Y Cyfarfod Llawn - Y Bumed Senedd
Plenary - Fifth Senedd04/02/2020
The Assembly met at 13:30 with the Llywydd (Elin Jones) in the Chair.
I call Members to order.
The first item on our agenda this afternoon is questions to the First Minister, and the first question is from Carwyn Jones.
1. Will the First Minister make a statement on the reforms to university student support? OAQ55044
Llywydd, Wales has the fairest, most progressive and sustainable student support system anywhere in the United Kingdom. It includes parity for part time and postgraduate students. The Welsh Government's target of a 10 per cent increase in the number of Welsh postgraduate students by the end of this Senedd term has already been achieved.
Thank you, First Minister. Can I congratulate the Government on the success of the reformed support packages for higher education? In particular, of course, we see an increase of more than 1,500 students who are now studying at postgrad level, and that shows that we continue in Wales to produce graduates of the highest calibre, and of course they contribute so much to us having a high-skills economy. First Minister, do you agree with me that this increase in postgraduate students is a sign of the success of the Government in looking to build the skills pipeline that we need in order to create a high-quality, high-wage economy?
I thank Carwyn Jones for that supplementary question. He's absolutely right, Llywydd, to draw the link between the investment we make in the higher education sector and the future success of the Welsh economy. The figures that he points to are remarkable. They show a 7 per cent increase in part-time students as a result of the policies followed by this Government. They show a 9 per cent increase in postgraduate students. And they really are an investment, as Carwyn Jones has said, in the sort of skills that we will need in the Welsh economy in the future. And it comes from that key insight of the Diamond review that it was living costs in the here and now, not tuition fees, that were the greatest barrier to people coming into higher education, both at undergraduate and postgraduate level.
And I know that the Member will be particularly pleased, because of the close interest he's always shown in this, with the decision to abolish means testing altogether for care leavers up to the age of 25, and the fact that we are consulting currently on potential changes to support for disabled students, to make sure that they too have as full and unfettered access to our higher education system as we can design for them.
This reminds me a little bit of the Programme for International Student Assessment results, which is a welcome halt to a persistent downward trend but still some way to go from where we were six years ago. If you look at undergraduates—obviously, we're all going to welcome any growth in numbers in undergraduates, even though that's smaller than the growth in the number of postgraduates—can you tell us something about whether they're choosing to go to Wales's universities? Because, obviously, part of the Diamond dividend is supposed to be an improvement for the security of university funding, as well as improving the opportunities for Welsh students. I am curious to know whether the Diamond dividend that you were expecting is actually what we're seeing in the latest figures.
Well, Llywydd, the Diamond dividend is there for anybody to see in the draft budget that we placed in front of the Assembly on 16 December, where we are reinvesting into higher education the Diamond dividend in exactly the way that the original report suggested. I want Welsh young people to feel confident to study wherever they think their future would be best enhanced. And that can be in Welsh universities, of course, with many, many brilliant departments and possibilities; but I want Welsh young people to be able to study elsewhere in the United Kingdom as well. And I don't regard it as a measure of success or failure of the system whether students decide to study in Wales or elsewhere. I want them in higher education; I want them to be where they think their future will be best secured.
Phase 1 of Diamond's reforms, which is the student-facing reforms, are being and have been implemented; but we are talking here about phase 2, in relation to the institutional reforms. I do welcome the uptake in part-time students, and I do reflect on the fact that this is improving in Wales. But I have spoken to some HE institutions that say that, in line with the increase in part-time students, many of them will have more complex needs and they will need more investment from an institutional perspective. So, what are you doing in that regard to ensure that higher education institutions are robust and resilient for the future here in Wales?
I thank the Member for that question, and for her recognition of the way in which the Diamond reforms have reached out to part-time students. I know it's an issue that she's raised before on the floor of the Assembly, and I'm sure she is right that people coming back into higher education through the part-time route will have many other things in their lives that they are juggling, many other demands that they are having to meet. And higher education institutions have a responsibility to respond to those needs. It's why that is particularly highlighted in the remit letter that the Minister for Education has supplied to the higher education sector in Wales this year. We are investing in those higher education institutions, they are seeing the Diamond dividend. They must play their part as well in making sure that the help that they give to students from non-conventional backgrounds coming into higher education is good enough to make sure that those people can succeed.
2. What action is the Welsh Government taking to support children in poverty in Wales? OAQ55025
I thank Mike Hedges for that question. The major levers for addressing child poverty remain firmly with the UK Government. The Welsh Government is focused on using devolved powers to leave more money in the pockets of families with children, particularly those children living in poverty.
Can I thank the First Minister for that response? I very much welcome that the Welsh Government has committed to additional funding for the discretionary assistance fund, which has helped individuals and their families during times of crisis and, quite frankly, destitution. To ensure the fund's long-term future, additional funding will be required. Will the First Minister outline his proposals for the fund in future years?
I thank Mike Hedges for that supplementary question. He is absolutely right to point to the success of the decision made here in the National Assembly to have a national scheme. When the social fund was abandoned by the UK Government, here in Wales we decided that we would have a fund that would be run on a Wales-wide basis with no local lottery in it. In England, we know that many local authorities took the money that they were given when the social fund was broken up and provide no service for poor people with it at all.
Here, we have helped 280,000 applications to the fund since its inception. The budget has increased year on year in this Assembly term. It was £7 million in the first year of this Assembly term; it's £11.2 million in this year. It went up £2 million in this financial year; it will go up by another £1 million in the next financial year. The number of applications has gone up remarkably quickly in an age of austerity: 65,000 applications in the first year of this Assembly term; 160,000 in this financial year, to the end of December; so it's going to be more than 100,000 additional applicants to the fund.
And not only have we sustained it, Llywydd, by more money to keep the fund available to people, but we've extended its scope as well. We've made sure that it can respond to the needs of refugees and asylum seekers here in Wales. We've made sure it's available to people who are discharged from prison with absolutely no possessions at all. I wish there wasn't a need for a discretionary assistance fund. I wish that the social security system provided people with enough to be able to meet their needs without this final safety net of the welfare state. But while it is needed, here in Wales we go on investing in it and making sure that those whose needs are the very toughest in our society have somewhere in Wales that they can go.
First Minister, Wales was the only UK nation to see a rise in child poverty in 2017-18. And of course, poverty is considered a contributory factor to children ending up in care. Last week, Cardiff University published the results of a survey of school students aged 11 to 16. They show: that young people in residential care had the lowest mental well-being score; that 56 per cent are being exposed to bullying; that more than a third had been badly affected by alcohol in the past 30 days; and that nearly a third had used cannabis in the last month. Your Government seems to be failing our most vulnerable young people: children in care. So, what responsibility will you take and what urgent action will you take to ensure that stronger support is provided to help improve the lives of our children in our care system?
Llywydd, it takes an extraordinary ability to distort the facts to provide a question of that sort. Because of the decisions of the Member's Government in Westminster, the Institute of Fiscal Studies—[Interruption.] I see that the minute you're provided with some real facts, the opposition thinks that the answer is to muddy the waters by muttering. The Institute of Fiscal Studies tells us that, because of the actions of Conservative Governments since 2010, there will be 50,000 more children in poverty in Wales in 2020 than there were in 2010.
Are you not ashamed? Are you not really and deeply ashamed of the fact that the direct result of cuts in benefits to families living on the breadline by your Government produces 50,000 children, who have only one childhood to live, having to live that childhood in Wales in poverty? If you are a child in Wales being brought up in a single-parent family, the direct results of the decisions that your Government has made mean that that family has £3,720 less to manage on, to provide for that child, to give that child the future that that child deserves. That's the truth of the matter behind the question that the Member raises.
I wish there were fewer children in care in Wales. I want to work with local authorities to do everything we can to reduce the number of children who have to be taken away from their families. But is it any wonder that families struggle and cannot do what they want to do for their children, when every single week they have tens and tens of fewer pounds to manage with, because of the actions that the Conservative Government in Westminster have deliberately and callously taken?
The First Minister is, of course, right to point out that many of the levers for tackling child poverty do, at present, reside with the Westminster Government, and I was pleased to hear what he had to say about the discretionary assistance fund in his response to Mike Hedges. But I wonder if the First Minister will agree with me that the most effective way to deal with children growing up in poverty is to put money into their parents'—particularly their mothers'—pockets. I take that from what he's just said to Janet Finch-Saunders.
I wonder if he'd agree with me that, now we do face another five years of a Boris Johnson-led Government, we cannot expect—[Interruption.] Well, I'm very glad that Janet Finch-Saunders thinks that's a good idea, because I can tell you that the single mothers in the region that I represent would not, on the whole, agree with her. But given that that is the case, Llywydd, I wonder if the First Minister would agree with me that now is the time to look at making urgent progress on what we can do to seek further devolution of the benefits system to Wales, so that we can use our discretion. We have the evidence that suggests that devolution of the benefits system could, in fact, take pressure off the Welsh budget for some of the reasons that he's just described in his response to Janet Finch-Saunders.
So, I wonder if he would be prepared to commit today to looking to make urgent progress in seeking to devolve some of those key levers that currently do not rest in the hands of this place, so that we can put money into parents'—particularly mothers'—pockets and lift some more of our children out of poverty. Because we certainly can't, as he's just said himself, rely on the other end of the M4 corridor to do that for us.
I thank the Member for that question. I agree with the first point she makes that putting money into the pockets of people who live in poverty is the best answer to the poverty that they experience. It's why there's £90 million extra in our draft budget for families living in those circumstances, on top of all the things that this Government already does: from the council tax reduction scheme, through to Families First and Flying Start.
I've always, myself, Llywydd, made a distinction between the administration of the benefit system and the devolution of it. I believe that the benefit system ought to be part of a glue that holds the United Kingdom together and that it's a way in which the better off make their contributions so that the less well off are able to enjoy the chances that they themselves have been fortunate enough to have in their lives.
The administration of the benefit system has been the subject of work in the Equality, Local Government and Communities Committee. We have commissioned work from the Wales Centre for Public Policy. And, given the fact of another five years of a Conservative Government, I agree that working on that agenda has a new urgency.
Questions now from the party leaders. Leader of the opposition, Paul Davies.
First Minister, your party colleague and MP for Wigan, Lisa Nandy, made it clear that she believes that people in north Wales do not feel that devolution is working for them. First Minister, is she right?
Well, Llywydd, I had the advantage of the Member in being in the room when that question was answered. Had he wished to be there, we would no doubt have found a ticket for him, provided he was willing to pay for it.
What Lisa Nandy, the MP for Wigan, was saying was this: that people throughout the United Kingdom, when they live at a geographical distance from where decisions are made, can feel disconnected from that decision. She was pointing to people who live in Wigan compared to decisions made in London, and she was saying that people who live in other parts of Wales can feel disconnected from decisions made here. And I don't disagree with her; I think geography does matter. I think when people live further away from decisions, it's harder for them to feel connected to them. I think that is true anywhere in the United Kingdom, and anywhere where distance is at play. And in that leadership hustings, I was very encouraged to hear a whole range of ideas as to how we can reconnect citizens with the important decisions that are made in their lives—ideas we can use here in Wales; ideas that Governments elsewhere in the United Kingdom should also be attending to.
Well, Lisa Nandy might think that devolution isn't working, First Minister, but we all know that it's not devolution that's the problem, it's the party running the Welsh Government that's the real problem, and that's why we need change. Now, First Minister, the people of north Wales feel rightly let down by your Government and frustrated at the lack of progress being made to tackle the issues that matter most to them, particularly when it comes to health services. It should be a great source of embarrassment and concern that Betsi Cadwaladr University Health Board is the worst-performing health board when it comes to accident and emergency waiting times, with just 66.8 per cent of patients being seen within the critical four-hour period.
Indeed, Dr Mark Payne, the clinical director of Betsi Cadwaladr University Health Board, told staff in an e-mail that 20 January was the worst start to a day he had seen in 13 years working at Ysbyty Gwynedd. First Minister, do you accept that the A&E waiting times at Betsi Cadwaladr University Health Board are a cause for concern? And can you tell us what urgent action your Government is now taking to turn around this poor performance, given that you are directly in charge of this health board?
Well, Llywydd, accident and emergency departments across the United Kingdom have been under pressure over this winter, and Betsi Cadwaladr performs a great deal better than many A&E departments under the control of his party across the border in England—[Interruption.] I know they don't like it when you tell them the facts of the matter, but that is the fact. You quote Betsi Cadwaladr's figures to me as though there was a direct connection between a political party and those results. If that's the case, how come where his party is in charge results are far worse in many places?
The system is under pressure; it's under pressure everywhere. Things in Betsi Cadwaladr have been resilient over this winter to those pressures. There are days when the pressures are greater than they have ever been, and that is true in Betsi Cadwaladr as in other parts of the country. What I think is remarkable is the resilience of the staff to that; the resilience of those staff to the criticisms that they constantly hear from his party. But they go on providing that service to patients across north Wales in accident and emergency departments, in elective care, in primary care and in the work of the ambulance service. Yes, the pressures are real; the response to them is real as well.
I know, First Minister, that you don't want to talk about your own failures, but you are directly responsible for running the health service in north Wales, and clearly, you are failing to do so. Now, last week, you said that we want a culture in the NHS in Wales where, when things go wrong, people feel empowered to speak up. But yet, whenever anyone raises an issue or scrutinises your record, like today, you tell us we're dragging the NHS through the mud. And let me remind you of the recent 'Psychological Therapies Review in North Wales' report that showed significant unwarranted variation in provision, access, teamworking practices and culture amongst the multidisciplinary workforce at all levels; unacceptably long waits in some areas; and a lack of strategic clarity and oversight at health board and divisional levels. It really doesn't get any more damning than that, First Minister.
Now, we know that Betsi Cadwaladr University Health Board is set to post a deficit of £35 million in this financial year. That is £10 million above the target set by your own Government, and that's in spite of almost £83 million that has already been spent on intervention and improvement support. First Minister, given that the health board has been in special measures since June 2015 and is under your direct control, how exactly now will you turn around the unacceptably high waiting times for A&E services in north Wales? How will you address the lack of improvement in mental health following the serious failings identified in the psychological therapies review? And what urgent action will you now take to address the current leadership and the ongoing special measures arrangements to actually deliver the service improvements that the people of north Wales actually deserve?
Llywydd, I'm aware of the psychological therapies report, because it was a report commissioned by the health board. When I said last week that I want a culture in the NHS where people feel willing to speak out and are willing to talk openly about the challenges they face, organising that report by the board itself is an example of what I was talking about. It is the board itself recognising that there is a challenge, it is the board commissioning a report, it is the board learning from its staff about things that need to be better for the future. And I think that is a good sign of the board being willing to work with its staff to learn from them and to find a plan to make improvements, alongside other improvements in mental health.
The Member paid not a moment's heed to the work that has gone on in Betsi Cadwaladr to improve mental health services, which have been improved in many different aspects. Psychological therapies is one aspect. You choose one aspect and you've never got a good word to say for it when there was an opportunity for you to do so, when you could have recognised the work that has gone on by clinicians to improve aspects of mental health services. You've never got a generous word to say about everything they do and everything that is done for patients. And Llywydd, I will give patients in north Wales this assurance: whereas his party continuously criticises us for providing the funding to that health board to go on providing services to patients in north Wales, while we expect and while we work with the health board to bear down on the deficit that it has run up, and while we are disappointed that it hasn't been able to make all the progress we wanted to see made this year, this Government always steps in to make sure that the impact of that is not felt by patients; that they are not disadvantaged by that. We find the money—we find the money from within our budget here. We will do it again this year, and that is a symbol of our determination to go on providing a service for patients in north Wales.
The Leader of Plaid Cymru, Adam Price.
Who is responsible for making the accident and emergency service at the Royal Glamorgan Hospital unsafe?
Services at the Royal Glamorgan Hospital are the responsibility of the local health board, and it is the local health board that is taking action with its local population, with those people who represent people in that locality— [Interruption.]
