are likely to get a more accurate assessment of someone’s ongoing support needs from a community bed—obviously, maybe not as accurate as in an individual’s home, but that still has its risks where assessment is not met by immediate provision. Until we can fully satisfy patient need by opening new community beds as part of their respite and reablement, perhaps in new settings, then Government should listen. In this and the last Assembly, which was also in balance, let me say, all opposition parties representing their constituents have been telling you to stop closing community hospitals.
We’ll be supporting point 1 of the motion, and our amendment to that just emphasises what’s now axiomatic: reabling care or delaying the need for hospital admission in the first place—that’s what we want for our constituents and that’s what we want for the NHS. You can’t get that contribution to sustainability without these guys, not just with physical care but psychologically too, because if you feel in control of your medical and personal needs—feel that they’re being met—you may also feel confident enough to ask for help with your social needs, and loneliness is the example that we’ve all been talking about recently.
Finally, point 2 of the motion and our second amendment—well, yes, of course, unpaid carers make this contribution to sustainability, and meeting their needs is part of meeting the needs of the cared-for, which is why I’ve used section 35 of the Social Services and Well-being (Wales) Act 2014, rather than section 40, in the amendment. I hope it won’t be rejected simply because I didn’t list nine separate sections from that Act. This is my clumsy attempt to say that social care is about a group of people of all ages, however it’s chopped up in legislation—the cared-for, first and foremost, but also carers, care workers, health workers, housing providers, house builders, families, charities, neighbourhoods, energy companies and, yes, even managers and politicians. We need to lift our heads a little on this, and looking at the NHS integration agenda means that we’re just looking for half a solution. Thank you.
I welcome the fact that Janet Finch-Saunders says we need to double the amount of investment in social care, and I wish her well in her attempt to get that sort of money out of the UK Government—not likely with the current Government. But I also welcome the slightly more grounded position of Suzy Davies, that neither the Welsh Government nor the UK Government is a golden goose, and I think we have to look at this quite differently, really, particularly as there’s unlikely to be any change in the levels of funding between now and 2020.
I’m not sure that community hospitals are the answer as such, because, certainly based on my personal experience, older people nearing the end of their life want to be at home, most definitely. There is, of course, a role for respite hospices so that carers don’t collapse under the strain of looking after their loved ones, but I think that—. So, there need to be various models of support given, and it’s very important that, in line with the health and social care Act, we’re looking holistically at people’s needs and listening to what they want, and also understanding what level of support can come from their relatives, because, at the end of the day, they most want to be with their relatives or friends, where possible.
But we cannot underestimate the strain that these cause to people who provide unpaid care, which particularly falls on women aged 50 to 64, but the gender inequality diminishes once people retire and, in fact, men are slightly more likely to be providing care than women after retirement age. The health of unpaid carers deteriorates incrementally with increasing levels of unpaid care. The burden of providing 50 hours or more unpaid care a week nevertheless, in terms of impact on their general health, is greatest amongst young carers under the age of 24. But we have to applaud the over 9,000 men and over 5,000 women who are in full-time employment and providing 50 hours or more of unpaid care. It seems to me that, in those circumstances, it’s extremely important that we know who the unpaid carers are and that we’re able to give them the support to make them not also become in need of care themselves.
I think, if we look at what we are going to be able to do, the current situation, for example, in Cardiff—in Cardiff, in 2014, the last year that figures were available to me, they had 11 framework providers, plus spot contracts from another nearly 80 provider organisations. And the impact of competitive tendering drives down prices, depresses pay and conditions, and the race to the bottom, because of the return to the shareholders, is the key driver for private firms. And the continuity of care required is simply not there. If you think about the intimate care services that carers are having to provide, to not know the person who’s changing your bed linen or helping you with toileting really is devastating, and we really do need to think of—
Will you take an intervention?
[Continues.]—other ways of doing things.
Thank you very much for taking the intervention. I was just listening to your point about driving down the costs within the private sector; would you accept as well that there’s a difficulty with local authorities being able to pay more to those private contractors as well?
I wouldn’t disagree with that, but I think we need to look elsewhere for some of the solutions. I’m particularly interested in the model that’s been developed in Holland, the Buurtzorg model, because that has both massively increased the approval rate and also the job satisfaction of the nurses. In 2006, four nurses in the small town of Almelo in Holland realised that the relationship with patients had been undermined by the system they were operating under the Government-funded insurance scheme. So, Jos de Blok and three other colleagues set up their own social enterprise called Buurtzorg to look after older people in their own homes, through co-ordinated compassionate care. And, 10 years later, they have more than 9,000 colleagues who have joined them, and they look after more than half of the Dutch people who need care at home. It’s been regularly named the country’s best employer, year on year, and is a role model for the rest of the sector.
Interestingly, it has also cut costs, because nurses manage themselves in 800 different neighbourhood teams. They are engaged more effectively with other local services, voluntary carers and patients themselves, and their self-organised teams are supported not by managers, but by peripatetic coaches and an IT system designed around care-giving and collaboration. The whole national operation is run from a small back office that looks after billing and co-ordinates information and learning across the teams. Forty admin staff for 9,000 people in the field; that is something we should be aspiring to.
So, I think that this is an ongoing debate, but I welcome the fact that there is going to be a seminar on Buurtzorg at the end of March in the Celtic Manor, and I hope that many of our local authorities will be sending delegates to find out how it operates.
I’d like to begin my contribution to today’s debate by emphasising the importance of supporting people in their homes, concentrating on one aspect specifically. One specific area that can have a practical impact on improving the lives of many people is making adaptations to their homes: making it easier for people to use wheelchairs; a purpose-built shower; a stairlift; or railings to help people move round the house more easily. As my fellow Member Rhun ap Iorwerth mentioned, since 2011 we have seen a reduction of 21 per cent in the number of home adaptations in Wales and a 15 per cent reduction in cases where equipment is provided to people who need it.
All of the problems and difficulties caused by bureaucracy in terms of accessing grants in order to make home adaptations continues to be a problem, and this was highlighted by the report by the Communities, Equality and Local Government Committee back in 2013. But to date, it doesn’t appear that there’s been much effort to take action on some of the issues raised in that report and the reduction in provision does suggest that the issue hasn’t been given due attention.
Now, behind every statistic there is an individual. I met a constituent recently who was concerned about a child in the family who needs surgery. In order to care for the child after discharge from hospital, the home needs a series of adaptations. The delays in making arrangements for these adaptations means that the surgery itself is likely to be delayed too. This adds to the stress faced by the family and the child and is unacceptable. It impacts the quality of life of the child and its family and the delays can lead to further problems down the line as the child’s medical condition deteriorates, leading to the need for further adaptation, which would be more expensive, ultimately.
It’s stories such as these that lie behind the statistics. I am looking into this case at the moment, but I suspect that it’s a shortage of funding that’s the heart of the problem—that is, that there isn’t enough money available to assist everyone who needs adaptations in this current financial year and that social workers have to make decisions that are extremely difficult in prioritising who is to receive adaptations and when. But, if the Welsh Government’s agenda is moving more and more towards preventative work, then there’s room to argue that adaptations should be fairly funded, if the Government wants to pursue priorities it has set for itself in the preventative sphere.
