The Assembly met at 13:30 with the Presiding Officer (Dame Rosemary Butler) in the Chair.
Y Llywydd / The Presiding Officer
Good afternoon. The National Assembly for Wales is now in session.
Y Llywydd / The Presiding Officer
The first item this afternoon is questions to the First Minister, and question 1 is from John Griffiths
The Welsh Government's Waste Strategy
1. Will the First Minister make a statement on the Welsh Government's waste strategy? OAQ(4)2413(FM)
Yes. The waste strategy is set out in ‘Towards Zero Waste’, published in June 2010, and it sets out our ambition to achieve a high-recycling, low-carbon economy and progress towards zero waste by 2050.
First Minister, the Welsh Government’s collections blueprint is being reviewed following a recommendation from the Environment and Sustainability Committee. If that review confirms that kerbside sort is the best method to achieve high-quality recyclate, high-quality materials from the recycling collections, will you seek to ensure that that is the method that’s used across Wales?
We’d like to see increased consistency of service across Wales. Currently, of course, the decision on which collection system to adopt is down to individual local authorities, and any change to this position would need careful consideration in the light of the blueprint review. Of course, I don’t want to pre-empt the findings of that review at this point.
First Minister, the Environment and Sustainability Committee published a report on recycling in Wales in December of last year, and the committee made seven very important recommendations. Given that all of these recommendations were accepted or accepted in principle by your Government, can you name one recommendation from that report which has now been implemented?
It is a matter, of course, for the local authorities. What’s important is that they shouldn’t mix everything together. We know that, if they do that, there isn’t very much value to the recycling product. Now, what is important is that local authorities are able to make decisions that are right for their areas, bearing in mind the fact that there are many alternative ways of dealing with waste across Wales. What is important is that we continue to recycle more, and that has been reflected in the figures that we’ve seen over the past decade.
I'm sure we would all be supportive of the principle of having a zero-waste Wales, but doesn’t that highlights the foolishness of your Government's policy in investing tens of millions of pounds in incinerating waste for energy? If the policy on waste were successful, there would be nothing left to incinerate?
That is very naïve, because that would mean that you would have some kind of control over how goods are packaged, and that is not the way things stand at the moment. That’s the problem. We have to deal with what arises in Wales—the waste that we have in Wales. We can’t deal with what is being sold in Wales. So, therefore, approaching zero waste is something that has to be done at a European level at least, if not a world-wide level.
First Minister, last month, the Welsh Government waived a £0.5 million fine for the City of Cardiff Council for their failure to meet its recycling targets on the basis that they had a credible plan to improve and meet the requirements under your waste strategy. Can you tell me was privatising the waste and recycling services of the city of Cardiff part of the plan you approved?
It’s a matter for Cardiff how it organises its waste and recycling services. What is important is that it meets its targets in the future, and we’ll be monitoring that situation very closely.
Electrification of the Main Line between London and Swansea
2. What discussions has the First Minister had with the UK Government regarding the electrification of the main line between London and Swansea? OAQ(4)2403(FM)
The UK Government has restated its commitment to the project. We have reiterated to the UK Government that the main line must be delivered in line with the original announcements, given the importance of the project for Wales, and that does mean electrification to Cardiff by 2017 and Swansea by 2018.
Thank you for that answer, First Minister. In replies to Baroness Randerson in the House of Lords, Lord Ahmad of Wimbledon stated that the chair of Network Rail is putting forward proposals for re-planning the enhancement programme and reporting to the Secretary of State in the autumn. Can I ask whether the Welsh Government has been part of the discussions that will lead to that report?
We expect the UK Government to deliver on its promises. The Prime Minister was absolutely clear that he would deliver on this, and he mentioned the timescale. The Chancellor of the Exchequer mentioned it in his budget speech. We expect that timescale to be kept to. It’s not a matter for discussion or for debate. The promise was made of 2017 to Cardiff and 2018 to Swansea. We expect that promise to be kept.
Does the First Minister think that the overspend on Network Rail’s five-year programme—which, it seems, was known before the general election, but not revealed—will impact on the Welsh access route into Heathrow, which is very important, along with electrification?
Well, the Member’s right to point out there’s a question as to whether this was known to the UK Government, and they chose not to make the situation public before the general election, for reasons best known to themselves. But it is not clear at the moment what this means for projects in Wales or that affect Wales, particularly of course the spur from Heathrow. We know how important that is to traffic from south Wales, particularly, and the ability to use Heathrow airport.
First Minister, your Minister for Economy, Science and Transport stated last week that she hoped the new rail franchise would bring rail improvements to Swansea and further west. We have a once-in-a-generation chance to improve the transport infrastructure on the back of electrification. South-east Wales is getting the metro. What improvements can people in my region expect?
Well, we know, for example, that, since the single franchise across Wales was created, there’s been much better integration of services, both east-west and north-south. Of course, for the first time, when franchising is next agreed, the Welsh Government will have a far stronger role, in terms of how the franchise is agreed and how rail services are then provided. We expect, of course, then, to be able to continue with the good work that’s being done in integrating services further west with the rest of the network.