Darren Millar, I'm sorry to name you, but you seem to be the most vocal person in this Chamber this afternoon. Please allow the First Minister to respond to Plaid Cymru. I did allow you to carry on with your vocalisation during questions by your own leader, but I won't allow it to carry on during questions from another party's leader. Adam Price—sorry, the First Minister was answering.
I'll finish the sentence, Llywydd. The health board is responsible for those services. It must work with its local politicians, its local population and its local clinicians to make a plan for that service for the future.
The health Minister's responsibilities are listed on your own Government's website as having 'oversight of NHS delivery and performance'. Therefore, there can be no doubt as to who is responsible for allowing the situation at the Royal Glamorgan Hospital to deteriorate. Staffing levels at all three of Cwm Taf Morgannwg's A&E units are well below UK-wide standards. The UK average is 7,000 people to every one consultant—it's 15,000 to one in Cwm Taf Morgannwg health board.
The Royal College of Emergency Medicine recommends that a hospital about the size of the Royal Glamorgan should have around 10 consultants. Why have you allowed it to get to this stage? During the recent general election, Labour's shadow health Secretary, Jonathan Ashworth, highlighted the 'extreme' and 'catastrophic' risk as a result of losing some 24-hour services in the north-east of England. His answer:
'We pledge that within the first 100 days of a Labour Government we will get on top of this.'
You've been in charge in Wales not for 100 days, but for 20 years. Where have you been?
Llywydd, the figures that the Member quoted at the start of his supplementary question are entirely wrong. He's dividing the wrong thing by the wrong thing. In a way, it's not the issue, but I think he ought to look carefully, so that when he does quote figures he tries to get them accurate, because he is very inaccurate in what he has said.
The real issue, though, is this: the Welsh Government funds the national health service at record levels, we have more consultants working in the national health service in Wales than ever before, we have more A&E consultants working in the health service than ever before and we have a pipeline of A&E consultants of the future being produced in the Welsh NHS with the training systems that we have. Right across the United Kingdom, there is a shortage of consultants to work in accident and emergency departments. The Welsh Government works every day to try to put that right here in Wales.
In creating the NHS in 1948, Aneurin Bevan won an argument around the Cabinet table, against the likes of Herbert Morrison, that regional boards within the NHS had to be accountable to, and working under the direction of, a health Minister, otherwise it would not be a national health service, hence the famous apocryphal quote about dropped bedpans in Tredegar reverberating around the corridors of Whitehall.
Your argument yesterday that the decision as to whether to downgrade A&E services at the Royal Glamorgan Hospital is primarily a matter for clinicians not politicians is against the founding principles of the NHS, it's against the founding principles of this Senedd and it's even against the core values of your own party, which is why so many of your own Members are joining with Plaid Cymru and others in ignoring your advice to protest against these changes. Aren't the people of the Rhondda, the central Valleys and, indeed, the rest of Wales entitled to expect a First Minister who will intervene on their behalf, instead of simply saying, 'Nothing to do with me'?
Well, the people of the Rhondda and the people who use the Royal Glamorgan Hospital are absolutely entitled to make sure that their views are known; that, through their local representatives, they engage with the health board and they make sure that the health board provides them with information; and that they feed ideas to the health board. Of course they are right to have that engaged relationship with the decision making.
The point I made yesterday, and I make it again this afternoon, is that when a decision has to be made as to whether a service is safe, whether it is of the right quality and whether it is sustainable into the future, then the right people to ask about that when the decision comes to be made, not while the decision is in preparation, are the people who are experts in the service that is being provided. I think that is a really important principle—that if you want to know whether a cardiac service is safe and sustainable, then you'd be better off getting your advice from people who are experts in cardiac surgery.
Leader of the Brexit Party, Mark Reckless.
Now we have left the EU, could I ask you, First Minister, about how the Welsh Government should be consulted on future trade agreements and what your priorities are? Of course, if the UK Government had listened to you before, when you said tariffs would devastate the UK car industry by causing it to relocate to the EU, they might be surprised by this week's news. Groupe PSA, who make Peugeot, Citroën and Vauxhall marks, said they would respond to tariffs within the EU by stepping up the company's presence in the UK at Ellesmere Port, where, of course, many in north-east Wales work. Meanwhile, Nissan plan to shut EU plants and relocate production to the UK, aiming to quintuple their share of the market from 4 per cent to 20 per cent, displacing EU imports. Despite this, are you as First Minister saying that the UK Government should have to agree its trade policy with you—in effect, a veto?
Llywydd, we left the European Union on Friday of last week. I think it's a little early by Tuesday of this week to have already decided what its impacts will be, particularly as there are no tariffs and there are no non-tariff barriers at the moment, because we are still in the transition period. So, I think he will have to let a little more time go before he can tell whether his rosy view of the future will turn out to be delivered.
My view of the right relationship between the UK Government and devolved administrations across the United Kingdom is that, when the UK Government comes to frame its negotiating mandate and its negotiating position with other countries, whether that is the EU or with other, third countries, the UK Government's hand would be strengthened if it was able to say to those who it is negotiating with that what it says represents not just the views of the UK Government, but of other Governments across the United Kingdom, and that therefore structures should be put in place to allow that to be attempted, and that the attempt should be made honestly and genuinely by all parties concerned. I think that will be right for Wales; I think it'll be right for the United Kingdom as well.
Thank you. Of course, it's not me who's saying these things, but the car companies, as reported in the Financial Times. But it should not be a surprise that, when the EU sells £265 billion-worth of goods to us and we only sell £170 billion-worth of goods to them, if you make trade more expensive through tariffs, that production would relocate on a net basis from the EU to the UK in light of those tariffs. I would prefer to see free trade and I would also support, I think, broadly what the First Minister has just said; I think there had been suggestions before of UK Government having to agree its approach, but to the extent the First Minister was just talking about—consultation—I support him in that, and agree that the UK Government's hand would be strengthened if there was wide support for its negotiating stance.
I would, however, caution the First Minister against assuming he'd have support in Wales for confronting the UK Government on this issue. We're reminded today that support for abolishing this place is greater than support for independence, yet your Minister, Ken Skates, has just written to Members of Parliament to tell them to change rail devolution—and I quote—to
'address...concerns being raised by the growing independence movements in both Scotland and Wales.'
First Minister, surely it's preposterous to pressurise the UK Government as if you're Cardiff's Nicola Sturgeon.
Well, Llywydd, I have no policy of confrontation with the UK Government, or with the Scottish or with the Northern Irish Governments either. The Welsh Government comes to the door in all the discussions that we have looking to be a positive contributing member of those inter-governmental discussions. Where I differ from him, however, is this: when our interests are different to those of the UK Government, of course, we will always speak up for them and nothing will stop us from making sure that, when we think that something is in the interests of Wales, whether that is in car manufacturing, whether that is in the way that rail funding is organised across the United Kingdom, then we will do our job. We will stand up to that responsibility and we will never leave them in any doubt—not because we are looking for confrontation, but because we have a job of work to do that means that this Senedd is here to represent people's views in Wales, and we must do that without fear of any contradiction by others.
3. How is the Welsh Government supporting the regeneration of towns in Wales? OAQ55028
I thank the Member for that. The Deputy Minister for Housing and Local Government's transforming towns announcement last week set out the significant investment the Welsh Government makes in supporting the regeneration of towns across Wales. We now intend to adopt and promote a town-centre-first approach to new developments.
Thank you for your answer, First Minister. I was really pleased to hear about the package of measures brought together under the transforming towns agenda, and they show, I believe, the Welsh Government's commitment to towns like Mountain Ash and Aberdare in my constituency.
Now, with my interest in a vacant land tax, it will come as no surprise to you that I particularly welcome the additional £13.6 million funding to tackle empty and dilapidated buildings and land. Can the First Minister say a little more about this, especially in the context of the recent consultation on compulsory purchase orders, which will give local authorities enhanced powers to drive this forward and to tackle urban blight?
I thank Vikki Howells for that. I thank her for her recognition of the transforming towns package and the way that it will reach into towns in her constituency. The Member's interest in vacant land tax is well known, having led debates on it here on the floor of the Assembly.
Llywydd, my view is that most empty properties and undeveloped sites in Wales can be remedied by agreed actions between owners, developers and public authorities. That's why we're putting £10 million into bringing empty homes in Wales back into beneficial use; that's why our £40 million stalled sites fund works with developers and owners to be able to invest in those sites so that they have a new commercial value. But, right across Wales, we have buildings that stand stubbornly empty, where their owners have often disappeared, where attempts by public authorities to reach out to them so that the blight caused by those empty properties can be remedied have no answer. That's why we have a £13.6 million fund to tackle empty and dilapidated buildings and lands, and that's why we need strengthened compulsory purchase orders to give local authorities the power they need when persuasion has broken down, when all the efforts that public authorities make to try to bring about improvement on an agreed basis—where those buildings and those empty pieces of land cause a blight on communities, prevent the regeneration of town centres, public authorities need the money we are giving them and the powers that we will supply to them to take decisive action.
A vital step towards regenerating town centres has to be taking firm action to deal with the terrible plight of homelessness that causes so much great suffering to vulnerable people and has a very visible impact on town centres and city centres. Now, new figures on homelessness released by the Welsh Government today do show an increase in rough-sleeping. I know it's only a snapshot, but they do suggest an increase of around 20 per cent for a two-week period in October 2019 compared with the previous year, and I note that Newport and Caerphilly fare particularly badly.
Now, First Minister, the answer isn't criminalising vulnerable homeless people, surely, and taking away their meagre possessions, as some councils are doing, but surely the answer is properly funding homelessness services and implementing robust action plans, such as the one put forward by the Crisis organisation. So, could you tell me, please, what steps your Government will be taking to deal with this increasingly desperate problem of homelessness on Welsh streets?
Well, I thank the Member for that question. I completely agree with her, of course, that criminalisation is not the answer to homelessness and rough-sleeping. I thank the Member, as well, for drawing attention to the figures published today. Some Members here will remember the debate we had last year when the figures went down, when there was a general feeling, from people's lived experience of seeing a rise in street homelessness, that it was hard to square a falling figure with what we are seeing. And, as a result of the discussions we had here, the methodology for this year has been revised and improved, and I think you can see some of that in the figures that were published today. They show, as ever, a mixed picture: five local authorities showing falls in the number of rough-sleepers, including Gwynedd, Wrexham and Cardiff, with significant falls, and then rises in other parts of Wales as well.
The Welsh Government is investing record sums in responding to homelessness. We have new ways in which we are trying to respond to rough-sleeping through the Housing First initiative, which is already helping over 60 people over this winter to go directly into accommodation. We do it in the teeth of the gale of austerity, which is the underlying cause of people losing their homes, losing their livelihoods, and finding themselves in this desperate situation. We will use the figures published today to work with our colleagues in local authorities, in the third sector, to see what more can be done, using the report that was commissioned by Julie James for this winter, chaired by the chief executive of Crisis, so we can learn lessons from elsewhere as well.
4. What is the Welsh Government doing to train and recruit medical consultants for hospitals? OAQ55057
I thank the Member for that question, Llywydd. Through additional investment in our workforce, health boards and trusts in Wales employ more NHS consultants than at any time previously. The overall hospital consultant workforce has grown by more than 10 per cent over the last five years.
We all know about the consultants shortage, but the local ratio locally of 15,000 people to one consultant is more than twice as bad as the UK average of 7,000, and, First Minister, those figures are not wrong, because those figures were being quoted just last night in a public meeting by health board officials. This gets to the very heart of the question at the Royal Glamorgan Hospital, which looks set to lose 24-hour consultant-led services. So, at a packed meeting that Plaid Cymru organised in Porth last night, the anger and frustration from people were palpable. False assurances have been given in the past about hospital services. Just eight months ago, in June of last year, I asked you to give guarantees about the future of A&E at the Royal Glamorgan Hospital and the recruitment of unfilled posts, and, in reply to me, you said, and I quote,
'where people move on, and people do get new jobs and go further in their careers, those posts will be replaced. They will be replaced, we hope, by substantive posts, and a number of expressions of interest for vacancies at the Royal Glamorgan have already been received and are being considered by the health board. If we have to fill those posts on a temporary basis by locum appointments, then that's what we will do. That is the future for that emergency department, and I'm very glad to have had the opportunity to put that on the record here this afternoon.'
Can you, First Minister, tell the people in the Rhondda what has changed since last June? Can you tell me why you were prepared to give those assurances then, but you're now advising local politicians to stay out of the discussion about the future of the Royal Glamorgan's A&E department?
Well, Llywydd, let me repeat what I said earlier: my advice to local politicians is that they should play an active and engaged part in the debate that will now be carried out by the local health board. I know my colleague Mick Antoniw and others have been holding meetings with their constituents, and that is exactly the role that local politicians should play—making sure that the views, the possibilities, that people might be able to contribute to the discussion, that all of that is well known and properly debated.
When I spoke in June of last year, I said what I said because it was the position at the time that the local health board were attempting to recruit substantively to vacancies; if they weren't able to recruit substantively, that they would aim to recruit locum consultants in their place. That is what the health board was doing then; it's what the health board has done in the interim. There comes a point when local clinicians believe that continuing the current service is not viable, would not be safe for patients, and they wanted to discuss alternatives with their local population. I hope that the health board will take every step to make sure that it engages directly with local representatives and local patients as part of that. But, given that that is the conclusion they have reached, they are surely right to have that conversation.
The Member for Rhondda rightly raises the amount of, or numbers of, patients that each consultant has to deal with, but, of course, another issue is about the spread of consultants across specialisms. If we're looking to be effective in outcomes and effective in the deployment of money, one of the things we must ensure is that, when a patient comes into hospital, they do not then submit to the revolving-door syndrome, where they leave because something is fixed, but actually, they had a number of things wrong with them, a number of conditions, or a mental health issue, and then, just a month later, or a few months later, they are readmitted again under a different consultant. This is partly driven by the fact that so many consultants are very specialism driven.
First Minister, can you please tell me what HEIW might be doing to ensure that we look at patients in a more holistic way, by employing more general medical consultants in hospital and more orthogeriatricians, for example? Elderly people, they go in because they've broken a hip, but they actually then develop pneumonia, or they have mental health issues, or dementia that's not picked up—bang, they're back in again. It doesn't help the NHS; it doesn't help the person to stay at home. If, while we had them there, we dealt with them in an effective way instead of just focusing on one issue, I believe that we could transform some elements of our services within hospitals. I'd be interested to hear your opinion.
Thank you. Llywydd, I had hoped not to take time up putting this on the record, but it's the third time these figures have been mentioned, so I feel that I must. The ratio of consultants to patients in England is derived by dividing the number of people attending major accident and emergency departments by the number of consultants. The figure quoted for Wales is derived by dividing the number of consultants into the people who attend all accident and emergency departments and minor injury units as well, and given that thousands and thousands of people attend minor injury units it is no surprise that, if you divide consultants into a different sort of total, you come up with a different sort of result.
So, I didn't want to have to go into all of that, but that's why I said in answer to Adam Price that the figure he quoted was not to be relied upon, because it is comparing apples and pears. As I said, it wasn't for me the central point of what he said, but given that it's been twice repeated since, I just want to make sure that people understand the basis of the figures that have been quoted and why they're not a reliable comparison in any way.
To the substantive point that Angela Burns makes, which I think is a very important one, when I was the health Minister, I worked with UK health Ministers on a report that the UK Minister had commissioned from the vice-chancellor of Sheffield university, as I recall, which proposed a new cadre of generalist consultants working with older people. Now, in many parts of what the health service does, the trend over the last 20 years to have ever greater sub-speciality is in the interest of patients. If you are going for an orthopaedic operation, you'd rather have it from somebody who is a specialist in the particular procedure rather than somebody who has a go at everything.