In turning to another aspect, it’s true that the care profession isn’t given the status and recognition it deserves. The working conditions are often very poor, and there isn’t much opportunity for career development within this sector. Zero-hours contracts remain a feature within the sector, despite the efforts of Plaid Cymru to ban them—efforts that, unfortunately, were frustrated by Labour and the Conservatives on a number of occasions. These factors do combine to make recruitment in the sector very difficult, which therefore has an impact on the services provided. The failure to pay staff for travel time has a disproportionate impact in rural areas, and the shortage of Welsh speakers within the sector is a cause for concern, particularly when they deal with people who have lost the ability to understand and speak English.
So, what can we do? Well, first of all, in terms of adaptations, certainly the Government needs to accept the recommendations of committee reports and to take action on them. Unfortunately, there isn’t much evidence of this happening, looking at the most recent reports and the statistics in terms of adaptations. Without doubt, we need to give more recognition to the social care profession and give it due respect, with people encouraged to see the profession as a lifelong career, and that must include a pledge by Government to ban zero-hours contracts.
Although it’s true that expenditure has increased in real terms historically, the problem of underfunding social care persists. It’s become like a stuck record to say this, but I will say it again and again, I’m sure, in this Chamber: we need to see far more collaboration between the health boards and the local authorities. The intermediate care fund must be a starting point and not the end of joint funding between the various institutions. We must have further integration between primary care, community care and social care for adults so that we can plan and provide care in a co-ordinated and person-centred way that’s provided locally.
Suzy Davies has raised some interesting points for debate this afternoon. It would be good to have more time to air those at some point in future. May I add the Alltwen Hospital in Tremadog as an example of good practice? These examples of good practice now need to be rolled out.
We need to move to remove the artificial boundaries between health and social services, and community hospitals need to be a key part in this—
Are you winding up, please? You’re well over time.
We are calling on the Government to cease closing the patchwork of community hospitals and to move towards creating health and care hubs in our communities anew, such as the one that I hope to see in Waunfawr in my own constituency before too long. These are an important part of the care chain that we want to see in Wales for the future.
I’m pleased to take part in this debate today. With the number of people aged 65 and over set to increase by about a third over the next 15 to 20 years, and a third of the adult population of Wales having at least one chronic illness, we are becoming more and more dependent on our social care sector.Unfortunately, cuts to local authority budgets have placed additional strain on social care, and have had a knock-on effect on our NHS. Delayed transfers of care remain unacceptably high. For the latest quarter for which figures are available, we saw a 2 per cent increase in delayed transfers and there are now over 500 patients spending longer in hospital than is necessary. In fact, around 30 patients faced a delay of more than 26 weeks, and that’s half a year spent in hospital unnecessarily.
These unnecessary delays cost our NHS millions of pounds a year, but the cost to the individual is immeasurable. According to Age Cymru, the main factors responsible for delayed transfers of care include a lack of appropriate facilities for reablement and recuperation, long delays in arranging services to support people in their own homes, and the barriers that exist between health and social services. A recent survey of NHS managers by the NHS Confederation found that many felt that shortfalls in local authority spending had impacted upon their services. Therefore, it is of paramount importance that we have effective and well-funded social care services that will keep the NHS sustainable.
UKIP’s policy and, indeed, one of our earlier debates was the reintroduction of community cottage hospitals, albeit a reformed version of them. Community hospitals, or cottage hospitals, have a vital role in providing respite care and in easing the transition back to community health settings for those who have required hospital settings. Some people aren’t required to stay in hospital, but they can’t go home to be on their own, or for other reasons that they’re maybe not well enough, so cottage hospitals are vital.
We now have just under 11,000 hospital beds and occupancy rates of nearly 87 per cent. When the Labour Government took over the running of the health service in Wales, we had nearly 15,000 hospital beds and occupancy rates of 79 per cent. I do realise that things have changed and that there are more services available, but if people are released too early—and we must bear this in mind—from hospital because of these shortages of beds, there is a high chance of a relapse, which will, again, impact on the financial services of the NHS. Where there are shortages of beds, the result is longer waiting lists, winter pressures lasting most of the year and our NHS stretched to breaking point. We recognise wholeheartedly the debt owed to unpaid carers and volunteers, which we can never really repay.
So, whilst being mindful of the available moneys, and a pot that can only stretch so far, I would like to see the closure of community cottage hospitals reversed and funding for the social care sector to be increased. Diolch yn fawr.
I’m pleased to have an opportunity to take part in this important debate. Of course, the fact that we’re all living longer is a cause for celebration, as I’ve said before. The success of the NHS is cause for celebration. Back in 1950, the king at the time signed 250 birthday cards for those who were 100 that year—250 of them throughout the UK. By 1990, 40 years later, Queen Elizabeth had to sign 2,500 birthday cards for those who were 100 years old. Two years ago, Queen Elizabeth had to sign 13,000 birthday cards for those in the UK who were 100 years old, and, on top of that, 14,000 last year for those who had reached their hundredth birthday. So, it is a cause for celebration that we are in the position we’re in, although it’s a cause for concern for the Queen’s work-life balance.
But at the end of the day, this is a cause for celebration, and the question is: how are we going to deal with this explosion in the older-age population, which is to be welcomed? Yes, we’ve lost too many beds. Increasingly, now, as GPs, we keep people in their homes who are in their 80s and 90s and who are very frail and are very ill. In previous years, we would have sent them to hospital, but now we wouldn’t be able to justify that because there are no beds available, so we have to keep these people, who are old and frail, in their homes. We are very reliant on the social care that’s provided in the home, and that care is exceptional most of the time, I have to say. I’m totally reliant on it as a GP, or the system would fall apart. We have to recognise—we’re always talking about the health service here, but if the social care system disappears, it does undermine the existence of the NHS and we shouldn’t forget that.
To talk in more philosophical terms, in terms of the best way ahead, I was listening to Eluned Morgan in a short debate recently about the need to recreate our social care system. I agree with that, because we do need a revolution, as Suzy said, because we’ve gone to disregard the importance of care as a dimension. Everyone says how fantastic doctors and nurses are, and there’s this great respect—but amid all this technology and this ability and the X-rays and all the technological expertise, we’ve gone to downgrade providing care for the people. We’ve downgraded that and we’ve lost that—we can’t do it—and we don’t give the respect that those who care should have. As Sian Gwenllian said, we’ve seen that with zero-hours contracts and so forth. You don’t get that with doctors and nurses, but carers have to accept those contracts, because, as a society, we don’t show enough respect to this idea of caring for our fellow person, and we’ve lost that. In our hospitals, when we couldn’t do this amazing surgery and so forth, we used to care tenderly for our patients because there wasn’t much else we could do. But now, we’ve forgotten about the importance of caring and looking after another person and we’ve downgraded it completely and we’ve devolved that to people who, perhaps, don’t have any qualifications. Only recently, we’ve had legislation that means that care support workers are going to be registered. Well, you wouldn’t imagine a situation where a nurse who was unregistered was looking after you, or a doctor, but we allow carers who are unregistered to look after you. We need to tackle this entire system and redesign it.
Also, the sheltered accommodation aspect is vital as well. We need to change the system—yes, to be revolutionary, as Suzy said. And as Eluned Morgan has also said, we need to create a new system of social care that tackles the housing issue, and sheltered accommodation—we need a network of those—so that we can care for our older people properly in the community. Thank you very much.
I was hoping to make a more comprehensive contribution to this debate today, but the advent of an awful cough means I’m going to have to curtail it, so I don’t treat the Chamber to my epic, hacking cough.
I want to start by welcoming the additional £10 million investment into social care, recognising the additional demands on social care, but we all know how we need to address how we build on this, going forward. As my colleague Dai said, people are living longer. We should, rightly, be pleased about that and celebrate that, but we can’t ignore the consequence—the growing pressure on our services—and we’ll need to do more to work together to deliver innovative services and support against a tight financial backdrop.
I’m proud that my own council of Flintshire retains three in-house care homes, and I had the pleasure of visiting Croes Atti Care Home in my constituency just a few weeks ago and had an opportunity to chat to the lovely residents and day users, as well as the fabulous, hard-working staff. One of the residents I met there was Jessie Joy, who was 100 years young, and when I asked her about the secret of a long life and if there was any knowledge she could impart to me, the advice she gave me was, ‘Don’t show in the window everything you have in the shop.’ [Laughter.]
In all seriousness, though, we are all too aware the cost pressures for care homes and domiciliary care providers are accelerating. I think, going forward, all partners: local authorities, Welsh Government and health boards need to develop new models of public sector-led provision, but we also need to use business support, capital availability and workforce planning to work with the small and medium-sized businesses that provide care. My own authority of Flintshire has led the way on this by funding a project manager to work with homecare and care home providers to make their businesses more sustainable in the medium term, but this also should be a key issue for health boards to address the manner in which they can support care providers.
Whilst in my own experience there’s a lot more help for unpaid carers through the local authority and voluntary sector working together, we also need to build on this work to develop innovative and sustainable solutions to plug the gap that sometimes remains between acute hospitals, community hospitals and other means of respite and homecare. Through the care given to my nan, who is now in her ninetieth year—she probably won’t thank me for telling the Assembly how old she is—I have actually seen at first hand, at the moment and in the previous 18 months, the role that community hospitals play in providing step-up and step-down care. It’s not simply about relieving the pressure on acute hospitals, but it also means that the often elderly patients receive the care they need closer to home and in a less stressful environment.
And on the topic of community hospitals, I must pay tribute to the tenacity and the commitment of the Flint hospital campaign group, a group I committed to work with the representatives of, both prior to the election and since I’ve been elected as Assembly Member for Delyn, to seek a solution that best serves the community today and is sustainable into the future.
I’m grateful for this opportunity to contribute in such an important debate today, and, as my colleague Suzy Davies said, there’ll be further opportunities. I really do think it’s surely one of the most pressing and crucial issues of our time. Diolch.
I’d like to focus my contribution to this debate on the role of young carers and the part that they play in keeping our health and social care system afloat and the support, or—very often, or too often, I would say—lack of support in terms of what’s there to help them. There are estimated to be over 11,000 carers who are children or young adults in Wales, although it’s likely to be an underestimate, clearly, as many of them wouldn’t be known to us. Many, of course, wouldn’t identify themselves as having caring responsibilities. Having those kinds of responsibilities puts a child at a disadvantage in terms of their educational opportunities. Young carers often miss out on opportunities that other children have to learn and to play.
Young carers, I’m told, are losing an average of 48 school days, either missed or cut short because of their caring role each year. The figures also suggest that around 68 per cent of young carers are bullied at school, and only half of young carers have a particular person in school who recognises that they are a carer and helps them. So, it’s perhaps not surprising that one in five carers will become NEETs when they leave school—one in five. Quite why caring isn’t considered employment, albeit unpaid employment—perhaps that’s maybe part of the problem here.
So, it’s a huge sacrifice. It’s a huge sacrifice that these children are making. Remember that, if they didn’t care, it’s the NHS and social care that would be picking up the pieces and picking up the tab. But the support we’re offering these children, I have to say, is nothing short of a disgrace. I’ve already highlighted that half of carers are not having a particular person at school who can help and support a carer. Clearly, there needs to be far greater support and working between local authorities and schools to put that support in place. But we’re starting from a low base here, of course. The information provided to young people just isn’t good enough. According to Carers Wales, the website of one local authority appears to exclude the carers of anyone under the age of 18 from accessing a carers needs assessment. At the very least that needs to be updated.
It isn’t just young people, of course, with caring responsibilities who are picking up the tab for our generation’s failure to protect them. There are also parents with caring responsibilities for children who had their support cut by social security changes. We’re all familiar with the bedroom tax, of course, and recently the particular case in west Wales is an example of this. But there are also 4,000 families with disabled children who have been affected by the decision to cut the Family Fund which, of course, has been described as providing a lifeline.
There are also parents who have children on the autistic spectrum who have persistently highlighted the lack of support and the fight that is required to get the support that they need. So, there’s clearly a great deal of improvement that’s needed in our social care and our education system if we’re to really support those who are giving so much in exchange for so little.
Carers Trust Wales, which called for the introduction of a young carers in school programme in Wales—one that can be a full integral part of the new curriculum. There are changes afoot in the curriculum, and clearly an opportunity there to address some of these areas. The programme would provide a step-by-step guide to identifying, engaging and supporting young carers. It would equip schools with effective practice and accredit the work schools do to support young carers. The programme would be based on the Young Carers in Schools programme in England, developed and run jointly by the Carers Trust and the Children’s Society there. The programme has been in place in England for well over a year now, and initial evaluations have shown the programme to be highly effective. For example, of the schools that participated, 94 per cent said they had identified more young carers in their school, 91 per cent had seen a positive impact on the achievement of young carers in their school, and nearly three quarters had noticed improved attendance among those young carers as well. So, there’s much that we can learn and look to replicate in Wales in that respect.
The Scottish Government as well has funded a third sector short breaks fund since 2010, with a focus on respitality—a combination of respite and hospitality. This can bring, of course, a number of benefits—clearly benefits for those providing care and respite for them, but also providing breaks during the off-season is cheaper, so it provides greater value for money, but also the additional income is provided there as well for tourist businesses at a quieter time of year. Now, I know that the Labour manifesto committed to investigating a national respite scheme. It didn’t appear in the programme for government, but I understand that plans are afoot, and it would be good to hear an update this afternoon.
For every £1 invested in support for carers, it brings a return on investment of £4, and £8 billion pounds is saved in Wales every year by the care carers provide. So, the statistics make their own case for investing in carers, and young carers particularly. I look forward to hearing what more the Government intends to do when they respond to this debate.
I’d like to echo the comments made by other Members on the debt of gratitude that we owe to unpaid carers. It’s crucial that we value and respect them, and I think Llyr has raised a really important point about young carers in particular.
Today I want to touch on the impact of the intermediate care fund. It’s a very good example where better integration between health and social care services exists in practice, preventing unnecessary hospital admissions and delays in discharges. One example of this success is in my constituency. The Welsh Government has invested £0.5 million in capital funds and £390,000 in revenue funds to develop the intermediate care unit at Parklands residential home in Malpas. The collaborative work between the Welsh Government, Aneurin Bevan health board and Newport City Council has provided a place where patients who are well enough to leave hospital, but are not yet able to return home, can access the care and support they need at that time.