But when it comes to older people, in the way that Angela Burns said, people present with a whole variety of different conditions that have an impact upon one another, and what you don't want, I believe, is that patient being handed from one slice of speciality to another. You need a doctor trained as part of that new cadre of generalists.
I think the truth is that that effort—which I say her Government had a leading hand in generating—didn't make the traction that we had hoped, and that's largely because the thrust of general colleges is in the opposite direction. We have to do more to persuade the profession as well that the nature of medicine for older people needs a different sort of response than the one that has been the dominant trend for nearly 20 years.
5. Will the First Minister provide an update on the delivery of the integrated care fund? OAQ55058
I thank the Member for that. Across the whole of Wales, the £124 million integrated care fund brings together health, social care and housing services, supports multi-disciplinary working, focuses on innovation, prevention and early intervention, and helps people live their lives in their own way.
Thank you, First Minister. The investment in the integrated care fund and the progress it has delivered, I believe, is a key part of the whole-system approach that Wales needs to meet the demands on hospital and care services. I've seen examples in my own constituency of the fund supporting a more seamless transition between health and care and breaking down some of the barriers that can be a burden both for patients and their families. But as the annual report for 2018-19 makes clear, the lessons that arise and the best practice being delivered must be adopted at pace. So, what further actions can your Government take to ensure the lessons from the integrated care fund are delivered across a wider range of services?
I thank the Member for that question. Thank you for the recognition of the work that the integrated care fund has done in the Member's own constituency. I'm sure that she is familiar with the stay well at home service that operates in Merthyr and the work that is being done in the Rhymney valley, through the fund, to improve services for people with learning disabilities.
There is a range of things, Llywydd, that the Welsh Government does to make sure that the lessons of the fund are spread across Wales. We have strengthened the membership of the regional partnership boards in the last year by making sure that housing is directly represented on the board, because so many of the lessons are lessons that are best implemented in collaboration with housing services. We hold an annual event where people from across Wales come together to make sure they share the learning from the fund over the previous 12 months and, as it happens, that annual event will happen on Wednesday of next week.
And we retain a small amount of the integrated care fund revenue funding every year to promote nationally those projects that have been most outstandingly successful at a local level, and where we are sure that that idea, that new initiative deserves to be delivered right across Wales.
First Minister, last year, I note that the Wales Audit Office found that the impact of the integrated care fund in improving outcomes for service users remained unclear and there was little evidence of successful projects being mainstreamed into core budgets. So, can I ask how has the Welsh Government implemented the recommendations that the Wales Audit Office made, and what work has been done to align specifically the use of integrated care fund capital and revenue funding to provide packages of care that will improve outcomes for service users?
Well, Llywydd, I think that that is a slightly selective reading of the WAO report that had many positive things to say about the fund and the impact that it has had across Wales. Of course it provides recommendations on how things can be done better, and we take that seriously. We wish we had a three-year budget from the UK Government so that we could provide the sort of certainty to service providers on the ground that the WAO report proposed to us.
On the specific issue of aligning the capital and revenue purposes of the fund, just to give the Member one example: in the Gwent area, the capital funding is being used to provide a new five-bedded respite home for children with profound physical and mental health needs. It's doing that because the basis of the fund has been broadened in recent years. As those Members who were part of setting it up will remember, it began very specifically as an initiative to prevent older people being admitted to hospital or to accelerate their discharge. We now use it for a wider range of purposes, including the needs of children with very severe health needs.
6. Will the First Minister make a statement on accident and emergency provision in South Wales Central? OAQ55023
I thank the Member for that. Accident and emergency departments across the United Kingdom, including in South Wales Central, have seen significant increases in demand over this winter season. While the system remains busy, it continues to respond every day to the needs of patients.
I appreciate that you've answered this question on several occasions so far this afternoon, but you can appreciate this is the major issue in my region at the moment: the provision of accident and emergency at the Royal Glamorgan Hospital.
Last week, in the topical question that was put to the health Minister, I made the point that strategic direction for the health service here in Wales is in the hands of the Welsh Government and the health Minister; day-to-day running is the health board, in this particular instance, Cwm Taf. You could stop the closure of A&E provision at Royal Glamorgan Hospital and instruct that health board to have a long-term plan to sustain the services there. The reason consultants haven't gone into the Royal Glamorgan Hospital is because it has had a closure notice over it since the south Wales programme was instigated back in 2014.
Will you now not live up to your responsibility as a Welsh Government and take hold of this situation? Because the strategic importance here is to maintain accident and emergency provision at the Royal Glamorgan Hospital. Or will you turn your back on the people who rely on that provision in that hospital and say 'no' and allow that provision to be taken away, against the wishes of your colleagues on your back bench and colleagues across this Chamber who've campaigned vigorously with local communities to maintain that service?
Well, Llywydd, I'm happy to answer another question on this matter, and I'll try and extract the serious point that I think was there in the Member's question. The strategic direction that the Welsh Government provides to the health service in Wales is that the services that are provided must be safe, they must be of a sufficient quality, and they must be sustainable.
I agree with the Member's point that the south Wales programme has provided the surrounding context for services at the Royal Glamorgan, and I agree, if this was the point that he was making, that when the local health board come to consider the future of those services at the Royal Glamorgan they need to revisit the context six years on from the south Wales programme, to make sure that the decisions are being made with the most up-to-date information that is available to them.
But people on the ground closest to those services, expert in the clinical work that an accident and emergency department has to carry out, have to be the people who, in the end, make decisions based on the strategic direction that the Government sets for them—and that is that those services must be safe, they must be sustainable, and they must be of sufficient quality. And I hope that we will listen to what the clinicians say to us on all of that, once they have been informed by all the views that local Members from all sides of this Chamber convey to the board on behalf of the populations they represent.
First Minister, it is a fact that there is a national shortage of A&E consultants across England and Wales, but it is my very firm belief that, in such challenging circumstances, health boards—and in particular, Cwm Taf Morgannwg University Health Board—must approach recruitment strategically if they are to be successful. For example, advertising for permanent not temporary positions, and drawing up contracts that mean that consultants are not tied to one hospital, but can be contractually obliged to move between two or more sites to help meet changing demands. Do you, First Minister, agree with me on that?
Llywydd, I do agree with the final point that the Member has made that we need to look at the contract. I hope that the British Medical Association will be willing to enter into discussions and negotiations with the Welsh Government about the hospital consultant contract here in Wales to see if there are new flexibilities that can be negotiated with the workforce. This is a workforce who are organised, who have unions who speak on their behalf, who have a contract that people have signed up to. I agree with what Vikki Howells has said, that the contract could do to be revisited, that we could do to have those discussions with the BMA about new flexibilities, and I hope that they will be willing to come to the table to conduct those negotiations.
First Minister, the Royal Glamorgan Hospital is in my constituency. In the Taff Ely area, there has been massive housing expansion and, over the course of the next decade or so, there is likely to be in the region of an extra 20,000 new homes. The demography has changed very significantly since the original south Wales programme. Do you agree with me that any clinical review of the provision of accident and emergency should take account of such significant demographic changes?
I thank the Member for that, and I echo the answer I gave earlier in this question, that in making decisions six years on from the south Wales programme it is important that those decisions are made in the most up-to-date set of understandings about the current context. Things will have changed in those six years, demographic trends will have changed, house building will have changed. I expect the health board to take account of all of those things as it makes decisions, so that its decisions are made, exactly as Mick Antoniw has said, in the light of contemporary circumstances.
7. What discussions has the First Minister had regarding Wales's constitutional status within the United Kingdom? OAQ55041
I thank the Member for that. I've had a number of discussions on strengthening the United Kingdom, and Wales's place within it. Respecting devolution, as supported by the people of Wales in successive referendums, is fundamental to ensuring the continuation of the union.
Is it not clear from the questions we've had today, from all parts of the House, that devolution over the last 20 years of Labour Government has comprehensively failed, and that this is a message that has percolated through to the Welsh people, because there's been a substantial increase in support in the latest YouGov poll, both for full independence on the one hand, and also, for abolishing the Assembly on the other?
Over 20 years, we've seen Wales sink to the bottom of the heap in terms of income in the United Kingdom amongst the home nations; we've heard the litany of failures in the NHS, which the First Minister is keen to ascribe to the United Kingdom Government, which has no responsibility for the day-to-day running of the health service. But it does give him a convenient opportunity to pass the buck, and therefore, avoid taking responsibility. The education system—we're consistently at the bottom of the Programme for International Student Assessment league tables.
He was a keen advocate of the people's vote during the referendum campaign on the EU, and we had to wait 40 years for a referendum after 1975 to reconsider the decision of the British people then. Is it not now time, after 20 years of devolution in Wales, for the Welsh people to give us their views on whether he has succeeded or failed?
Well, Llywydd, the Member comes amongst us, as ever, in his prophet-of-doom personality. I disagree with him completely on most things that he has said. I've lost count of the number of times that he has shrilly urged me to respect the results of a referendum; I suggest to him that he might want to do the same thing.
Finally, question 8, Delyth Jewell.
8. What action is the Welsh Government taking to ensure adequate provision of GP services in South Wales East? OAQ55063
I thank the Member. Primary care services in South Wales East, as elsewhere, are provided by multidisciplinary clinical teams, brought together in clusters to develop and diversify services for local populations.
Thank you, First Minister. I am concerned at the potential closure of a number of surgeries within my region. Last week, I wrote to the health board to ask for assurance that Lansbury Park and Penyrheol surgeries will be kept open, following the news that the GP there is to retire with no replacement yet appointed, and I'm awaiting a response. I'm worried, however, about the general picture for surgeries in the south east, given that the British Medical Association's GP practice heat map suggests around 32 surgeries may be at risk in the Aneurin Bevan health board region. And a recent survey they conducted found that 82 per cent of GPs in Wales were worried about the sustainability of their practices. Now, BMA Cymru says the root of the problem is due to underinvestment combined with a growing workload for GPs, and they call for a plan from the Welsh Government to train more GPs in Wales, which is a policy Plaid Cymru has long been advocating for.
So, could you tell me, First Minister, what assessment you would make of the situation in terms of GP training and recruitment in the south-east region, and what action your Government will be taking to ensure adequate provision and recruitment of practitioners for the future?
I thank the Member for that. Llywydd, I'm aware of the developments at the Lansbury Park surgery, and grateful to my colleague, Hefin David, for reporting to me on the meeting he held last week with representatives of the Aneurin Bevan health board on that matter. So, I'm aware of the steps that the health board are taking to advertise for that vacancy, both locally and nationally, and their intention to fill that vacancy.
I agree with the Member on the importance of training places for GPs here in Wales, and she will be glad, I know, to learn that there was a 50 per cent increase in the number of GP training places in Gwent last year, going from 16 to 24 places, providing the foundation for the GP leaders in the Gwent area in the future.
But, primary care services are more than GPs, and the clusters in Caerphilly, the three clusters in Caerphilly, I think, are very good examples of developments that draw in that wider range of primary care clinicians, who are able to provide face-to-face and direct services. So, the first-contact physiotherapy service that is available through the Caerphilly clusters means that a patient with a musculoskeletal condition doesn't have to wait to see a doctor in Caerphilly, they can go direct to the physiotherapist, who will provide them with the right clinical advice. And I think that's a very good example of how we can best sustain primary care services in Wales for the future.
Thank you, First Minister.
The next item would have been questions to the Counsel General, but no questions were tabled this week.
Therefore, the next item is the business statement and announcement. I call on the Trefnydd to make the statement. Rebecca Evans.
There are two changes to this week's business. As no questions were tabled for answer by the Counsel General this week, I've amended today's agenda accordingly. Additionally, the External Affairs and Additional Legislation Committee's debate has been withdrawn from tomorrow's agenda. Draft business for the next three weeks is set out on the business statement and announcement, which can be found amongst the meeting papers, available to Members electronically.
Trefnydd, can I call for two statements today—the first from the Minister for Health and Social Services, in relation to the NHS redress system? I'm having increasing problems getting responses, in a timely fashion, to concerns that I'm raising on behalf of my constituents in north Wales, with the Betsi Cadwaladr University Health Board. I've got a very tragic case at the moment, of a woman who, unfortunately, passed away last year. Concerns were raised with the health board in July, and I'm still waiting for a substantive response. I think we'd all agree that it's not satisfactory for a family to have to wait that long for a substantive reply. And I know that that's not the ambition that this Government has in terms of the way that these sorts of things are dealt with. And I think it would be useful to understand how the Welsh Government makes sure that the redress system is working effectively for patients across north Wales, and indeed the whole of the country. And I'm sure that there are some performance indicators that might be usefully applied.
Can I also call for a statement from the Minister for Economy and Transport on the railway network safety system? You will know that Network Rail have a programme to eliminate level crossings across the whole of the United Kingdom. And, unfortunately, we've got level crossings here in Wales, some of which are very, very dangerous. There was a tragedy in my own constituency last year, where a teacher—Stephanie Brettle, from Ysgol Emrys ap Iwan, my former school—was unfortunately killed when she was hit by a train at the Ty Gwyn crossing in Tywyn, on the north Wales coast. Within just a few months of that tragic incident, another lady was killed on the same particular crossing. Now, I appreciate that the Welsh Government isn't directly responsible for the rail infrastructure, or for improving those crossings, but I do think that a Welsh rail safety fund, perhaps, could be established, in order to get a greater sense of priority for these crossings in Wales, where we know that there have been these sorts of tragic incidents. And I would welcome a statement on whatever the Welsh Government can do, in order to enhance the work of Network Rail in eliminating level crossings in Wales over a period. Thank you.
I thank Darren Millar for raising both of those issues. The health Minister was here to listen to your concerns about the delay in the response in terms of those representations that you've made on behalf of your constituent to the local health board. And, obviously, that delay is disappointing, so the health Minister has indicated that, if you write to him with the details, then he'll be certain to raise it directly with the health board on your behalf.
And I will ensure that the Minister with responsibility for transport hears your concern about the many tragic incidents that we see across the railways in Wales. I know that Network Rail have recently written to all Assembly Members on this particular issue as well. And perhaps the Minister will be able to write to all Assembly Members with an update on the discussions that he and Transport for Wales are having in that regard.
Figures have emerged from a freedom of information request that my office have submitted on school exclusion rates in Rhondda Cynon Taf. The data provided shows that, over the last two years, there has been a marked rise in the number of fixed-term exclusions. The latest available figures show a rise of nearly 60 per cent on the figures from last year. I understand that the council has now sent a report to their children and young people's scrutiny committee on this matter. But whether this matter in RCT is linked to autism, and the lack of support for pupils and parents, remains to be established, but it certainly is something that merits further investigation.
I've recently been researching the experiences of people in the Rhondda trying to access support and services for children with autism, and, it's fair to say, that parents' experiences can be summed up as frustrating, exasperating and heartbreaking. The general feeling is that pupils with autism are, by and large, being failed and it's simply not good enough. So, will the Government bring forward a statement demonstrating how you intend to improve support for people with autism, with a particular emphasis on providing what is needed to allow pupils in school who are neurodivergent to thrive, rather than what is currently happening, where so many of them are being discriminated against and are losing out?
The Deputy Presiding Officer (Ann Jones) took the Chair.
I know that the Welsh Government provides regular updates on the work that we are doing to support people with autism, including children and young people with autism, through our national autistic spectrum disorder action plan through the national service that we're currently in the process of implementing as well. But I will make sure that the Minister has heard your request for that statement and particularly with your concern about the impact that it might have on young people and children in their ability to stay in school. So, making sure that we take that joined-up approach across Government and so, also liaising with my colleague with responsibility for education to ensure that young people and children with autism get the best support in school to enable them to continue being educated at school. So, I'll ensure that an update is forthcoming to you in one way or another.
Trefnydd, I'd like to ask for two statements today. Yesterday, I held an event on children and type 1 diabetes, which the Deputy Minister came and spoke at. It was an opportunity to celebrate examples of people's strength, determination and success with type 1 diabetes. It was good to welcome so many inspiring young people to the Senedd and to spread the message that you can still thrive with the condition.
A prime example is a story from one of my own constituents from Newport, Hugo Thompson, who, with his friends, rowed across the Atlantic ocean. Hugo's got type 1 diabetes, but it didn't hold him back from becoming the first person with the condition to row 3,000 miles across the Atlantic in a race that's renowned for being one of the most challenging. But big achievements don't have to be climbing mountains or sailing oceans. Sometimes, it's about having the courage to not let anything hold you back. So, please could we have an update from the Minister on what measures the Welsh Government are taking to ensure that children with type 1 diabetes in Wales are diagnosed quickly and safely and can go on to live happy and healthy lives?
Secondly, I'd like to ask for a statement on corporate fare structures for businesses from Transport for Wales. Last month, a constituent who works for the University of South Wales, got in touch with me to explain that the workplace discount that they used to receive from Arriva Trains Wales is being reduced from 34 per cent to 5 per cent under Transport for Wales. I've spoken to Transport for Wales about this and I gather that this is an attempt to bring educational bodies into line with other businesses by standardising the discounts. While I appreciate the benefits of standardisation, the drop from 29 per cent will mean significant additional costs to staff and seems to go against our need to encourage more people on to public transport. So, please could we have a statement on how the Welsh Government and Transport for Wales plan to work with larger companies and workforces, especially those in the public sector, to ensure that train fares are as affordable as possible?
Thank you to Jayne Bryant, in the first instance, for sharing Hugo's inspirational story with us this afternoon. And I know that the Deputy Minister for Health and Social Services was able to attend yesterday evening's event to celebrate the achievement of Hugo and other young people in Wales living with type 1 diabetes—and congratulations to you and to Diabetes UK Cymru on an excellent event.
I think that we would all want to pay tribute to the achievements of young people who have had to manage a difficult condition, as well as their families and the clinical team that supports them. We are obviously committed to providing all people with diabetes in Wales the best possible care and support and we have worked very closely with the NHS and, again, with Diabetes UK Cymru on implementing the diabetes delivery plan for Wales. Diabetes UK Cymru is a key partner in that.
The second issue that you raised on transport fares is one that is primarily a matter for Transport for Wales. But having listened to your concerns, I'll ensure that Welsh Government officials liaise directly with Transport for Wales on that and provide you with a written response to the concerns that you've raised this afternoon.
Could we have a statement by the First Minister on the launch of the Welsh Government's first ever national strategy for the nation, which, of course, begs the question of why it has taken over 20 years to provide such an overarching document and why is it deemed necessary at this particular time? Perhaps the Minister could also explain why, once again, there are no timelines or signposts in this strategy, which, of course, avoids the possibility of scrutiny of missed targets. For instance, one stated aim in the strategy is to increase exports by 5 per cent, which, given the level of our exports at the present time, would indicate an increase of around £900 million. So, could the Minister also indicate how this is to be judged, given that Tata Steel and Airbus contribute so much to our export figures, over which the Welsh Government has little or no control?
Again, could the Minister explain why no timeline is given for the increase in exports? Is it one year, five years, 10 years or never? Would the Minister also comment on the extraordinary fact that there is little emphasis on manufacturing within the document, given the importance of the sector to Welsh exports? And perhaps he could explain that only one in 10 small or medium-sized enterprises are involved in exporting and yet there is no mention in this strategy of how the Government intends to either encourage or support such businesses in their exporting endeavours.
Well, the Minister with responsibility for international relations and the Welsh language consulted widely on the compilation of that international strategy, and, of course, we did have an opportunity to debate it here in the Chamber just recently. But, if you would like to write to the Minister with those very specific questions, I know that she'll be very happy to provide a response.
Minister, last week the cross-party group on suicide prevention, which I chair, had a presentation from Professor Ann John on the thematic review of deaths by suicide and probable suicide in children 2013-14. The review examines the deaths of 33 children who died by suicide and probable suicide and seeks to identify opportunities for prevention of further suicides. I've said before in this Chamber that I think the review is the closest thing we have to actually hearing the voices of those children and young people who died. I would therefore like to ask for a debate in Government time on this very important review so that all Members can give it the focus and consideration that I believe it deserves.
I'm grateful to Lynne Neagle for raising this issue this afternoon and for the way that she has championed this particularly important issue over a long period in the Assembly. And we did have the opportunity to have an excellent debate, albeit not in Government time, recently, and of course the health Minister has been here to hear that request for a debate on that particular report in future.
May I ask for a statement from the Minister for Environment, Energy and Rural Affairs about air pollution levels in Newport? The Centre for Cities research institute recently found that the deaths of 113 people in Newport in 2017 were linked to air pollution. This research follows the British Heart Foundation's announcement of a new campaign to highlight the dangers of air pollution and the warnings that hundreds more people in Wales could die from pollution-linked heart attacks and strokes in the next decade. Newport City Council says it has no plans to introduce clean air zones in the city, so can I ask for a statement from the Minister on what action she intends to take to improve air quality in Newport and in other towns and cities across Wales? Thank you.
Well, the Minister is currently leading work on the development of a clean air plan for Wales, so I know that she's heard your particular concerns about the area of Newport, but, if you were to write to the Minister with your reflections on the particular issues that you've described in the area of Newport, then I know that she'll take those into consideration throughout the development of that plan.
Trefnydd, there is significant concern in my constituency, and across the wider Valleys communities, about Cwm Taf Morgannwg health board's planned review of accident and emergency services at the Royal Glamorgan Hospital. The review is predicated on the south Wales programme document, which is now six years old. That document does not reflect today's pressures on A&E services, nor does it take account of the challenges around recruiting consultants and doctors.
Equally importantly, the south Wales programme does not take account of the huge population growth in the immediate area, nor indeed the significant increase in housing that is planned. Trefnydd, could we have an urgent debate on the future of the south Wales programme to determine whether it remains fit for purpose and to ensure that the concerns of the hundreds of constituents who have contacted me on this issue are fully explored?
I'm grateful to Mick Antoniw for raising this issue this afternoon, and I know that he did have the opportunity earlier to express his constituents' concerns directly to the First Minister. The health Minister did answer a series of questions just last week in the Chamber and he does have questions next week, and I'm sure that he'll be pleased to take further questions on this particular issue, but, again, he's been here to hear the request.
Two statements, if I may. Firstly, may I endorse the call by Leanne Wood regarding autistic children and young people? She referred to the situation in the Rhondda. I can confirm that, despite the integrated autism service, the situation in north Wales remains the same as in the Rhondda. I'm contacted, or my office is contacted, daily. The school exclusions and self-exclusions are still happening. I was contacted two weeks ago by a clinician in one of the child and adolescent mental health services in north Wales, desperately concerned about the number of cases they were encountering with exclusions from a college, a further education college, in their area, failures of safeguarding, particularly involving children and young people who'd been victims of sexual abuse and assault, and, above all, the charities that are providing the key support for autistic people and their families receiving no statutory support whatsoever. In every single case, the autistic people are being treated as the problem by public sector officials at senior levels, who have failed to establish their communication and sensory processing needs, and who continue to fight them rather than recognise that they were the cause of the barriers they encountered and they are the solution to removing them. This remains, sadly, a north and south Wales problem.
Secondly, and finally, today is World Cancer Day. The Welsh Government's current cancer delivery plan is coming to an end. I call for a statement on the progress of the next cancer delivery plan to improve cancer services and outcomes. Thanks to research, two in four people in Wales survive their cancer for 10 years or more, but we still have a long way to go. Cancer Research UK's ambition is to accelerate progress and see three in four people surviving the disease by 2034. As constituents told me, we're so close to major steps forward in curing and preventing cancer. However, we're going to need this final push over the coming years to get there. As Cancer Research UK told Members at their event upstairs earlier, they're calling for a commitment to address the gaps in the diagnostic workforce to allow for more testing and improved outcomes for patients in Wales, and they're calling for an assurance that the Welsh Government is committed to a new and ambitious cancer strategy in Wales.
Thank you to Mark Isherwood for adding his voice to the concerns that were raised by Leanne Wood earlier on during this session. On the second issue, I'm very pleased to be able to respond positively, because the health Minister will be making a statement on progress on the single cancer pathway update on the twenty-fifth of this month.
Trefnydd, can I ask for a statement—request a statement—from the Welsh Government updating the Assembly on Operation Jasmine, specifically the progress made regarding the recommendations of the Flynn report in 2015? As you may be aware, Operation Jasmine was a major Gwent Police investigation, which started in November 2005 and has been estimated to have cost around £15 million. It concerns 63 deaths that were a cause for concern in care homes and nursing homes for older people in south-east Wales. It was recently reported that one of the owners of the affected care homes, Dr Das, has now died, and I know that the absence of a judgment or a legal resolution compounds the family's grief and sense of grievance, and that includes the delays that took place in arranging coroners' hearings into the deaths. I understand that a new coroner for Gwent has now been appointed and that we may now at last see the inquests finally taking place, but, in the 2015 Flynn report, a series of recommendations were made about accountability in the care sector, and I believe we'd all benefit from a Government statement about the progress made, the changes delivered, and any outstanding issues in relation to the Flynn report on Operation Jasmine.
Thank you to Dawn Bowden for raising what is a really important matter; I recall it from my days in the social services portfolio. I know that you're representing particular concerns of constituents, so I will ask the Minister who's the current Minister for social services to provide you with an update on progress and, obviously, she'll have heard the request for that wider statement as well.FootnoteLink
Out of practice. Trefnydd, it wouldn't be the business statement without me bringing some of my well-trodden pet causes to your attention, as I've done before, the first of those being the ongoing and pressing case for a Chepstow bypass. Could we have an update from the Minister for transport on any discussions that may have happened over recent months with the UK Government to develop this scheme? It does, of course, rely on cross-border partnership. Now that the general election has happened and we have a UK Government in place in Westminster, perhaps we could have an update on whether any discussions have taken place with the new people in place. Congestion in Chepstow is getting worse on a daily basis and the people of Chepstow are quite simply looking to the Welsh Government—and, indeed, looking to the UK Government—to try and resolve this. So, it would be good to have an update.
Secondly, and still on roads, an update on the Heads of the Valleys A465 Clydach Gorge project, which has been going on now for some considerable length of time—it has been subject to a large amount of slippage both in terms of finance and in terms of the timing of that project. I think there was another recent delay announced over the Christmas period. So, it would be good to have an update from the transport Minister on that project as well, and what lessons are being learned from that to make sure that future road and infrastructure projects aren't subject to the same issues.
Thirdly, and finally, the Welsh Government's commitment to a national forest, which I asked the First Minister about before Christmas—I recently spoke with farmers who believe that, in terms of developing that forest, they have a valuable input to make there and, obviously, a lot of farmers are managing a large amount of land across Wales. If farmers provided maybe 5 per cent of their land to trees, you would find that you would have a large amount of land across Wales that would be a great basis for that forest. I don't think it would be the entirety of it, but I think that you could—through liaison with farmers, that could be achieved. We're always talking to them about diversification; perhaps a dialogue with farmers would help. So, could the Minister for rural affairs look into doing that, now that we are here in the new year?
Great. Okay. So, thank you for raising two of your pet issues and a new one, so that's very welcome. On the first two issues, I would ask you to write directly to the economy and transport Minister to explore what discussions have been had since the last update that he was able to provide. But, on the second, I know that the Minister will be making a very exciting announcement very shortly in terms of the national forest, but I do recognise, as I know that she does, the important role that farmers can play in terms of supporting our ambitions for a national forest. I know that those discussions will be ongoing with farmers and their representative bodies to explore how they can maximise their contribution to what is a very exciting piece of work.
Could we have a statement from Welsh Government on safeguarding the future of the six nations rugby tournament on free-to-view channels? This incredible competition, the crown jewels of international rugby, faces the real threat of disappearing behind a pay wall. Now, the UK Government has classified the six nations as a second-tier event of national importance, which can be provided behind a pay wall by a commercial pay-to-view provider and which then may subsequently be offered to secondary providers, maybe a day after the match, maybe in a highlights programme after midnight, in the mid week, or maybe not at all. This isn't good enough. Faced with the reluctance of the UK Government to give a cast-iron guarantee of a group 1 national significance tournament, Kevin Brennan and fellow Welsh Labour MPs have written to the Welsh Rugby Union to urge them to do all in their power to influence the forthcoming negotiations. Now, I and Labour Members of the Senedd have also written to the WRU because we know that, from recent history, the impact of putting, for example, cricket behind a Sky pay wall was to see participation rates in cricket plummet in the following decade. And when Sky took Formula 1 behind a paywall, audience figures in the UK crashed.
We don't want to see grass-roots participation in rugby in Wales decimated or audiences for the game with the oval ball destroyed by a short-sighted move to make a fast buck by charging to see Wales play rugby in the six nations. For many of us in Wales, rugby is part of our birthright. We were not born with a silver spoon in our mouths, but with an oval ball in the cot next to us and a red shirt waiting for us to grow into it, boys and girls alike.
So, Minister, could we have a statement from the Welsh Government on their position on safeguarding the right of the people of Wales to see, free of charge, our rugby heroes in the six nations, and what representations you can make to influence the upcoming contract negotiations? And by the way, our best wishes to Wales taking on Ireland in Dublin next week after a great start against Italy.
Excellent. Well, thank you very much to Huw Irranca-Davies for the way in which he's framed this particular debate this afternoon, but also for the work that he's been doing in brigading the support of Assembly Members in order to have a voice on this issue.
Welsh Government agrees that it is vital that the six nations tournament remains on terrestrial television and that the majority of the Welsh population are able to watch what is such an important tournament. When the UK Government last consulted on the list of sporting events in 2009, the Welsh Government was very, very clear, even back then, that the six nations tournament should remain free to air. Our view was that the average Welsh viewer would recommend moving the tournament from group B to group A, as you've described, on the list of protected events and therefore ensuring that it would continue on terrestrial television.
I think it is easy to underestimate the benefits that we derive from ensuring that those major sporting occasions are available to the widest number of people. The example that Huw has given in relation to the impact that it had on cricket participation is a perfect illustration of that.
Thank you very much, Trefnydd.
Item 4 on the agenda this afternoon is a statement by the Minister for Health and Social Services: update on the work of the inter-ministerial group on paying for social care. I call on the Minister for Health and Social Services—Vaughan Gething.
Thank you, Deputy Presiding Officer, and thank you for the opportunity to update the Chamber on the work of the inter-ministerial group on paying for social care.
There is broad concern over the quality and sustainability of social care, both here in Wales and across the wider United Kingdom. If we are to have a meaningful conversation about the future of social care, then we have to consider seriously the quality and reach of social care, together with the funding that it requires, and how we raise this. Social care is a significant budget pressure for local government. Despite the reality of a decade of austerity, budgets have continued to rise annually by around 5.5 per cent over recent years. Across each area of Wales, with each different political leadership, there is a recognition in local government of the scale of the challenge.
This Government has prioritised social care by making it one of the six priorities in our national strategy, 'Prosperity for All'. We've delivered on our manifesto commitment to raise the capital limit for residential care to £50,000. In Wales, we offer the most generous allowance in the UK for the savings and other capital that a person can keep without using those to fund their care. But we believe that we do need to go further. That is what the inter-ministerial group has been considering.
The existing pressures on social care are very real. We have considered Professor Holtham's proposals for a social care levy designed to meet the needs of an ageing demographic. However, pressures exist across other demographic groups, including for working-age adults as well as for older people. Recent research that the inter-ministerial group commissioned from LE Wales highlights uncertainties in projecting future expenditure needs for social care.
Using five illustrative scenarios, LE Wales estimates the need for additional funding over the next three years could range from £35 million a year for 2020 to 2023 to an additional £327 million a year by the same point. And these amounts are projected just to maintain, not extend, current provision.