Between 1 April and 31 December 2016, 55 people were admitted to Parklands, with an average stay of four weeks. Of those who were admitted only six people returned to hospital, with 47 being able to return to their own home. The experiences of two of my constituents demonstrate the difference this facility has made to these individuals and their families. One constituent was admitted following a stroke. He had reduced mobility and speech and had lost a lot of weight. He received support from the neurological community rehabilitation team at Parklands, which consisted of an occupational therapist, physiotherapist, a dietician and a speech and language therapist. During his stay of approximately six weeks, he gained weight and his mobility and speech improved, meaning that he was able to return home to live with his wife.
Another former resident of Parklands was referred following multiple hospital stays, due to a general deterioration in her health, and she had an inability to cope at home. She felt she needed to go into residential care but had the opportunity to stay at Parklands first. She stayed at Parklands for approximately 10 weeks, but early in her stay she had built up her confidence enough to want to return home. With the help of staff, she regained her mobility, and following a meeting with her family, she realised she could live independently. A stairlift was fitted to enable her to access the whole of her property and she returned home with a care package. She has not been readmitted to hospital since.
There are many more examples that I could quote, all of which demonstrate Parklands was able to personalise the care needs to the individual. This type of step-up, step-down care is making a real difference to people and their families, as both myself and the Minister have seen for ourselves. The intermediate care fund is able to improve the quality of life for many in need of social care and alleviate the pressure put on hospital beds. With an ageing population, more accommodation like Parklands is crucial to ensure people remain in their home for as long as possible.
It is now 11 years since I launched CHANT Cymru at the request of campaigners across Wales, fighting for local beds at community hospitals. Campaigners against the closure of Chatsworth House Community Hospital in Prestatyn had asked me to form CHANT Cymru—Community Hospitals Acting Nationally Together—to bring together local groups from across Wales campaigning to save their local community hospitals, threatened by the then Labour Welsh Government’s closure programme.
Widespread opposition to closure had already generated popular public protests across the whole of Wales, and CHANT Cymru was the campaigners’ national voice in the fight to save their community hospitals. We promoted at national level the role of community hospitals in providing quality healthcare, supported local campaigns and held the Welsh Government to account over its promise to meet the health needs of its patients and to provide accessible local healthcare. I led a debate on this here, we held a rally on the Senedd steps, attended by coachloads from across Wales, and we successfully ensured that this was a key issue in the 2007 Assembly election.
The new coalition Welsh Government announced a u-turn. In March 2010, the Labour health Minister said,
‘I am not aware of any threats to community hospitals across Wales’.
However, when Labour returned to single-party power in Cardiff in 2011, they again pushed ahead with their community hospital closure programme. North Wales community health council wrote to the then health Minister expressing concerns about the robustness of the information provided by Betsi Cadwaladr university health board, which they used to inform their decisions to close community hospitals in Flint, Llangollen, Blaenau Ffestiniog and Prestatyn. Dozens of community beds were lost, despite bed occupancy levels at 95 per cent and above. The GP who set up the north Wales pilot, the enhanced care at home scheme, with the health board, said that
‘This will bring a service that is currently frequently gridlocked, further to its knees’,
and that
‘a central part of the proposed shake-up of health services—providing more care in people’s homes—won’t fill the gap left by shutting community hospitals.’
This Welsh Labour Government ignored the Flint referendum, in which 99.3 per cent voted in favour of returning in-patient beds to Flint, and then ignored the Blaenau Ffestiniog referendum where an overwhelming majority voted in favour of returning beds there.
When I visited Holywell hospital, staff there told me that extra investment in our local community hospitals, such as Holywell, and NHS community beds in Flint would take pressure off our general hospitals, help tackle the A&E crisis and enable the health board to use its resources more efficiently. As the head of the NHS in England said, smaller community hospitals should play a bigger role, particularly in the care of older patients.
At last June’s Royal College of General Practitioners Wales’s Assembly event, ‘Strengthening General Practice to Support the NHS’, we heard that general practice in Wales provides 90 per cent of NHS consultations, 27.8 per cent of the budget, and that prolonged underinvestment means that funding for general practice has been decreasing compared to the overall Welsh NHS.
‘Yet we face the significant challenges of an ageing and growing population. Consultations are becoming longer and more complicated as we deal with an increasing number of patients with multiple chronic conditions.’
We also heard from them that NHS community beds add to the breadth of things GPs can do, including respite and step-down care, assisting both primary and secondary sectors. If it really means what it says about co-production in health and social care, the Welsh Government must start listening to these professionals and designing and delivering local services with clinicians and local communities.
The Well North Wales programme identifies a requirement to tackle issues around deprivation and poverty at a local, community level via co-production. As the Chief Medical Officer for Wales said in his annual report 2015-16,
‘Social prescribing can improve self-esteem, mood, social contact and transferrable skills—and decrease demand for Health services.’
The Co-production Network for Wales, All in this Together, have highlighted, for example, the Green Dreams: Creating Health through Community social prescribing initiative, established by a GP in England. As Wales’s chief medical officer states,
‘Co-production with communities is a potentially powerful way in which public sector staff can respond to the social gradient of health need.’
‘The optimal arrangement of primary and community care services may be best understood through co-production.’
‘Understanding community assets and co-productive working seems vital for GP practices, primary care resource centres and primary care clusters.’
And, may I add, vital for community hospitals and community beds also?
Can I thank Plaid Cymru for bringing forward this very important debate? I think most of the points that I wanted to cover have now been dealt with. So, I’m going to confine my contribution to this particular debate to the part of the motion that deals specifically with community hospitals and, in particular, the importance of developing the integration agenda.
I guess, like me, everybody places great value on our local community hospitals, but unfortunately, I think the wording of the motion implies that keeping every existing community hospital open is the answer to delivering community-based health services and social care. It’s quite possible that some existing community hospitals could provide the base for some community-based schemes, not just providing a range of healthcare services, such as GP practices, dental services, opticians and pharmacies, but being the base for social care provision. But, a blanket policy of keeping open every community hospital could, in some instances, actually be a barrier to initiatives for the better integration of health and care services.
There are great examples already out there, and Sian Gwenllian mentioned some in her constituency, of one-stop centres for health and social care provision. In my constituency I have two great examples, one of which is the Keir Hardie Health Park in Merthyr, and the other is the integrated health and social care centre in Rhymney. I believe that that should be the general direction of travel, in terms of community provision.
From the contributions we’ve heard from Mark Isherwood and from Hannah Blythyn, I know how emotive proposals to close community hospitals can be, but that shouldn’t deflect us from the need to take forward the process of social care and health integration, and it shouldn’t deflect us in the short term, just for political expediency, to unjustifiably keep open unsustainable community hospitals, if doing so prevents the development of local, sustainable integrated health and care services.
Would you give way? Would you agree, recognising—[Inaudible.]—out of date, buildings need to be replaced, that shouldn’t have been done without transition and without replacement beds?
I totally understand and agree with that. When moving services or closing hospital services, there need to be services in place before other services are closed. I think the point I’m trying to make is that we shouldn’t use the closure of community hospitals, and oppose the closure of community hospitals, just because the community wants to oppose that, because I think everybody wants to keep what they have. I think sometimes we have to look at the bigger picture, and that’s really the point that I was making.
So, I will be supporting the amendment from the Welsh Government that recognises the role that community hospitals may have in a wider capacity, but crucially recognises the significance of the £60 million integrated care fund and the £40 million fund to develop integrated health and social care centres, at the heart of which may or may not be community hospitals.
Thank you very much. I call the Minister for Social Services and Public Health, Rebecca Evans.
Thank you, Deputy Presiding Officer. In the few minutes I have to respond to the debate today, it would be impossible for me to put in the window everything I’ve got in the shop, to use Hannah’s phrase, because it has been such a wide-ranging debate and we are doing so much in this field.
But, I’ll start by saying that the Welsh Government has prioritised social care as a sector of national strategic importance. This isn’t a new approach, of course—our Social Services and Well-being (Wales) Act 2014 was developed in response to the Welsh Government’s 2011 White Paper, ‘Sustainable Social Services for Wales: A Framework for Action’. The Act is based on the fundamental principle that whilst demand is rising across social services, and the financial outlook for all public services is difficult, we do need to do more than just pursue the obvious efficiency savings. The Act gives us a new legal framework for the way in which we provide care and support services.
In Wales, we continue to invest in social care to ensure the delivery of high-quality care and support. The 2017-18 budget includes an additional £25 million for social services, and this extra support has been welcomed by local government and will help respond to pressures. I’ve also announced a further £10 million of recurrent funding to help to manage the impact of the national living wage.
Standards can best be raised when partners work together. In order to increase resilience in health and social care, we need to take a whole-system approach to planning and service delivery. The intermediate care fund has been developed to develop new and innovative models of integrated working between health, social services, housing and the third and independent sectors. Sixty million pounds have been set aside this year, and ‘Taking Wales Forward’ includes a commitment to retain this important fund. The ICF supports initiatives that prevent unnecessary hospital admission, inappropriate admission to residential care and delayed discharges from hospital. These initiatives have created capacity in the care system and have improved consistency in the provision of services within regions.
The Social Services and Well-being (Wales) Act provides for the establishment of seven regional partnership boards on a health board area footprint. These boards bring together health, social services, the third sector and other partners to take forward the effective delivery of integrated services in Wales. Their purpose is to improve the outcomes and the well-being of people, and improve the efficiency and the effectiveness of service delivery. ‘Taking Wales Forward’ also includes a commitment to invest in a new generation of integrated health and social care centres. Forty million pounds has been announced to support this, and organisations are in the process of prioritising plans as part of their estates and service-planning work.
So, whilst we can support point 1 of the motion today, we can’t support points 2, 3 and 4, for a number of reasons. There are approximately 384,000 carers in Wales providing dedicated support to their loved ones, and we’ve heard how, in practical terms, this care equates to more than £8 billion a year. But it’s simply not true to say their contribution is unappreciated. The Welsh Government recognises that we owe our carers a great debt of gratitude, and that’s why we’ve long sought to improve the lives of carers. In 2000, we published our ‘Carers Strategy for Wales’, which provided a framework for delivering services and support for carers. In 2010, the Carers Strategies (Wales) Measure was introduced, further improving support for carers locally, and the groundbreaking Social Services and Well-being (Wales) Act enabled us to build on our progress and strengthen our commitment to carers. The Act recognises explicitly the key role played by carers and will give them rights to assessment and support that are equal to those of the people they care for. And I’m very familiar with the survey to which Rhun ap Iorwerth referred, having already discussed it myself with our carers’ forum, and as a result, I’ve written to all local authorities in Wales on the issues that you described, and I’ve also asked my officials to look further in-depth at the findings and, of course, there will be this three-stage monitoring process for the implementation of the Act.
I also announced the intention to refresh our current carers strategy in my written statement, which was published on Carers Rights Day. The strategy will be developed in partnership with carer networks, organisations and carers themselves, building joint ownership and capturing the issues that really matter, and I give Members reassurance that young carers are a particular focus of this piece of work. The work will include examining a national approach to respite care, because carers tell us that this is a major priority for them, and discussions have already begun with third sector organisations on what the detail of this might be. And I can reassure you also that some of that work includes discussions with the Carers Trust, relating to the approach that has been described in Scotland.
In the meantime, we expect health boards and local authorities to work together to plan and deliver care and support as locally as possible. This includes respite care to support carers in their vital role. Respite care should be flexible and be able to take place in a wide range of settings, including at home and in the wider community. I’m aware that the closure of community hospitals continues to receive much attention, but I would correct Mark Isherwood: there is no Welsh Government community hospital closure programme. It’s for local health boards, working in partnership with their local communities, to determine the care that’s necessary for local needs.
I was referring to 2006, when there most clearly was. That’s why we generated a campaign, with hundreds and hundreds of mayors and residents on the steps outside. And paradoxically, and oddly, in 2011, the closure programme announced by health boards matched exactly the Labour Welsh Government closure campaign from five years previously.
Well, Deputy Presiding Officer, it’s 2017 now, and depending on local needs and circumstances, community hospitals can play an important role in delivering a range of facilities and services, including respite. However, quality care is about more than just buildings and bed numbers. A number of very old and outdated community hospitals have closed in recent years, and I do recognise that these hospitals were much loved and much cherished by their local communities, but they were no longer able to provide care that’s appropriate to meet today’s modern standards. These hospitals are being replaced with new primary care resource centres, funded by Welsh Government, and are providing an increased range of services in a modern setting, resulting in people receiving more of the care and support they need close to home. There’s often criticism that these new centres do not have in-patient beds, but it’s often far more appropriate for people to receive care through enhanced services at home. In cases where an in-patient bed is deemed to be clinically required, these are being provided through nearby modern hospitals, so the emphasis has to be on the quality of the service and meeting people’s needs, rather than where that care is physically delivered.
A pipeline of primary and community care investment is being delivered as part of health boards’ estate priorities, and this is linked to the work that we want to see done to increase the scale and pace of service shift into primary and community care settings. Some early opportunities for investment have already been identified in the NHS-owned estate as the longer-term investment programme is developed. We have approved nearly £5 million of capital funding for a number of priority schemes, and opportunities for further capital investment in 2017-18 and beyond are being discussed with health board teams as service planning work develops, and in line with their integrated medium-term plans.
We are now seeing the benefits of this approach. We saw a further fall in our delayed transfer of care figures for December, and I expect my confidence to be rewarded by a further reduction when the January figures are published shortly. I want to reassure Rhun ap Iorwerth that we’re not complacent, though, and it might be interesting for Members to know that the major cause of delayed transfers of care is actually patient choice, rather than a lack of numbers of beds. So, the situation is perhaps more complicated than it first seems.
Turning to the second amendment, tabled in the name of Paul Davies, we agree that allied healthcare professionals play a vital role in reducing avoidable demand for social care by actively working in the community and primary care. Through multi-professional teams, they’re delivering preventative care and admission avoidance, reshaping the way patients are supported to live their lives and better manage their conditions. So, we support this amendment.