As I said, we want to go further. Our ambitions for social services in Wales are to keep pace with people's needs and expectations. This will inevitably require additional resources and investment.
In previous debates, we've all recognised the amazing work done by social care staff up and down the country, delivering vital care in our communities. We've discussed the need to drive up the quality of care and the vital role it plays in helping people to live quality lives, independently, in settings that meet their needs and expectations.
Social care free at the point of need is an aspiration that many of us share. However, we currently estimate that providing just free personal care and accommodation in a care home is likely to cost over £700 million a year in addition. Our view is this would be well beyond our ability to provide, and it would not, on those figures, address staff terms and conditions. Therefore, our focus has been on developing funded options that are sustainable and deliver better quality care.
With this in mind, the inter-ministerial group has considered a number of areas where investment could have the greatest impact, whilst looking to build on existing initiatives and policies. This includes: exploring new models of care; possibly offsetting elements of social care charges; and a consideration of how to deliver service quality improvements from investment in the social care workforce.
There is widespread recognition of the importance that our workforce plays in the quality and effectiveness of social care. However, the pay and terms of employment don't reflect this. The result is in an estimated annual 30 per cent turnover in the domiciliary care workforce. In my view, it is important that we identify as a priority what we can do to tackle retention and improve continuity and the quality of care. This should also support our approach on the foundation economy and fair work.
We are already driving a number of new models of integrated health and social care through the transformation fund that I announced as part of 'A Healthier Wales', our long-term plan for health and social care. We'll be drawing on the learning from transformation fund projects.
The group is keen to deepen the benefits of our integrated care fund, where the capital programme has strengthened the link between good-quality housing and good health and well-being outcomes. We're exploring the development of new models of housing-related care with the aim of keeping more people independent and out of residential care and acute care for as long as possible.
As I said, we already provide in Wales a generous charging framework, but we recognise the need to keep on improving what we offer. The inter-ministerial group is exploring options around: the introduction of funded non-residential care; a contribution towards the cost of residential care for those who pay the most; and the provision of funded personal care for anyone eligible.
Taking forward any or all of the options that I've just summarised will require investment over and above the resources required to maintain current service levels. We have previously debated the possibility of raising taxes in Wales to generate resources for social care. We need to be confident of delivering a sustainable funding solution that works for Wales.
So, the group has not limited its thinking. We've considered the joint work on the funding of social care by the select committee on health and social care and the select committee on communities and local government in the last UK Parliament. We've also reviewed the available evidence of international models. These illustrate the challenges in establishing a new funding model for social care. Where countries like Germany and Japan have well-established models of funding social care, or models of long-term care insurance, these were based on a clear acceptance of individual contributions for social care insurance.
We have a deep-rooted respect and support for our national health service and remain protective of access to free healthcare at the point of need. The established international models reviewed require changes to remain viable and have restricted benefits for social care or raised financial contributions. This would imply that, if we were to raise taxes to fund an improvement in social care, we would need to align closely with the specific outcomes we want to achieve to deliver a sufficiently flexible and sustainable solution.
There are real choices here for the nation. Building a consensus around the need for change and the nature of that will be fundamental to delivering reform for the future. I'm keen to continue this conversation today and beyond with Members, with committees and wider stakeholders to help inform our direction of travel and to build a picture of our collective vision for the social services that we want for the future of Wales.
In the run-up, Minister, to the general election your Labour leader Jeremy Corbyn stated in his election bid that Labour would develop a system of free social care in Wales. It is now clear, however, from this statement that you have u-turned already on this and that your solution is to introduce a tax here in Wales.
I would like to thank the Minister for acknowledging the uncertainties in projecting future expenditure needs for social care. This is undeniable. The cost is predicted to grow between £35 million and £327 million a year by 2022-23, which is a huge variation, and makes it that much harder to identify the figure actually needed and to how to fund it going forward.
I would like to share an important message that I hear from those delivering and receiving social care, and they say this: we need to invest more in prevention and early intervention. Too often, things are allowed to—. There's a lack of access to available services, and too often money from the health budget and the social care budget is going in at a very high level when things have reached almost crisis point. Actually, if there were better prevention models, if there were better intervention models, and if money was going in at that lower level, you could assist and support more people at a more reasonable cost, preventing this high-end cost that ultimately arises when people end up in crisis.
According to 'The "Front Door" to Adult Social Care' report by the Wales Audit Office, local authorities are preventing social care demand, but information, advice and assistance—IAA—are not consistently effective. They say themselves they have found a postcode lottery on preventative community services. They also say that regional partnership boards don't always necessarily have the right commitment and buy-in from, on most occasions, our health service, despite our local authorities working really hard in social care departments on very fixed budgets that are not allowed to go into deficit. They find that the regional partnership boards, in some instances, are little more than a talking shop. This, to me, sounds like an ineffective system, so what consideration will you give to making the system we currently have more efficient by putting strong prevention and intervention measures first?
Prevention, of course, is one of the underlying principles of the integrated care fund. Your statement notes that the group is keen to deepen the benefits of the ICF. So why then, tell me, of the 493 projects supported by the ICF in 2018-19, did around 60 per cent of those not continue to receive funding in 2019-20? As a businesswoman, that tells me that the project shouldn't have been started in the first place, or there were excellent projects that you have failed to continue funding. That is not a good way of actually moving forward. This is an important point because, whilst the draft budget provides £130 million into the ICF to help regional partnership boards, the auditor general himself has remarked that there is little evidence that successful projects were being mainstreamed into core budgets.
So, question 2: how can we be sure that the £130 million would not be better spent through a fair distribution of that money between Wales's 22 local authorities, allowing them to lead on prevention and integration and cutting out this ridiculous, costly bureaucracy and financial incapability, because of the money being so ring-fenced and tied to these boards?
Before considering a levy or a tax to our people in Wales, I believe that we need to acknowledge that an extra £1.9 billion will be coming to the Welsh Government following increased health spending in England by the UK Government.
Also, as part of my spokesperson's role within the Welsh Conservatives, I have been proud to work with care home proprietors across north Wales, and I've challenged Betsi Cadwaladr University Health Board in an effort to secure fairer CHC fees. So, with that, will the inter-ministerial group explore the potential benefits of the Welsh NHS making more finance available to support the social care sector?
What has come through to me is that people are fed up. They're fed up with budgets in health boards being allowed to grow and grow in debt and deficit, yet local authorities are bound to deliver a balanced budget. Quite often, as a result of people stuck in beds in the health service, when they really should be in their own homes or in the respective care surroundings that they need, too often money that should be spent by the health board is actually being picked up by our already-cash-strapped local authorities.
Are you winding up, please?
I will, yes.
Finally, from reading your statement, it seems that whilst you could be sailing towards a tax, I do welcome the fact that your group has explored new models of care. If that is the case, I would ask that you kindly place a greater emphasis on alternatives such as the Buurtzorg model. It has revolutionised community care in the Netherlands and has seen overhead costs reduce by 25 per cent. Would you at least, Minister—? You don't often agree with me on anything, but would you agree with me that that model is worth consideration by your Government? Let's look at a model that actually we can look at to be more effective, more beneficial to those who need it, more manageable, and not have to introduce an overburdensome tax to the people of Wales. Thank you.
Thank you for the series of comments and questions. I don't want to be overly unkind, but there are a number of factual challenges in the statements that were made by the Conservative spokesperson. It is, of course, the case that Jeremy Corbyn is not the Prime Minister. Labour didn't win the last election. We got a real shoeing at the last election; there's now a Conservative UK Government. The idea that we are therefore going to be held to the last UK election manifesto when we can't possibly influence it is beyond parody. It's a bit of an embarrassing statement for Janet Finch-Saunders to start off with.
It's also worth pointing out that I can see the Chair of the Health, Social Care and Sport Committee in here and we recently had a debate on district and community nursing, which considered the Buurtzorg model and the work that the Government is already doing. There was an agreement within this Assembly term on further investment in district nursing, looking at principles from the Buurtzorg model and how they might be applied within Wales. So, we're deliberately increasing our investment in district and community nursing. So, far from this being a new issue, it's actually something that, through the whole of this term, you'll have heard in this Chamber and in the committee and in the report. To be fair, you may not have been in the Chamber at the time, but we've talked about it on several occasions and I'm glad to help to bring you up to date on that.
In terms of the cost pressures, the cost pressures range that I outlined, Deputy Presiding Officer, when you look at what 5.5 per cent over the last seven years or so that is going—the amount that, across local authorities, they are putting into social care, well that's actually nearer the top end of the £30-odd to £300-odd million range. There's a really big cost pressure that, despite austerity, political leadership of every shade is responding to. Independent-led councils, Welsh Conservative-led councils—so, your colleagues Sam Rowlands and Peter Fox, they are making those choices as well—together with Plaid Cymru and Welsh Labour-led councils, they're all responding to the reality of the increase in pressures.
We could do broadly what you say and say, 'Just make it more efficient, try to develop some new models and carry on.' And that's a choice. It's a choice that we could make as a country. If we do that though, we have to accept, if we want an honest and mature debate, that that means that there'll be extra pressures on other budgets and it almost certainly means cuts in other areas of expenditure. Now, that's an honest choice that we could all make, but that would be the choice that we would be making. If we really want to see an improvement, we've got to consider the amount of funding that goes into it. At the last UK election, the Conservatives pledged to put £1 billion extra into social care, but that was actually money that they'd already announced. So, actually, there isn't new money that's going to come, arriving from May onwards; we've apparently already had it. It's been passed on in local government budgets through the RSG to local government. And that is only just about keeping pace with where we are. In fact, the NHS Confederation in England said that that funding pledge was well short of what was required—not Labour politicians, but people who are providing health and social care across our border.
We do want to see more efficiency in services, so we do want to see a transformation, we want to see reform and prevention going into how we look at the future of social care, but we also have to address the issue of funding. If we want to improve the quality and the reach and safeguard the dignity of social care, then we've got to have this serious and honest conversation about funding. And that's what we're prepared to do.
I don't want to leave unaddressed issues about the integrated care fund. Part of the reason why some ICF projects don't proceed is that they're piloting and trying new ways of working. And when we often have these debates here, your colleague, Angela Burns, regularly says to me, 'You have to be prepared to go and run projects that may not always succeed. If you're refusing to take any risk, you're not really trying something new.' And you can't then say on the other hand that it’s outrageous that not all of those projects have gone ahead. There will be different reasons why partners on the ground have looked and decided to proceed or not proceed. And actually, across local government, there's widespread support for the ICF and the way that it's worked, the way it’s brought different partnerships together, including health together with different parts of local government, the third sector, and other providers.
And you can't have it both ways on funding when it comes to health consequentials. Your party have regularly said, 'All the health consequentials should go directly into the health service—don't direct them or transfer them anywhere else at all.' We've actually gone well beyond that, and this Government, over the whole of this term, has put a lot more into the health service then direct consequantials that we've had from UK settlements. If you then say you want us to take more money into social care, well, we know we'll have a different debate about money that hasn't gone into the health service. And you can't have it both ways.
We—I—have made a choice to put £30 million last year, from the health budget, into social care. This year, I made the choice to put it up from £30 million to £40 million from the health budget into social care, because we recognise the pressures. So, we're doing the responsible and the right thing already, but the debate about the future should really be an honest and a grown-up one, and that's what I desperately want to see; not to try and have it both ways, but to be honest about what is available. And when we go out to further consultation with more models, we'll be open about that and about the basis of the funding questions for them, so people in this Chamber and beyond can look honestly at what's possible. We don't have a fixed view in the Government about what the exact future models of social care should be, or indeed how they should be funded, but I do hope that, over the coming months, we'll have a deal more maturity than we've heard thus far in the Chamber today, and I look forward to hearing what other parties have to say.
I'm not entirely sure what you've announced today, to be honest with you. Maybe you can give us a bit more information about this conversation that you're keen to start today and what form that conversation might take. There are references in your statement to all sorts of international models for paying for care. I read it that you want to have some sort of conversation, as I say, about raising a tax or perhaps a levy to fund social care, but given the long lead-in time for UK Government to agree to the devolution of any new taxes, I think, perhaps, you're happy enough to just keep on kicking that particular can down the road for a while longer.
You're quite right to say, of course, that there is concern about the sustainability of care as a whole—the care that we'll need to provide for our ageing population in future. And you know what? Given the narrative around concern about the cost of providing social care in particular, I can understand why it would appear to make sense to think of some sort of fund, perhaps, to build up to pay for that in future, but I think there are some real flaws in that. We can have a conversation about it, as you say. But we think that the question isn't about finding money for social care; the question is about paying for health and care services in the context of an increasingly older population in future. That means funding for the NHS and funding for social care and funding for good housing and tackling poverty and so on, amongst a whole host of other public services that are needed. The clear gap, I think, in funding, isn't social care, per se, or the NHS, or the other services separately; it's that lack of investment in services that prevents people from becoming ill in the first place and requiring NHS and social care. If we are to build funds—and I think we do need to think differently about models for the future—I think perhaps we should be thinking in terms of building up a transformation fund to get us to that care service that is fit for the twenty-first century and beyond, indeed.
In response, actually, to some comments made by the Conservatives' spokesman, I think we can't just build the future of Welsh health funding on what we hope a UK Government might decide to spend on health in England in years to come. I think, based on the track record of successive Conservative Governments, their willingness to cut services deeply makes me nervous about hanging in there with a begging bowl for decisions on the NHS in England to be made.
I'll come on to just a couple of questions. I have sympathy with the Minister's view that we need an honest conversation about the level of taxation paid. I believe it's a matter of principle that the best way is to fund care, both NHS and social, from general taxation, but I would strongly argue also that, if the Government does intend to raise taxes to fund health and care services, you'll only find support for that if, in exchange, there aren't going to be charges still for people who need those services. For example, that they would not have to sell their homes as well.
A couple of claims were made in your statement. The statement claims that free personal care and care home accommodation could cost £700 million a year, but the accounts for local authorities—recent accounts—show that they've raised only £163 million from charges for social care for over-65s. Of course, you would also have to account for behaviour change, with self-funders moving into the funding, but the gap is still rather considerable. The Barker commission estimated the cost of providing free social care for those with moderate and critical needs for England would be £5 billion, which would translate to Wales as being around £250 million. In fact, LE Wales's own research in 2014 estimated this cost, which included under-65s as well, to be around £350 million. So could you explain why the figure you use is so considerably different to other estimates? A cynic would suggest that you're trying to undermine the case for social care free at the point of need whilst in the same breath claiming to aspire to that. Linked to this, you've stated that the research conducted by LE Wales on the additional funding needs required to maintain existing services by 2022-23, which is not far away, range from between £35 million and £327 million. That seems to me to be an extraordinarily wide range, so perhaps you could explain to me that wide gap in more detail.
I'll just deal with the last point first. The research that we've had done, we're going to publish all of it fully before Easter and we expect then for the final to-ing and fro-ing between civil servants and LE Wales to allow us to do that. It will show the range of different assumptions that you make, from the most optimistic about the most minimal level of increase, that's where you get the £35 million, to, if you like, the maximalist position in terms of the impact of the growth. There are a number of different scenarios, but actually tracking what's happened in the last seven years, that 5.5 per cent rise is much nearer to the top-end scenario. So I don't think that the £35 million is the most optimistic; I don't think you're going to see that founded in reality, certainly not within what's happened in the last seven years.
When it comes to the estimates we provide for what different scenarios might produce, for example the £700 million figure in terms of fully funding personal care and accommodation costs, we'll, again, publish all the reasons why that is. So it's not about wanting to make it an unaffordable and unachievable aspiration, but to say 'At this point in time, is this achievable or not?' And that's because of the advantages we have in getting civil servants and others to do that work. So we'll debate openly and it'll be put out into the field, because obviously we don't have a fixed view in the Government about what the exact model future social care should be or, indeed, the exact funding mechanism to try to lever more resources into our system. And that's where we'll be genuinely trying to have an open conversation from Easter onwards, and that's why we've made offers of technical briefings to both the Finance Committee and the two committees, and I think both Chairs are in the room—the Children, Young People and Education Committee will have an interest, together, I'm sure, with the Health, Social Care and Sport Committee—and to make available a briefing from the civil servants who are doing this work to say, 'Here's how we get to these figures, here are the different assumptions, and here's a go at asking the public some open questions about what they want and how they value it.' It's about the balance between improving social care and extending what we have, or just keeping what we have, the choices that will mean, and then what that means about what they are or aren't prepared to pay.