And, interestingly, having considered the comments raised by Rhun ap Iorwerth on the issue of aids and adaptations with me in questions last week, I did discuss this with front-line professionals, who told me that there isn’t a major backlog in terms of aids and adaptations, and decreasing numbers may well actually be the result of the success of our Welsh Government housing standards, which are making homes more appropriate for people to live in in later ages, and also our focus on prevention is working. So, whilst it’s really good to be interested in outputs, it’s even better to be interested in outcomes.
I’m glad that Sian Gwenllian is looking into the case that she described, and, if she’d like to write to me, I’d be more than happy to also look into that case. Obviously, Members will realise that intermediate care fund money is actually being used in the field of aids and adaptations as well.
So, there’s no doubt that our health and social care services are facing challenges, but we are meeting these challenges head on, and have already increased resilience by taking a whole-system approach to planning and service delivery. We’ll continue to work with our partners and support them in working together to deliver integration and collaboration.
Thank you. I call Rhun ap Iorwerth to reply to the debate. Rhun.
Thank you very much, Deputy Presiding Officer, and thank you to everyone who’s participated in this debate. I have just a few minutes left. May I first of all thank Sian Gwenllian for highlighting how appreciative we should be of professional care workers across Wales, a point that’s been echoed by a number of Members? It is extremely important that those professionals are given the recognition that they need and deserve—many of them, of course working on very low wages. And then the point was made very strongly by many people, including Jenny Rathbone, Jayne Bryant and Llyr Gruffydd, on the immeasurable contribution made by voluntary carers. The Minister said that the Government does recognise the work that they do. On an individual level, of course, every one of us would be grateful to an individual for caring for a member of their own family or a friend, but as a sector we must do more to show our appreciation and recognition that the work that they do is carried out free of charge and supports other professional services.
Hannah Blythyn, thank you for summarising how important community hospitals are, and, yes, it’s beds that are important. In response to Dawn Bowden’s comments, we didn’t want to give the impression that bricks and mortar are the important thing here, but there has been a reduction in the number of community beds available, and we must somehow recognise that there is an important role for those community beds in the care pathway. I very much hope we can reach a point where we can achieve consensus on the need, after years of losing these beds—because that’s what happened, there are 7 per cent fewer beds in the NHS in Wales than there were a few years ago—to turn that tide and provide more beds in terms of providing choice, a broader range of options, in providing social care.
Suzy Davies started the debate by talking about integration. It’s not whether we want to see integration that’s the question, I think, but rather what model of integration we are seeking, because we must think about this as a unitary service—it must work in that way—because, on their pathway through the health and care service, a patient shouldn’t feel at any point that there is any barrier in the care provided. Once again, I hope we can agree on that. What we need to do, of course, is to find a way of implementing and delivering that the length and breadth of Wales.
I am grateful to the Minister for her comments—yes, I am more interested in outputs. The Minister listed a number of budgetary elements, financial contributions to various strategies, and, of course, I do recognise that funding, and some of that has emerged from negotiations that have taken place between the parties here. But the stresses on social services are clear—I hear about it in my own postbag and in my inbox. And whilst the evidence demonstrates that that strain is there—and the statistics also demonstrate that in terms of the recent increase in delayed transfers of care—we will continue to hold the Government to account and to insist that there is a move to strengthen this crucial sector.
To conclude, Dai Lloyd said that we needed to celebrate the fact that we are in a situation where there has been an increase in demand, because we are living longer. But the demographic change, which we do welcome, does bring responsibilities with it. That’s what we’re discussing today: how to face up to those responsibilities and to build a system that can cope with the needs of today and is prepared for tomorrow.
Thank you very much. The proposal is to agree the motion without amendment. Does any Member object? [Objection]. Okay, we’ll move to voting time, then.
Voting deferred until voting time.
Oni bai bod tri Aelod yn dymuno i’r gloch gael ei chanu, symudaf ymlaen yn awr i gynnal y bleidlais. Na. Iawn, o’r gorau. Diolch yn fawr iawn.
Galwaf am bleidlais, felly, ar y cynnig a gyflwynwyd yn enw Rhun ap Iorwerth. Os gwrthodir y cynnig hwn, byddwn yn pleidleisio ar y gwelliannau a gyflwynwyd i’r cynnig. Agorwch y bleidlais. Caewch y bleidlais. O blaid y cynnig 19, neb yn ymatal, 32 yn erbyn, felly gwrthodwyd y cynnig.
Motion not agreed: For 19, Against 32, Abstain 0.
Result of the vote on motion NDM6223.
I call for a vote on amendment 1, tabled in the name of Jane Hutt. Open the vote. Close the vote. For the amendment 39, no abstentions, 13 against, therefore amendment 1 is carried.
Amendment agreed: For 39, Against 13, Abstain 0.
Result of the vote on amendment 1 to motion NDM6223.
I call for a vote on amendment 2, tabled in the name of Paul Davies. Open the vote. Close the vote. For the amendment 51, no abstentions, one against, therefore the amendment 2 is carried.
Amendment agreed: For 51, Against 1, Abstain 0.
Result of the vote on amendment 2 to motion NDM6223.
I call for a vote on amendment 3, tabled in the name of Paul Davies. Open the vote. Close the vote. For the amendment 51, no abstentions, one against, therefore amendment 3 is agreed.
Amendment agreed: For 51, Against 1, Abstain 0.
Result of the vote on amendment 3 to motion NDM6223.
I now call for a vote on the motion as amended.
Motion NDM6223 as amended:
To propose that the National Assembly for Wales:
1. Believes that good social care services play an essential role in keeping the NHS sustainable and recognises the role of allied healthcare professionals in reducing avoidable demand for social care.
2. Recognises and appreciates the contribution unpaid carers make to the health and social care system.
3. Believes respite care should be flexible and can take place in a wide variety of settings, including at home and in the wider community.
4. Notes that community hospitals are one of several settings which can play a role in providing both respite care and step up/step down care.
5. Welcomes:
a) the Welsh Government’s commitment to develop a national approach to respite to ensure that respite is responsive to individuals’ needs in a consistent manner across Wales;
b) the investment in extra care services made possible through the £60m Intermediate Care Fund in 2017-18; and
c) the new £40m fund announced in the 2017-18 Budget to develop new integrated health and social care centres across Wales.
5. Calls on the Welsh Government to update the Assembly on the operation of S35 of the Social Services and Well-being (Wales) Act 2014, with regard to meeting carers’ respite needs.
Open the vote. Close the vote. For the motion 38, no abstentions, 14 against, therefore the motion as amended is agreed.
Motion as amended agreed: For 38, Against 14, Abstain 0.
Result of the vote on motion NDM6223 as amended.
We now move to the short debate. If Members are leaving the Chamber, can you do so quietly and quickly, please? Thank you. We now move to the short debate and I call on Nick Ramsay to speak on the topic he has chosen. Nick.
Thank you, Deputy Presiding Officer. I’ve agreed to allow Jenny Rathbone, Hefin David and David Melding to contribute a minute each to this debate. 15 March 2016 was an historic day for Wales: the day the Cardiff capital city region deal was finally struck by the First Minister, the UK Government and representatives of the 10 participating local authorities. Since that day, local authorities across the region have ratified the scheme—Cardiff back in January.