The most generous investing would be that if we all had the funding we needed without having to consider that, but I don't expect there to be a Green Paper any time soon; we've been promised a Green Paper for most of the last decade at a UK Government level. But there are real questions to consider about the impact, together with the rest of the UK system, because what I wouldn't want to see is that we try to provide a benefit to people in Wales and that's clawed back in a different way through the benefits system. So, we do need to think carefully about how to design something that would make sense and deliver an improvement in care for people. And, I think, on that, there isn't much difference between us, but it's about how we could get there.
We've also taken seriously the point about, if we were to go down the line of suggesting there could be a tax rise, we'd have to think about how that could actually be linked directly to an improvement in the care that people receive, to be able to set out clearly what the offer would be if there were further income raised through taxes of any sort. Now, I say 'if' because, as I say, the Government doesn't have a fixed view. But it would be important to be able to understand not just the public view on that, but how you're going to link the two together. I think that's important in terms of people accepting that there really is something for something rather than another way for politicians to take money off them for no particular benefit.
When it comes to health spend, I'm proud of the fact that we've got a Government where we have invested, despite austerity, more than we've had in terms of consequentials. The gap now is that, on average, we spend 9 per cent more than the UK average on health and social care in Wales, and we are taking steps to provide money to join the system more together, to have integrated models of health and social care together. But the way that the systems are funded is different. Social care is means tested, and many people are pretty horrified when they find out about that and they rub up against the system. So, it is a different system, so we do need to look at the funding around social care as a different matter to healthcare. Now, if there was a uniform way of funding it all, well, we could look then again about how that's organised in a different way, but I don't think a reorganisation is the answer to all of the challenges that we face.
And I do want to just be clear that the focus on prevention is absolutely there—from the parliamentary review, to the 'A Healthier Wales' response, to the work we're doing with the transformation fund, prevention is absolutely a central focus on what we're looking to do in reforming and improving health and social care services—and, also, to give the assurance that we have maintained contact with the local government family, and will continue to do so across party. So, I and the Deputy Minister will openly brief local government cabinet members when they meet in their social services policy group. We'll meet them in the spring and over the summer, and I definitely want to hear from them the realities of actually having to make some of these choices in local government, together with the sorts of answers in terms of quality, reach and funding that they're prepared to support.
Can I thank the Minister for his statement, and commend the approach of having a conversation, although I would urge some urgency in the conversation, because we've been talking about these things for over 20 years now? I can remember a commission for the long-term care of the elderly reporting in the year 2000 about various things that we're still discussing now, and there's been no work in the meantime. So, while commending the approach, I do think we need some urgency and fleetness of foot. Because it was Aneurin Bevan who removed the fear of paying for healthcare individually by effectively making everybody pay. Regardless of your risk, regardless of your health status, regardless of your personal usage of the healthcare system, everybody pays through general taxation: the nation pooling its collective risk to free the individual from paying for that risk individually—in other words, not having to sell his or her home to pay for healthcare as a result.
We've accepted that for healthcare, and people wouldn't expect, having a conversation with their GP, that I would have to balance the cost vis-à-vis why they should sell their home. We don't have that conversation in health; we have it for social care, though, because, in contrast, people pay for social care individually. Huge costs can be incurred. Your home is at risk, and people have had to sell their homes to finance their long-term social care, because the risk is borne individually, and, therefore, the costs are paid individually, not by the whole nation as a collective.
That's why I think we need a national care service, financed by general taxation, exactly like the NHS, and with national terms and conditions for fully employed staff as well. Let's look at care exactly like we look at health, because, after all, 80 per cent of social care costs now, today, are paid for by public funds. They're publicly funded now—80 per cent of social care costs are publicly funded now. So, Minister, can you confirm whether any type of social care levy will transfer the financial risk from the individual to the nation? And is not your home still at risk with any type of levy or funding that's targeted at a group of individuals, as opposed to everybody? Isn't your home still at risk when paying a social care levy?
After all, in closing, Aneurin Bevan's victory against all odds, including medical opposition and huge vested interests saying it was too complicated, too hard, and too expensive, exactly like we're saying now about social care—that's what Aneurin Bevan faced down at the time, by sheer force of political will, which is why I'm such a fan of his. His victory was to remove the fear of paying for your individual healthcare. We face the same challenge with paying for social care individually today—some of us sooner than others. Thank you.
Well, indeed. And some of the drivers in the conversation have been about the predictions on the demographics of the population, which were talked about at the start of devolution. And I recognise there are a number of original Members in the room now, but it's a topic that's been going on, a conversation about what that means in terms of public services. And we're seeing that pressure in the health service; we see the pressure also in social care. It's why the Health Foundation estimated a couple of years ago that the cost would be on average 4.1 per cent. Actually, as I've said, local government is putting more than 4.1 per cent into their social care budget already. So, there's a real pressure and real challenge.
But it is difficult, because you have got to think about how you raise the money, what you get in return, and what that means—not just for the benefits system, but there are challenges about any sort of way to generate extra income. Because there are challenges about inter-generational fairness, on the one hand. If you're nearing retirement age, or expecting to receive social care because of your age, as opposed to children, a young person, or a working-age adult who still needs social care, then you may well say, 'I've paid into the system all my life, and this is what I expect to receive in return'. Whereas, if you're in your 20s, at the start of your working life, you may say, 'I don't expect to receive the benefit of this for some time to come'. And there's a real challenge about what is fair between generations, as well as between people who pay taxes, people who receive care. And there's a challenge about the current means testing environment and reality of social care.
So, we've capped some of the costs that people would pay for domestic care costs; we chose to do that. And that's taken away some of the fears that some people have about paying for care. But we still have challenges. We want to do more. It's not just about whether we have a vision that we'd like to have social care funded like the national health service, but about our capacity to do so. And that's an honest conversation we should have. And when we provide more information in the technical briefings and the conversations from the spring/Easter onwards, I think we'll be able to have that conversation with more facts in the field for all of us to look at. And I think that will be a good thing.
But to improve staff terms and conditions—we could spend lots of money on doing that, and that might improve the quality of care, it might reduce the churn in the workforce, but that in itself won't extend the reach of social care as well. So, these are all choices we'll need to make, and to be clear sighted about them as we make them.
Thank you very much, Minister. Thank you.
Item 5 on the agenda is the Sustainable Drainage (Enforcement) (Wales) (Amendment) Order 2020. And I call on the Minister for Environment, Energy and Rural Affairs to move the motion—Lesley Griffiths.
Motion NDM7258 Rebecca Evans
To propose that the National Assembly for Wales; in accordance with Standing Order 27.5:
1. Approves that the draft The Sustainable Drainage (Enforcement) (Wales) (Amendment) Order 2020 is made in accordance with the draft laid in the Table Office on 14 January 2020.
Thank you, Deputy Presiding Officer. I must begin with an apology. The National Assembly has previously approved an Order almost identical to this one. However, the Order debated on 26 November last year contained an error, which prevented it coming into force. We only discovered this following the debate. My officials liaised with Assembly officials to identify whether commencement could be achieved by some other means. However, the conclusion we all reached was that the error prevented the instrument being able to come into force at all. As a result, unfortunately, there is no available solution other than to re-lay the instrument. I wrote to the Llywydd on 11 December, informing her of the position and stating my intention to lay a revised Order, as we've now done. Fortunately, the legal change we are seeking to bring about in the Order is not time-critical.
Whilst Members will appreciate that the circumstances of this case are very unusual, I am mindful of the need to avoid this type of error recurring on another statutory instrument. Therefore, we've introduced an additional check, an assurance procedure, to our internal processes, and have informed the relevant teams working on the preparation of subordinate legislation.
The revised Order contains a new provision for commencement. In all other respects, it is identical to the Order approved by the Assembly last November, aside from the year in the title. To recap, this Order concerns sustainable drainage systems on new developments, which was introduced in Wales from 7 January last year. SuDs, as they are more commonly known, will provide multiple benefits for flood-risk reduction, amenity and biodiversity. The original enforcement Order was made to implement the SuDs provisions in Schedule 3 to the Flood and Water Management Act 2010. Under the Act, approval is required before construction of drainage systems can commence on new sites. The Order applies where approval has not been obtained.
However, a minor amendment is needed to article 21 of the enforcement Order to bring it in line with recent changes to other enforcement legislation. Article 21 limits the fines that can be passed in a summary case to a maximum of £20,000. The Order was drafted before section 85(1) of the Legal Aid Sentencing and Punishment of Offenders Act 2012 commenced. The 2012 Act removed the upper limit on the fines magistrates' courts could pass for almost all offences. To provide consistency with similar offences we propose to amend the £20,000 limit to simply a fine. This would enable magistrates' courts to pass an unlimited fine, consistent with amendments to other legislation made by the 2012 Act. The proposed amendment does not expose persons convicted under the SuDs legislation to greater liability, as unlimited fines have always been available for this offence in the Crown Court. But it will reduce delay and expense for defendants and the public. I commend the Order to the Assembly.
Thank you. Can I call on the Chair of the Constitutional and Legislative Affairs Committee, Mick Antoniw?
Diolch, Dirprwy Lywydd. We considered this Order at our meeting on 27 January 2020, and subsequently reported one point to the Assembly under Standing Order 21.3. That reporting point noted that this Order was originally approved by the Assembly in Plenary on 26 November 2019, however, it could not be made as it did not contain a commencement provision, as the Minister has reported. I welcome the fact that the explanatory memorandum accompanying the Order notes the previous Order and identifies why it could not be made. The explanation provides helpful clarity for the record. Diolch.
I did think we had been here before, but I thank the Minister, who's made a fulsome apology and perhaps, I think, has gone further even than necessary in terms of accepting or apologising for error. And I think I'd say also I think it's an issue for us as an Assembly. We debated this before, I spoke and I myself did not notice this error or draw it to the Minister's attention and no other Member did. So, I think it is a joint issue, and I think the Minister has acted correctly by bringing it back in the way that she has.
She's re-emphasised that it's the magistrates, rather than Welsh Government, who'll be applying this fine. And I do have some concern about this concept of an unlimited fine, but when it's applicable generally in so many other areas and is there for the same offence in the Crown Court, I can take no objection of principle to that.
She mentions that there are great advantages in these SuDs applications. I also still just worry that they're also very significant costs and it's an additional hurdle that construction firms in Wales need to get over, and, of course, we want to encourage construction and house building and I just believe there should always be a balance taken in these approaches. But we don't intend to object to the statutory instrument today.
Thank you. I call on the Minister for Environment, Energy and Rural Affairs to reply.
Thank you, Deputy Presiding Officer, and I thank both Members for their contributions. I'd just like to say, in answer to Mark Reckless' last point, since this was placed on the order paper, the Association of British Insurers actually came forward with a supportive statement specifically on the point that you raised, in that they very much welcome the plans for boosting the supply of new homes and believe that SuDs can play a pivotal role in ensuring these new properties are built in a manner that helps to manage surface water flood risk at the local level. Because I have seen that there have been some concerns. And I know it's a relatively technical issue—this Order—but I thought it was important to show that, when people do raise that they think it will be an additional burden on the developers, this is what the Association of British Insurers are saying. Thank you.
Thank you. The proposal is to agree the motion. Does any Member object? No. Therefore, the motion's agreed in accordance with Standing Order 12.36.
Motion agreed in accordance with Standing Order 12.36.
We now move to item 6, which is a debate on the draft budget of 2020-21, and I call on the Minister for Finance and Trefnydd to move the motion—Rebecca Evans.
Motion NDM7259 Rebecca Evans
To propose that the National Assembly for Wales, in accordance with Standing Order 20.12:
Notes the Draft Budget for the financial year 2020-21 laid in the Table Office by the Minister for Finance and Trefnydd on 16 December 2019.
The Llywydd took the Chair.
I'm pleased to open the debate this afternoon on the Welsh Government's draft budget for 2020-21. This builds on the constructive debate that we had in the first week of this session. Since then, the Finance Committee and the other Assembly committees have scrutinised our spending plans set out in the draft budget. I'd like to place on record my gratitude to the Finance Committee and the other committees for doing so, and for publishing their reports in the truncated timescale as agreed before Christmas.
Today's debate provides an opportunity for me to provide some early reflections on the recommendations and the general themes arising during scrutiny, focusing in particular on the Finance Committee's report. Before I do that, Llywydd, I want to acknowledge the wider context in which this budget has been developed and the challenges that remain, before reminding Members how this budget delivers for the people of Wales.
As I have rehearsed a number of times, the failure of the UK Government to deliver on its multi-year comprehensive spending review last year means I am only in a position to lay a one-year revenue and capital budget. Despite claims that austerity is over, the Welsh Government budget in 2020-21 is nearly £300 million lower in real terms compared to 2010-11.
Within weeks of confirming the long-awaited UK budget will take place on 11 March, the UK Government has once again demonstrated its chaotic approach to managing public finances. With just over a week before we published today's second supplementary budget, the UK Government confirmed both positive and negative adjustments to our budget for 2019-20. Most of the positive consequentials had been confirmed by the Treasury earlier in the year, but not the reductions.
When compared to the planning assumptions we have based our plans on, the net result of these changes is a modest revenue uplift, with a simultaneous reduction of just over £100 million of financial transactions funding and nearly £100 million general capital. This is wholly unacceptable at this stage in the financial year without any prior notice, and by no means the first example of the UK Government ignoring the principles set out in the statement of funding policy.
I've written to the Chief Secretary objecting strongly to the principle of these changes being made so late in the day. We do not accept them, and have pressed for further clarity on the changes at a UK level that result in consequential reductions.
Notwithstanding this, however, we have agreed we will absorb the financial transactions reductions this year, which is prudent financial management in the circumstances. I have also secured the maximum flexibility from Treasury to manage the other adjustments as we move through the next year. Our decision to take this approach is without prejudice to the further discussion on the wider position and the handling of reductions carried forward.
At this stage, I believe it's also prudent not to adjust the spending plans for 2020-21 that I've tabled before the Assembly, given the strong likelihood our settlement for next year will change again on 11 March. It does, however, reinforce our case for additional funding flexibilities and a more formal role for the finance Ministers' quadrilateral in reviewing the statement of funding policy—a theme drawn out in the Finance Committee's report.
As well as possible changes to our settlement, the UK budget could also include changes to tax policy, which might affect decisions about the devolved taxes in Wales. As well as considering proposals to bring forward an early supplementary budget, I am committed to providing an early update on the impact of the UK budget, including the impacts on Welsh tax forecasts.
Llywydd, I'd like to turn to the spending priorities set out in this budget. I am proud of everything we have achieved as a Government, despite the uncertainty and the challenging context that we have faced. This fourth budget of this Assembly, which provides for the final full year of this term, delivers on the key spending pledges we made to the people of Wales in 2016 on all-age apprenticeships, school improvement, childcare, help for small businesses, quick access to new treatments, affordable housing, and much more.
We are bringing our total investment in health and social care to more than £8.7 billion in 2020-21, with an above-inflation increase of more than £400 million; providing a real-terms increase to every local authority through an extra £200 million through the revenue and capital settlement next year, which will bring total funding to nearly £4.5 billion; and we're supporting a world-class education system through the local government settlement and through our £1.8 billion education budget.