So, what exactly is all the fuss about? Well, ‘city region’ is a term in use since the early 1950s by urban planners to describe an urban area with multiple administrative districts. The Cardiff capital region comprises 10 local authorities: Blaenau Gwent, Bridgend, Caerphilly, Cardiff, Merthyr Tydfil, Monmouthshire, Newport, Rhondda Cynon Taf, Torfaen and the Vale of Glamorgan. It is the largest city region in Wales, and accounts for half of the total economic output of the Welsh economy, 49 per cent of total employment, and has over 38,000 active businesses. The city deal also provides an opportunity to continue tackling the area’s barriers to economic growth by improving transport connectivity, increasing skill levels still further, supporting people into work, and giving businesses the support they need to innovate and grow.
I believe this project has great potential, but let us not be under any illusions about the challenges ahead. Gross value added is lower than in all but one of the English Core City regions. There are also connectivity issues across the region that make it more difficult for people in the Valleys, for instance, to access economic opportunities.
If I can turn to the key elements of the deal, and, at its heart, the development of a 20-year £1.2 billion investment fund, which will be invested in a wide range of projects, as we know, the UK and Welsh Governments are each contributing £500 million towards this fund. The local authorities involved in the Cardiff capital region will contribute a minimum of £120 million over the 20-year period of the fund. A key priority, is, of course, the delivery of the south-east Wales metro, and, unsurprisingly, a proportion of the investment fund focuses on both phases of the wider metro scheme, the delivery of the Valleys lines electrification programme, and the delivery of the wider south-east Wales metro scheme beyond that.
Can I, once again, make a plea for all parts of the city region to benefit from the metro scheme, including outlying rural areas such as Monmouth, which have regularly appeared and disappeared on various metro maps over the years during the last Assembly and into this one, which I have raised many times with Ministers in this Chamber? As I’ve said before, a public transport hub at the Celtic Manor could help deliver this, but, however, it needs to happen so that everyone feels included. And, yes, whilst light rail and trams are the best solution for some routes now and in the future, where the infrastructure is there, we should not underestimate the important role of buses, particularly in providing connections from hubs to rural areas.
But it’s not just about the metro, important though that is. The rest of the investment fund will be used to take forward a wide range of projects that support economic growth across the Cardiff capital region, which will be decided upon by a new regional cabinet. That will include further transport schemes, investment to unlock housing and employment sites, and the development of research and innovation facilities.
So, what assurances are there underpinning all of this? Well, encouraging collaboration between local authorities has not always been too successful in the past. The local authorities involved have committed to an assurance framework for this investment fund, and at the heart of this is that the schemes represent good value for money and are underpinned by a robust business case. We will be watching closely to ensure that this happens, because the next five-year tranche of funding will only be unlocked if the UK and Welsh Governments are satisfied that the investments to date have met key objectives and contributed to national growth. And we should remember that this is not a blank cheque. There is risk involved; the local authorities involved are aware of that. If initial funding does not lead to progress, then the future costs will fall on local authority budgets. That is part of the deal. So, this isn’t a panacea; there are hard-headed economics involved.
What of the future? Well, the devolution of business rates income could provide funding for the city deal. We could look at allowing for an infrastructure supplement, allow local authorities to use alternative finance sources, or there could be removal of the conditions around some specific Welsh Government grants to allow funding to be pooled at the regional level. I’m sure that the Cabinet Secretary will have his own thoughts and proposals on some of these areas.
I’m pleased that there is a commitment to look again at a single integrated ticketing platform for public transport across the region, as considered by the previous Assembly’s enterprise committee, when I was the Chair. In the words of Professor Stuart Cole, who was a witness to our inquiry in that committee, it is a devilishly difficult thing to achieve, but the holy grail of public transport planning, and completely in tandem with the spirit of the metro.
Turning to infrastructure, we hear a lot of talk about the arc of innovation that runs along the M4 corridor. That’s great, but I think we also need to look outside of that to supporting projects outside of the M4 corridor in other parts of the region—in rural areas and areas like the Heads of the Valleys—and look at the enormous potential of projects like the Circuit of Wales, as recognised by the leader of Monmouthshire County Council, Peter Fox, recently rewarded with an honour for his work on the city deal project. By the way, I am pleased that the Welsh Government has now given the company involved, HVDC, a deadline to demonstrate that it has the necessary funding to move that forward. I think that’s a healthy development.
I think, above all, we need clarity in the city region area. We also need close relationships with the region’s three universities, which can help underpin the potential development of an internationally competitive compound semiconductor cluster that many believe will put the UK at the heart of an emerging global growth technology.
Of course, it’s clear that the Cardiff capital region needs an outstanding digital infrastructure, not always achieved in the past. It needs 4G and 5G technologies, and also increased Wi-Fi services across public transport. They’re becoming increasingly important.
Can I also just say a little about the development of green infrastructure in the capital region? Because that has a role to play in relation to the well-being of future generations Act brought forward by the Welsh Government and approved by this Assembly. Green infrastructure provides a number of opportunities and advantages if it is embedded in the city region project. GI should not just be identified, but it needs to be engineered into our villages, towns and cities. It needs to involve communities and the private sector. This is a way to ensure that work is not done in silos—and how important it is to break through those silos in a project like the city deal project.
In conclusion, Deputy Presiding Officer, although much work has been done over the last few years to strike the deal, we are, in reality, just at the start of this journey. It will not be an easy journey, but I do believe that it is a necessary one and one that will, in the end, prove worthwhile for all the partners involved. In the wake of the vote to leave the EU, it is particularly important that the component parts of the capital region work well together to maximise their assets and advantages. We’re stronger together than we are apart.
I will close this short debate—or my part of it, anyway—with the vision for the Cardiff capital region set out in the city deal, which is to
‘work together to improve the lives of people in all our communities. We will maximise opportunity for all and ensure we secure sustainable economic growth for future generations.’
This city deal provides local partners with further powers and tools to realise this vision. It is now, of course, up to the signatories of the deal to ensure that this happens.
Cities are widely recognised by the policy wonks as the engine of economic growth, and connectivity between cities and their hinterlands is a key ingredient of spreading that economic success to the whole region, not just those at the centre. We have to acknowledge that the Valleys were the original engine of Cardiff’s past growth, and therefore we have a responsibility to ensure that the Valleys benefit from Cardiff’s current growth. We can see from the examples of both Manchester and Stuttgart that successful large-scale regeneration through expansion of the knowledge sector has to be underpinned by a metropolitan rapid transit network. At the moment, 80 per cent of the nearly 80,000 people who commute into Cardiff come by car. It’s unsustainable now and getting worse by the day. It was, frankly, embarrassing when young people at the recent mock COP seminar last Friday said, ‘Why can’t we have the modern integrated transport system they have in Ireland?’, to which I had no answer. Why indeed? It’s a matter of urgency to get on with the metro, without which new businesses and new talent will not come to this region.
I report to the Chamber that I was at Caerphilly council last night as a member, on one of my last appearances there, and I voted to support the city deal, and the whole council did as well. I’d say to Nick Ramsay: I’m sure you remember the south-east Wales shared service model, which constituted the same 10 local authorities but failed to emerge, simply sharing payroll, training and HR. This, therefore, is an example of something that’s gone much further than that, and has been much more successful. I think we should owe every leader of those authorities, and every chief executive, a debt of thanks and gratitude. I think that is cross-party.