Prevention has been at the heart of this budget, supported by our focus on eight cross-cutting priorities of: early years, social care, housing, employability and skills, better mental health, decarbonisation, poverty, and biodiversity. We're investing in the areas where we can maximise our impact over the longer term, and this includes an extra £175 million capital next year, taking our investment to more than £2 billion in affordable housing over this Assembly term; and an additional £19 million to help some of the most vulnerable people living in poverty in our communities, building on existing action totalling more than £1 billion; and increased investment in better mental health and early years through the extra funding for the whole-school approach and Flying Start.
This is a budget that delivers a new level of ambition in the fight to protect the future of our planet, building on the wide range of investments that we're already making. That is why, in the first budget since our declaration of a climate emergency, we are allocating a new £140 million capital package to support our ambitions for decarbonisation and to protect our wonderful environment.
Llywydd, I'd also like to take the opportunity today to provide some early reflections on the key themes arising from scrutiny. With the process of leaving the EU now under way, the importance of ensuring a smooth transition to a post-EU UK funding framework that delivers for all parts of the union is imperative. I welcome the committee's recommendation that recognises the need to review the statement of funding policy, which will be particularly important in the context of post-EU-exit arrangements. I also accept the Finance Committee's recommendation that we continue to negotiate with the UK Government to secure more frequent and structured quadrilateral meetings of UK finance Ministers. This is a matter I will raise with the Scottish finance Minister and Northern Ireland finance Minister tomorrow.
The interaction between our budget timetable and that of the UK Government's is a matter that's been considered in previous years, but the awkwardness this year has been more prominent. I welcome the acknowledgement of the committee that our approach to the timing of this year's budget was practical in the circumstances, and balanced the need to provide early funding certainty for stakeholders against providing time for scrutiny of our plans.
Continuing to drive forward improvements in our budgeting is also an important consideration. For the first time, we have published a budget improvement plan that sets out how we intend to take continuous steps to embed the Well-being of Future Generations (Wales) Act 2015 into the budget process. This includes a number of areas identified by the Finance Committee, including improvements to how we assess the impacts of our budget decisions. I welcome the Future Generations Commissioner for Wales's statement that Wales should be commended for being at the forefront of a movement towards well-being budgeting, and I look forward to working with the commissioner as we take forward this ambitious plan.
I am pleased that the Finance Committee has welcomed the single largest ever capital package to help combat climate change. I'm disappointed by claims that the action that we're taking does not match our commitment to tackling the climate emergency. The draft budget will deliver new investment in the areas where the current evidence tells us we can have the greatest impact, as well as investing in other measures such as £64 million next year to defend our communities from the most severe and immediate impacts of climate change. I and my colleagues will respond formally to the recommendations of the Finance Committee report and those of the other Assembly committees in advance of the vote on the final budget next month.
So, Llywydd, to conclude, despite ongoing austerity imposed at the UK level undermining our ability to deliver the investment our country truly deserves, I am proud to introduce a budget that continues to invest in our vital public services while supporting our ambitions for a more equal, more prosperous and greener Wales.
I call on the Chair of the Finance Committee, Llyr Gruffydd.
Thank you very much, Llywydd. I'm pleased to contribute to this important debate on the Welsh Government's draft budget for 2020-21 on behalf of the Finance Committee. Our report does make a series of recommendations, and I'll cover some of the most prominent of those in my contribution to this debate this afternoon.
Now, as we've heard, given the uncertainty around the UK general election and Brexit and so forth, the committee recognises that this draft budget has been delivered under exceptional circumstances, and this has impacted on the ability of the Government and other stakeholders to plan.
As a result, the Finance Committee has made every effort to engage with stakeholders on this draft budget. This began in June 2019 when we held a pre-budget stakeholder event in Aberystwyth. This formed the basis for a Finance Committee proposed debate here in the Siambr, which followed in September 2019, giving the Assembly an opportunity to debate the spending priorities of the Welsh Government prior to the publication of the draft budget.
This year, it was particularly pressing to hold such a debate given the uncertainty of the proposed timing of the draft budget. However, the committee believes that a debate should be facilitated on a permanent basis—every year—to afford Members the opportunity to influence budget priorities and allocations earlier in the process. We hope very much that the Minister agrees with us and that we can work with her to ensure a debate can be built into the scrutiny process in future years.
The UK Government has announced that its budget will be published on 11 March. The committee recognises that macro-economic forecasts for the UK could impact on devolved tax revenues and the associated adjustments to the block grant. We have recommended that an update is provided as soon as possible after the UK budget. We understand that there will be a need to reflect the impact of the UK budget in the first supplementary budget of the Welsh Government and we welcome the Minister's commitment to bring this forward as early as possible, should the changes be extensive.
During our scrutiny, we reviewed how the Welsh Government intends to spend its £17 billion budget in the next financial year, and overall—. We know that this is an increase of £593 million on last year's budget: a 2.3 per cent increase in real terms. The committee notes that the Welsh Government has spread this increase across all departments. However, we would have liked to have seen a more ambitious approach being taken to its prioritisation in terms of a focus on future sustainability and service transformation in the future.
Moving on now to borrowing and taxation, the committee heard evidence suggesting that increases in future budgets will be unsustainable without higher borrowing or increases in taxation. We also believe that a change in strategy will be needed to ensure that sufficient funding is available for investment in public services in future years. The Welsh Government has already said that it's pushing against the limits of its fiscal borrowing rules, and it has pledged not to raise income tax during this Assembly term. We as a committee have supported the Welsh Government's requirement for increased borrowing flexibility, and clearly changes in taxation will be a matter for all parties in their manifestos as we approach the 2021 Assembly election.
In April last year, the Minister for Environment, Energy and Rural Affairs declared a climate emergency in Wales. We've heard reference to that in the comments by the finance Minister. However, the Welsh Government’s draft budget does not reflect its own declaration of a climate emergency. While the draft budget shows, as we heard, an allocation of £140 million in capital investment to support decarbonisation, the committee is not convinced that the Welsh Government has a clear understanding of the impact that its decisions have on carbon emissions or the climate. While we welcome the allocation of £140 million, it's disappointing that a more radical approach has not been taken to mitigate climate change.
This is the fourth draft budget to be published since the Well-being of Future Generations (Wales) Act 2015 came into force. The committee has used the Act as a lens to assess the draft budget since its enactment. In terms of the progress made by the Welsh Government to embed the Act into its decision making for 2020-21, the office of the future generations commissioner told us that there had been, and I quote, a visible shift in relation to decarbonisation and preventative spending. However, and I quote again, there was still considerable scope for progress, and, in anticipation of an imminent UK spending review, the commissioner urges the Welsh Government to use this as an opportunity to make more transformational strategic decisions. The committee believes that the Welsh Government should consider ways that it can improve the integration of well-being goals in the presentation of future budgets to demonstrate more consistently how the Act is embedded in its decision-making processes.
Having left the EU on Friday, there is still uncertainty surrounding the future relationship between the EU and the UK. The impact of Brexit in Wales, including the continuation of funding previously provided by the EU, particularly regarding direct payments to farmers and other businesses in the fisheries and agriculture sector is a major concern for the committee.
We are concerned that the transition period, up to 31 December this year, raises the risk of trade deals not being in place. In these circumstances, we believe that further assistance would be required from the UK Government to minimise the impact on the Welsh economy. At present, Wales receives funding from the EU through structural funds and agriculture support. The expectation of the Welsh Government is that EU structural funds will be fully replaced. However, the transition agreement does not cover agricultural support, and the committee would welcome confirmation from the Welsh Government that it has obtained assurances from the UK Government that this funding will be provided.
The committee welcomes the inclusion of poverty in the budget priorities, but it believes that there’s a lack of clarity in the Welsh Government’s strategy for tackling poverty, its objectives and how the budget will drive long-term improvement, particularly in addressing the root causes of poverty.
More action needs to be taken to reduce poverty in Wales. There are too many people in low-skilled and/or low-paid jobs, and upskilling the workforce and increasing employment will benefit the Welsh economy regardless of the outcome of Brexit. The Welsh Government should, therefore, evaluate its investment in into-work programmes and economic development programmes to ensure that they provide value for money.
I would like to thank everyone who contributed at all stages of the scrutiny process and those who attended the stakeholder event as well as those who gave formal evidence. All of this has helped us as a committee shape our findings, and I look forward to seeing the formal response of the Government to our report before the vote on the final budget next month. Thank you.
I'm pleased to be speaking in this important debate today, a debate, of course, about the budget, but also about the future of the people of Wales. Let us be quite clear about the context of this budget: yes, the Welsh Government has found itself developing this budget during an exceptionally short time frame, with issues surrounding the recent general election, and we recognise the challenges that that has brought. But all of this is also set against the backdrop of an extra £600 million a year being provided by the UK Government. So, taxpayers in Wales have the right to question some of the Welsh Government's decisions when it comes to investing in the Welsh economy and driving the Welsh economy forward post Brexit.
I see as well that the budget narrative looks back on the achievements and the spending of the Welsh Government on each department since 2016, but there is, perhaps unsurprisingly, little mention of any of the missed targets that Ministers are, of course, aware of, which, I think, at least in part, in the spirit of fairness, the Welsh Government would be wiser to admit to.
The Welsh Government will, of course, blame the UK Government for all its woes, although, to be fair to the Minister, austerity wasn't mentioned in any great depth until quite late in your debate there, so maybe you have listened to some of my criticisms in the past. But the Welsh Government does have to take responsibility for its own financial mistakes. That's part of being a grown-up, devolved Government with far-reaching and growing powers.
So, what do the public expect to see from this budget? What should we expect to see? Well, I would expect to see the Welsh Government investing in the NHS for transformational change. To be fair, you have put £37 billion into the Welsh NHS since 2016. That is quite a difference from the real-terms funding cut that we saw earlier, between 2011 and 2016, although I know that was with your predecessor as Minister, rather than yourself. You are, I think as you mentioned, pressing ahead with an extra £400 million spend on health, which is positive news. All these are increases of money, so that's good.
But, of course, that doesn't mitigate the fact that A&E waiting times have been the worst on record for two months in a row in 2019 and four out of seven health boards are under some form of Welsh Government intervention—Betsi Cadwaladr, as mentioned earlier, in special measures for over four and a half years. That's received around £83 million in turnaround costs, yet it's predicted to end the financial year in deficit. So, it's not just a question of providing more money, Minister, is it? It's a question of what that money is actually achieving, because there's also a value-for-money argument to be spoken about here, too.
This is, we are told, overall a green budget—a great label, and an admirable way to try and proceed, but the question is raised: is it ambitious enough to really deal with the environmental challenges that we face? Does it adequately deliver on the Welsh Government's promises in calling a climate emergency, for instance? I don't personally think there's anywhere near enough detail here on offering new, innovative thinking when it comes to how the Government will, for instance, meet its target of at least a 95 per cent reduction in greenhouse gases by 2050.
I appreciate, Minister, that these are enormous, bold commitments, and they will take enormous willpower to achieve, but it's not simply a case of relying on yesterday's outdated policies to achieve these goals; it's about delivering a bold, confident vision for Wales, and we need to see a budget that drives a vision, that takes the people of Wales with it, that inspires and motivates the people of Wales. Because these climate change policy targets are going to be tough. I don't think we should be in any doubt about that, and no Government should enter into these commitments lightly. I'm sure you would agree with that.
Interestingly, I was watching the clock earlier and you mentioned the future generations commissioner—I think it was about eight minutes in. Often raised on the Finance Committee over the years I've been on it is this question: during the budget-setting process, is the future generations legislation really at the centre of that policy from the start and throughout, or is it too often perceived to be added as an add-on towards the end of the process? I don't know. I put it out there that I think you do need to justify that the future generations commissioner is consulted at all points in that process, because what is the point, as our late colleague Steffan Lewis used to say, of legislation like this, which sets out a very bold agenda, but actually, when it comes down to the practicalities of policy making isn't factored there early on in the process? So that needs to be addressed.
What about north Wales? It's not specifically my comment today, but of course Labour leadership contender Lisa Nandy has also raised a similar question. Although the budget outlines an additional £20 million for the north Wales metro, to be welcomed, and I've been a big supporter of the investment action on the south Wales metro, and I think good momentum has been started there, but we need to see that followed through in the south. And we certainly need to see momentum in the north, and I think there is a question in the north about whether that has been happening.
Nothing has been said, aside from the metro, about investing in upgrades to the A55, the lifeline to the north Wales economy. I think this is a wasted opportunity. There is a need for a key transport artery from the port of Holyhead to Deeside; a need for that to be fully ready to deliver exports from Ireland to the rest of the UK now we're in the post-Brexit period. And by the way, of course, the UK Government is investing in upgrading part of the A55 to help drive the north Wales economy forward, so, surely, Welsh Government funding in this area would be wisely spent. It's not match funding, exactly, but it almost achieves a similar goal if the UK Government is going to be committing money like that.
Of course, no Welsh Government budget would be complete without some funding for Cardiff Airport, and the budget outlines yet more funding—£4.8 million, I believe you mentioned, of financial transaction capital in relation to this budget in your speech.
Will you take an intervention?
I will now, Mike.
On 31 December 2019, the airport announced a pre-tax loss of £18.5 million in the financial year up to 31 March 2019. I've previously said that I don't think that the airport should be given what could effectively amount to a blank cheque, so I would be looking for assurances that that isn't going to happen. I give way to Mike Hedges.
Thank you. I'm very pleased this has happened yet again. Can I say that you've talked about north Wales transportation, you've talked about south Wales transportation; what about those of us in west Wales and the west Wales metro?
Well, of course I'm not the Minister. I mean, yes, there are gaps in west Wales, but you might want to raise that yourself with the Minister in your own comments. But okay, I take the point—all aspects, all parts of Wales need to be considered equally, and I think the point you're making is that if you set out a preference for one area, such as north Wales, then you automatically lose out in another area. We've had discussions about this in the past. I think that there is a case to be made for north Wales, because it does feel often particularly cut off from the south when it comes to Cardiff specifically. So I think there is a case for that to be made. But I understand what you're saying, Mike.
Will you take an intervention?
Yes, I give way to the former First Minister.
He's mentioned Cardiff Airport. The mayor of Tees valley, who is a Conservative, has made great play of the fact that he has bought what is now Teeside International Airport, intends to invest in it and has said that it's a public asset. If it's the case that the Conservative mayor there can praise public ownership of an airport, why can't the Welsh Conservatives do the same?
Well, there's a question. Thank you for the question. Gosh; in at the deep end today, isn't it? I don't know that mayor specifically, but I would question what he paid for the airport to start with, did he pay over the odds for it and whether he has a strategy for that airport. I've not been questioning during this, the ownership of the airport, but I am questioning the strategy behind the running of that airport and I'm also questioning a blank cheque being provided for that and continual money. So, let's see a strategy, let's see a vision and I'm more than happy to look into the mayor of—was it Tyne? Tees valley. I'll look at what the mayor is doing up there, because perhaps we all in this Chamber could actually learn from what a Conservative mayor in the north of England is doing.
If I can just briefly turn, in the last few minutes, to supporting the economy and business taxes, Welsh Ministers could, of course, have lowered punitive business taxes to regenerate high streets, which are often talked about in this Chamber, to boost the Welsh economy. Look, we are still left with some of the most expensive business taxes in Great Britain, whatever reasons might be given for that. Both land transaction tax for non-commercial properties over £1 million and business rates outstrip our counterparts in both Scotland and England, and are set to do so again. Perhaps we need to look at all this afresh. Perhaps we've got the powers here to do something different. I think that other parties—Plaid Cymru might have mentioned this in the past. Perhaps we need to be looking at whether business rates can be addressed in a completely different way. At the moment, we're not at that point, so let's see some all-important relief for our businesses.
Now that we are the other side of the Brexit deadline, it's clearly important that we get on with developing our own external relations. Rightly or wrongly, Wales is too often perceived as trailing the rest of the UK when it comes to global investors' perceptions. The draft budget allocates an additional £2.5 million of EU transition funding in 2020-21 to support export, trade and inward investment activities, but we need to see more use of existing devolved economic levers, such as the taxation system, to provide a welcoming environment for businesses to invest and grow. Scotland has really built on this connection between the tax system and inward investment. It's something that we need to see in the future and it's a shame that we haven't seen more of that in this budget.
So, to finish off, Llywydd, let's drive Wales forward. The UK Government is delivering record investment this year with £790 million into growth deals and £500 million to the capital region city deal. There is money going in. Let's see similar investment from the Welsh Government. Wales has two Governments: it has a Government here; it also has a Government in Westminster. Those Governments need to work together to drive the Welsh economy forward now and in the future.
There are plenty of yardsticks in the way that we in Plaid Cymru assess the budget of a Labour Government. Fundamentally, the question that we ask is: is the Government using its fiscal resources in the most efficient and effective way possible to transform Wales? Can the Government tell us that there is funding here that is innovative and that drives not only improvement in the way that public services are run in Wales, but also changes culture in a fundamental way in terms of how we think about delivering for the people of Wales? And the answer, I fear, quite clearly, is 'no'.
What we have is a Labour Government that is unwilling to be radical and the background of a Conservative Government that has proved to be totally uncaring as to the impacts of grave cuts to public expenditure for ideological reasons over a decade and more. We can't afford to be tinkering at the edges of the budget and expect transformation. I fear that this draft budget is another missed opportunity to tackle some of the main threats that we face. Yes, there is more money in the pot this time. There is some breathing space after 10 years of harsh cuts—I fear it will be temporary respite, however—but there is no change of direction here. There is no signal that the Government has realised, at last, that we need to tread a new path, otherwise we’ll face the same problems time and time again and nothing will change.
I would like to thank my former fellow members on the Finance Committee—I've left the committee now—for the detailed scrutiny of the budget in far too brief a period. And at this point, I will again echo what I and others have said in the past: yes, the circumstances have been unusual and extraordinary in that we had a UK general election at the very period when budgetary decisions would usually be made at a UK level, and that's what led to the fact that we are dealing with a Welsh budget here without knowing exactly how much is in the pot for the next financial year. But the fact that that has happened—that we are having to follow a scrutiny process without knowing exactly what we are scrutinising—is proof to me that being so closely attached to the Westminster system doesn't work for Wales.
There are a number of individual elements of this budget that I'd like to refer to, but there's also a theme. There is a fundamental weakness running through this budget, and that is the failure to start to think in a truly preventative manner in order to engender the kind of transformation that we need. If you look at the budget for tackling climate change—the most preventative funding possible, perhaps—yes, there are not insubstantial elements of this budget that are targeted at tackling climate change, but if we put that in the context that we are in, the fact that we as a Senedd and you as a Welsh Government declared a climate emergency recently, then the response in this budget to that, I believe, is inadequate.
The commissioner for future generations estimated that there is as much as a 28 per cent increase in the funding allocated for decarbonisation, which sounds great, but she also reminds us that we're starting from a very low level. And, crucially, what the commissioner has told us, which is damning, is that it appears that there’s very little evidence of strategic action from the Government—[Interruption.]
In a second.
And the main weakness that she's identified is the lack of assessment of how the funding allocated is likely to make a difference.
Diolch yn fawr. In regard to the fact that you've mentioned there is 28 per cent uplift in terms of the decarbonisation agenda, and that £140 million on top of what was before, you are absolutely correct in stating that we have announced an unprecedented climate change emergency. In that regard, where would you like to see that money come from? Would it be local government or health, or where would you like to have seen that money come from to go into that agenda?
Okay. It's up to Government to show it is prioritising through its budget, and, if we listen to what the future generations commissioner has said, this is what she said in an article for the Institute of Welsh Affairs last month:
'can the whole infrastructure of Government answer the question of whether its spend increases or decreases carbon emissions in Wales? From what I have seen the answer to that question is no.'
So, it's not just about how much—it's about how that money is spent.
The commissioner goes on:
'we don't know whether the worthy and important new investment in climate and nature in this budget is being undone by business as usual elsewhere in Government.'
That is damning. There's the £29 million for electric buses. Well, excellent. The figure itself is fine. You'll know that I'm a keen campaigner for electric vehicles, but, with a budget such as this, we need evidence to show whether giving £29 million for new buses is the best way of having the best impact in terms of decarbonisation from that expenditure of £29 million. And, in addition to that, there are elements of the budget that could be negative, even, in terms of their impact on the environment.
'Without a comprehensive assessment of all spending decisions,'
said Sophie Howe,
'positive progress in some areas may be undermined by high carbon projects or programmes in others. The Welsh Government have an opportunity to become a global leader on budgeting in a climate emergency, by publishing a "carbon impact account" alongside its annual budget.'
They haven't taken that opportunity in this budget. To respond to the question that was asked earlier, it's not just where the money comes from, but what message the Government is conveying through this budget as a whole. It's not just looking at environmental sustainability that the commissioner is doing. It's the commissioner's role to ask more general questions as to whether decisions we're taking now are going to have a positive impact on future generations. And how we spend public funds is at the heart of that: are we making the right choices now?
This is the fourth budget since the passing of the well-being of future generations Act, but we're still not seeing real culture change in Government. We must do more to ensure that that Act is not simply a piece of paper but the basis of future budgets. That's why we in Plaid Cymru have committed to a well-being budgetary process, similar to New Zealand's, and officials in the commissioner’s office have said that they also wish to see a similar process adopted here.
Health and care is another area where so much more could be achieved by securing a real shift to a preventative approach, thinking of the future now. It's a very small percentage of the budget that is allocated for that real preventative work. Certainly, there is no sign of transformation here, and I'm not just talking here about expenditure on the NHS, but the failure to bring together all of those elements that have an impact on people’s health.
We know full well about the relationship between ill-health and poverty. There's nothing new in this budget when it comes to tackling poverty. Time and time again, the Government is trying to do the same things rather than introducing the ambitious change required to bring those who are most in need out of poverty. We see concerns about the shortage of funding in areas such as housing, homelessness and the Supporting People programme—the Bevan Foundation say that there's little evidence of new methods being adopted to prevent poverty. For example, it's critical of the same old practice of emphasising the numbers of jobs created, whatever the levels of salary or the terms and conditions of those jobs.
Local government plays a key role in delivering preventative elements of public services. Again, while we see an increase of £184 million, or 1.8 per cent in real terms, in the support for councils in Wales, the Welsh Local Government Association has estimated that councils need an increase of £250 million just to stand still. Local government can't play its full part in the preventative agenda that we want to see develop without receiving the support to do that.
I'll turn to the Welsh language briefly. We can all agree on the value of having a target of a million Welsh speakers, but how can you square that with the real-terms reduction of £400,000 in expenditure on the Welsh language directly? In addition to that, there's a cut of £1.65 million for the Welsh language within schools. I had an opportunity in the Chamber last week to push the Minister for the Welsh language not to cut the budget for Welsh for adults. Now, I know that her view is that perhaps we need to look at spending on giving people opportunities to use the Welsh language. Now, whilst that is important, in places such as my constituency, there are plenty of opportunities to speak Welsh—it's giving people an opportunity to have those skills to participate in those opportunities that's important in those constituencies and those areas. And, as a whole, it appears that the Government's decisions on expenditure on the Welsh language are entirely contrary to what is needed in order to ensure the viability of the Welsh language in future years.
I will conclude, Llywydd: the budget is part of the furniture of this Senedd, part of our governance, but it's more than that. It is crucial in terms of setting direction. It tells us what kind of Government we have. This is where rhetoric is supposed to become reality, the proof of the willingness of Government to implement their pledges. Yes, there are challenges. There are challenges in terms of Brexit and the costs of that, there are challenges in that we still don't have that full budget available to us, there is uncertainty as to how long the increases coming from the UK Government will continue, but this is not an innovative budget, it is the contrary of salami-slicing—where we see every department getting a slight uplift. That, I fear, is the most unimaginative form of budgeting that the Welsh Government could have adopted.
I thank Rhun for his contribution there and for his service on the Finance Committee. We're sorry to have lost him. And I also welcome Nick Ramsay back to the Chamber and thank him for his contribution.
He mentioned the airport, and the Conservatives were criticising the further expenditure on that, and Carwyn Jones, the ex-First Minister, who is no longer in his place, came back by saying, 'Well, you have opposed the spending here, but you support it in Durham Tees', where a Conservative bought the airport. I've looked at how much was spent on it, and it was £40 million they paid up on the Tees, and that airport only had 130,000 passengers.
So, while we thought £52 million was quite a lot for the Welsh Government to spend on Cardiff Airport, compared to the KPMG estimate of a valuation of £25 million to £35 million, it suggests that, actually, the £52 million compares relatively well to the £40 million, when Cardiff had 1 million passengers compared to the 130,000 there, but whether that's the right valuation I don't know. But I would note, in response to Carwyn's comment, the response of five Labour council leaders to the Conservative mayor buying the airport in Durham Tees: they warned that the mayor's plans to sink money into the struggling airport would create a black hole in investment plans.
I hope we'll look at these issues on merit, rather than simply from party political allegiance. I think the important point I'd like to make, in terms of cash going from Government into the airport—yes, if it's a black hole and it's consistently taking cash and there's no prospect of it generating cash to pay back down the road, then that wouldn't be a good idea. But, at the margin, what they are doing with the additional money? When I met with Roger Lewis and others, when he was chairing the airport, I think they made a case that at least some of the extra cash they were looking for was going to get a payback within a year or so, in terms of extra retail units and improving terminals. If that payback is the case, then it would be sensible to put the cash into it, and, given that the Government is the shareholder, for now that duty falls to Welsh Government.
We heard, as Nick said, relatively limited mentions of austerity from the finance Minister, at least compared to previous contributions. However, she did emphasise—and her comparison was one, again, back to 2010-11, and how we, she says, have £300 million less in real terms now than then. I just think it's more helpful, in scrutinising and considering the budget, and deciding what we think of it, to compare what the budget is for the year ahead compared to the previous year. What are you actually doing in this budget? For that, I think the important number is that £593 million increase in spending, or 2.3 per cent in real terms.
I think the finance Minister was a little unfair to criticise the UK Government for its chaotic approach to the budget timing, since I think the timing of that 12 December general election, or the necessity of having it, was not entirely in the UK Government's hands. Opposition Members in Westminster had at least as much responsibility for those timings and the impact they had on the budget process.
However, I would like to commend the Welsh Government on its pragmatic response to those timing difficulties, its, I think, sensible liaison with the Finance Committee in terms of scrutiny and the debates we've had here. I think it's worked okay, in light of the challenges that we had. Certainly, compared to the Scottish Government, and the huge problems they've had, I think we have acquitted ourselves well in terms of those timings working together.
I also think, in that context, we, on the Finance Committee, are looking to give greater consideration to the budget process, stepping back from the specifics of this budget to ask if this is the right process. The thing that I've become most concerned about, about the process and how it works, being on the Finance Committee on and off over the years, is that the draft budget, and then the scrutiny and the debates and the stakeholder meetings, I think possibly lead to heightened expectations from stakeholders, interest groups, those who are funded—AMs here, to an extent—of the prospect for change. And I wait to see what happens in the finance Minister's final budget to see what is changed then.
But, if the scrutiny process is to have any value—. I'd just give one example of an area where I think there's been cross-party consensus, and that is bus services. Yes, it's welcome to have this £29 million of capital funding for electric buses, and I'm sure that those who use them and those in city centres who benefit, perhaps, from reduced air pollution because of them will appreciate that spending, but we're not clear as to whether that is the best value of spending compared to other projects, to the extent that the Minister is focused on climate change objectives. Obviously, there are other benefits to these as well, but are those benefits greater than how that money of £29 million could be used elsewhere to support bus services?
Myself and the Member for Blaenau Gwent both brought this up repeatedly in committee: that, actually, if in Ebbw Vale you've seen the frequency of the service halved, whether it's an electric bus is much less important than whether there is a bus. I just hope the Minister, if she is listening to the scrutiny—and it's come from Plaid, us, Conservatives and from her own back benches. A real-terms cut in the subsidy for bus services on a revenue basis does not seem to gel well with her purported climate change objectives. And I just would, again, encourage her to reconsider that aspect prior to the final budget.
I also wonder, given we've had this long period of relative austerity and we've come out of it—yet the approach of Welsh Government is largely to hand out fairly similar increases across the board. Some areas have particularly benefited; I see the Minister for the international side in her seat, and that's a significant percentage although quite small as an absolute-terms increase, and I hope she won't go overboard with opening too many offices across every EU country with the extra cash, but that's a big area of increase.
But I just wonder, in terms of that core decision—the NHS versus local government—similar increases to both—. Yet, what has happened in dealing with austerity in Wales is there have been relative cuts in the health service compared to England, yet local government has been protected much more than has been the case for English local government. The Welsh Government used to tell us that we needed structural change in local government, and I agree with them. Why do we have so many councils, 22 unitary councils, much smaller generally than those in England that are delivering unitary services? There's a desperate need to try and encourage regional working to mitigate some of those inefficiencies. But ultimately, would it not be better if we had fewer and larger councils that were better suited to carrying out those tasks?
I will give way to someone who will disagree strongly with what I've just said—Mike.
Thank you for giving way. Would you not accept that the councils in Wales are substantially larger than those on mainland Europe and north America?
It depends which council you refer to. Some of the activities carried out by unitary councils here would be carried out by states in the United States, which are of course much bigger. But what I would say is: I believe 22 is too many, and I think we should require local councils to merge with at least one other. I think Cardiff and Powys should probably be exceptions on account of their size. I think it should be a bottom-up process with councils deciding on their merger partner, rather than a top-down map. I think that would allow savings to be deployed into front-line services. And while we're about it, I would cut the number of councillors and I would question why they all need to be paid a minimum of £14,000, which is far more than I saw when I—. Many councils in England have substantially less, despite being larger unitary councils than those who are paying that sum.
Finally, I look forward to seeing the final budget done. I thank the Minister for scrutiny in difficult circumstances, and it's good to see a budget where we have some opportunities to deploy and invest some money after so many years of austerity. Long may it continue now that the United Kingdom is once again an independent country.
Firstly, can I say how nice it is to see so many people taking part in this debate for such a major debate? Far too often, four of us used to debate the budget and the Minister used to reply. We're dealing with substantial sums of money, and I think it really is worthwhile for the Assembly to give it a full debate. I want to address this debate in two parts; firstly, on the overall budget, and then on the budget covered by the areas scrutinised by the Climate Change, Environment and Rural Affairs Committee. I want to address how money is spent, because the increases are welcome, but how it is spent within departments is at least as important—I would argue more so.
The role of Government can be broken down into three areas: health and well-being, security, and the economy. Starting with health and well-being: health is no more all about hospitals than car maintenance is about cars being repaired in garages. People's health and well-being begins with having a warm, waterproof and safe home with enough nourishment. Stopping people being homeless and providing supported accommodation will keep many people out of hospital. I want to highlight two areas that are important: the provision of social housing so that people have a home; the provision for supporting people who aren't able to look after themselves to have a home in which they are supported. These are fundamentally important for the lives of people.
Within health provision—and my concern about the size of the geographical areas of the health boards is well known—the funding of primary care needs to increase. What is happening is that people cannot get an appointment in primary care and then go to A&E. Often, the default position in A&E is to keep patients in for 24 hours' observation when they come in with non-specific symptoms. On hospital discharge, it's ensuring that the hospital pharmacy provides the medication, so that patients can go home rather than waiting until the following day when the pharmacy is able to provide their medication. Why do so many patients who go into hospital able to look after themselves get discharged either to nursing homes or to a substantial care package? Whilst understandable for stroke patients, I find it less understandable for people who go in, sometimes for orthopaedic operations they've asked to have, and they end up then being no longer able to look after themselves.
On the economy, we can either try and make a better offer than anyone else to attract branch factories, or we can produce a highly skilled