The city deal, as Jenny Rathbone’s already indicated, needs to go beyond Cardiff, otherwise it’s no deal at all. I’d like to contextualise that: it’s not just the Heads of the Valleys, but the northern Valleys, which includes an area that’s actually bigger than that, which stretches across the northern Valleys areas. The success of Manchester lies partly in the fact that it’s a concentric region. Well, the problem with the Valleys is that they are spokes moving out from the Cardiff area, which presents us with another challenge—and a challenge that can be overcome, I think, if we work collectively together.
Finally, Welsh ICE is based in my constituency. It’s in Caerphilly Business Park. I think it’s a fine example of the kind of thing the city deal can achieve in the northern Valleys. We see Welsh ICE as a hub of business growth and development. Why not scatter Welsh ICE—that kind of model—across the northern Valleys? It’s not just job creation, but business growth and creation, too. I think we can achieve it.
Like Jenny Rathbone, I’m very concerned about congestion in our cities, particularly Cardiff, and the sheer inefficiency with which we allow current traffic flows. Obviously, we need to do more in terms of public transport. We need to build on what we have and ensure that other schemes are there to get people off the roads. Not driving single journeys with just one passenger would improve the flow of traffic dramatically. Car-sharing schemes via the larger employers, but also through the net, the wonderful new technology we have, should be encouraged, as should special lanes for cars that are shared to use. That also will improve the urban environment and give us other options in terms of designating some roads for pedestrians and cyclists.
We really need to think in a very comprehensive way about how we manage traffic flows. It’s got to be done at peak level. Otherwise, the current gridlock will just get worse and worse.
Thank you very much. I call the Cabinet Secretary for Finance and Local Government to reply to the debate. Mark Drakeford.
Diolch yn fawr, Ddirprwy Lywydd. Can I begin by thanking Nick Ramsay for taking the opportunity of a short debate to highlight the current state of progress in relation to the Cardiff capital city deal? His contribution, I thought, was thoughtful, wide ranging, optimistic but realistic about the challenges that we face. City deals have the potential to make a lasting impact, and that’s why commitment to making the Cardiff capital city deal a success is so important.
Now, one of the defining features of the deal in this Chamber has been the strong cross-party support that there has been for it. We’ve seen some of that again today. The partners involved have shown ambition, vision and hard work in getting this far forward, but it’s only with continuing support, and continuing political support, that we can be confident that the deal can deliver on its promise.
Dirprwy Lywydd, the promise is substantial, because the deal has an investment fund for the region of £1.2 billion over a 20-year period. It is the biggest per-capita city deal of any of those agreed by the UK Government to date. It’s bigger than the Glasgow deal and it’s bigger than the six main English city region deals as well. It aims to provide local partners with the powers and the resources to unlock significant economic growth across the Cardiff capital region, and that’s a theme in what we’ve heard this afternoon. It’s absolutely important that that growth happens right across the region, through developing stronger and more effective leadership and enabling 10 local authorities to unify decision making, pool resources and work more effectively with local businesses. It’s a deal that seeks to build on the region’s sectoral strengths, its high skill base, its three successful universities, and to provide an opportunity to continue to tackle the area’s barriers to economic growth by improving transport connectivity, increasing skill levels, supporting people into work and giving businesses the support they need to innovate and to grow.
Over its lifetime, the Cardiff capital region city deal is expected to deliver up to 25,000 new jobs and leverage an additional £4 billion worth of private sector investment. As we’ve heard loud and clear this afternoon, a key priority for that investment will be the delivery of the south-east Wales metro, including Valleys lines electrification. The deal sees the metro at the centre of a significant programme of infrastructure development with £734 million ring-fenced for its delivery. That’s made up of £503 million from the Welsh Government, £125 million from the UK Government and, of course, £106 million from the European Union, through ERDF.
Beyond the metro, the deal sees a further £495 million, made up of £375 million from the UK Government and £120 million from local authorities themselves, available to prioritise in line with the goals of the deal.
All this has been made possible by the ambition of local authorities themselves and a step change in their willingness and ability to come together for regional collaboration, but also by the strong collaboration with and between the Welsh Government and the UK Government coming together to make all this possible. All parties are working to put in place the necessary governance arrangements early in this year to enable project activity to commence. That is why, of course, as you’ve heard this afternoon, the local authorities across the city deal are voting to make those governance arrangements a reality, and I congratulate Hefin on the part that he played in making that happen just yesterday.
A great deal has happened, Dirprwy Lywydd, since the 10 months that have elapsed from the time that the First Minister and others signed the deal. The partnerships are working, as you know, on the procurement of the metro and it’s absolutely right, as others have said, that the metro will play this key part in moving people right across the region and moving people to Cardiff, but not just that—moving people from Cardiff to other parts of the region and between parts of the region as well.
As Nick Ramsay said, we have to take a more imaginative idea of what the metro will be like than is sometimes described in public debate. And David Melding was right too when he pointed to the fact that transport challenges in the Cardiff capital region will need solutions beyond the metro. That’s why it is so important that, as well as establishing a joint Cabinet in shadow form, that a shadow regional transport authority has already been established as part of this deal and has been working actively, meeting together, in order to plan for the future.
Now, while the ratification of the deal is extremely important in terms of its governance arrangements, it’s important because it marks the move to the next stage and that next stage is about delivering, through the authorities and their partners, on the projects that will make a difference right across south Wales.
The deal has always been driven by the clear ambition for economic growth through investing in infrastructure, innovation, skills and business. The competitive commission set up by the deal, led by Greg Clark—or the other Greg Clark, as I suppose we should refer to him—published its report in December last and it identified as a strength of the deal that there are so many people, organisations and businesses that want to make sustainable economic growth across the south of Wales a reality and that want to play a part in making that happen.
It’s vitally important, therefore, that the capital region works closely with its partners and stakeholders in developing the programme of projects. The governance arrangements support the specific involvement of business representatives, but I expect the city deal to engage widely in making sure that all those who have a part to play feel that they have a genuine opportunity to make that contribution.
Much has been made this afternoon, Dirprwy Lywydd, of the economic opportunities of the city deal, particularly the financial boost to the region. There’s real importance as well, in my mind, in the important step of giving local authorities the opportunity to make this happen and in developing that cross-border working between the 10 local authorities coming together for the benefit of the wider region that they represent. As was said in the Chamber yesterday when we debated the White Paper on local government reform, the achievements of the Cardiff capital deal have been very influential in designing that wider regional working for the future.
Today’s debate has focused on the Cardiff capital city deal. I don’t want to end my comments without recognising the work that is being undertaken elsewhere in Wales. Discussions in the Swansea bay city region are well advanced, and I’m confident that we have the makings of a deal that can be supported by all partners. The North Wales Economic Ambition Board’s work is at an earlier stage of development, but it has real commitment from the partners around that table, and we continue to work with them to explore how a growth deal could help to deliver their ambitions for that part of north Wales and maximise links with regions across the border in England.
The path that the Cardiff capital city deal is treading today sets the example for what we want to see delivered across the whole of Wales. We will work with local partners and we will work with the UK Government, so long as we have that shared agenda of maximising our combined interest and unlocking further economic growth for all parts of our nation. Thank you.
Thank you very much. That brings today’s proceedings to a close.
The meeting ended at 18:03.