First Minister, Network Rail has details on its website about the modernisation plan with electrification, consultation with local people with regard to bridges, and any changes that will take place. I notice there’s been consultation in Newport and Monmouthshire, with regard to bridge changes there, but, in Llanharan, it seems that the bridge will be totally removed, and that’s causing some concern to local people. Is there anything that you’ve had by means of an update on this particular issue?
No, but we would expect Network Rail to conduct the work they need to conduct on the bridges as quickly as possible, and with the least disruption possible. It’s inevitable, with electrification, there will be some disruption, with some of the bridges, but, certainly, we expect that work to be carried out in a peremptory fashion.
The importance of electrification is not only the shortening of the journey times, but the message it sends to potential investors. Will the First Minister continue to press the economic case for the electrification of the main line to Swansea?
Absolutely. The Member and I are in exactly the same place on this. He will recall that, when the UK Government decided that it would not electrify to Swansea, we were in the vanguard of making the call that it should. When the UK Government took the view that it would not electrify between Cardiff and Bridgend—for reasons best known to itself—but further west, from Bridgend to Swansea, we were in the vanguard of holding the Prime Minister to his promise that electrification would take place as far as Swansea.
Questions Without Notice from the Party Leaders
Y Llywydd / The Presiding Officer
We now move to questions from the party leaders, and first this afternoon is the leader of the opposition, Andrew R.T. Davies.
Thank you, Presiding Officer. First Minister, the disposal of land by the Welsh Government to help regeneration was a critical part of providing a fund that could regenerate large parts of Wales. I appreciate the report is embargoed and not due to come forward until tomorrow, but, in your opinion, do you believe that the disposal attracted good value for money for the Welsh taxpayer?
As the leader of the opposition says, the report is due to come before Members tomorrow, and Members will, of course, have the opportunity to consider it.
The question was quite simple. Because you’ve obviously, as a Government, disposed of this land, I was merely seeking your view. This is the last time we will meet at First Minister’s questions for eight weeks, it is. You obviously have taken a view as a Government, because you disposed of this land. I’m not asking you to prejudge the report, because it’s not coming forward till tomorrow morning. So, what I’m merely trying to elicit from you is: did you believe that it provided good value for money? I’m assuming you did; otherwise, as a Government, you wouldn’t have sanctioned the disposal of that land. So, I put the question again: do you believe it provided good value for money to the Welsh taxpayer, the disposal of these very valuable pieces of potentially developable land?
Well, it’s a question, of course, that the leader of the opposition is perfectly entitled to ask, but I don’t think it’s fair to other Members, until such time as they’ve seen the entire report and will wish to ask their own questions, to try to identify certain issues in the report and deal with them today. It’s right to say that Members should have the opportunity tomorrow to deal with the issue.
I find that a very perplexing answer. You’ve obviously disposed of this land, so someone, somewhere decided it did have value for money for the Welsh taxpayer, because, otherwise, was there no ministerial oversight? Okay, let’s take it to the next stage. If the report does identify a lack of ministerial oversight, because ultimately, it would’ve had to be sanctioned—and I’ve used the word ‘if’, so I’m not trying to prejudge anything, and we’re not meeting for eight weeks at First Minister’s questions—will you take action against those Ministers, if they are currently sitting in the Government, who have proved not to return value to the Welsh taxpayer by disposing of valuable Welsh Government assets?
I have to say I believe that Members of this Assembly as a whole should have the opportunity to ask questions on this tomorrow, and rightly so. The report has to be taken as a whole. As a Government, we will, of course, respond to that report and any recommendations it might make.
Y Llywydd / The Presiding Officer
We now move to the leader of Plaid Cymru, Leanne Wood.
Diolch, Lywydd. First Minister, medical professionals are increasingly saying that the link between children’s health and sugary drinks has created an obesity time bomb. It’s estimated that unhealthy diets cause 70,000 premature deaths every year. This affects people who live in poverty more, of course. Now, as you know, Plaid Cymru proposes a levy on sugary drinks, and we welcome the support for that from a growing number of individuals and organisations, including the British Medical Association. Rather than ridicule our proposals, isn’t it now time for you to perform a u-turn and back Plaid Cymru on this?
Well, there are three issues here. Firstly, is the issue of whether there should be more tax on sugary drinks, and I think that has merit, I must say. But, there are two other issues: first of all, we don’t have the powers to do it, which is one of the issues, of course, that Plaid Cymru have not really fully dealt with; and secondly, it’s this issue, which I have raised in this Chamber, that, if you raise a tax with the intention of reducing a particular form of behaviour, you will inevitably reduce the amount of money that is taken in that tax. If you hypothecate it for a particular purpose, it’s inevitable that the amount of money available for that particular purpose will drop. So, the disagreement that I have with her is that if she says she’s going to hypothecate a tax and it’s going to pay for, as she put it, 1,000 extra doctors a year, it’s going to come from an ever-decreasing pot of money. That’s the problem of hypothecation. If you have sin taxes—and smoking is one area that’s taxed heavily—she will notice that it’s not hypothecated, for the obvious reason that it provides an ever-decreasing amount of money to pay for a particular policy.
But that’s not the question I asked you, and the arguments that you are putting are arguments against taxing cigarettes, alcohol, and carrier-bag usage. It’s well established that you tax to disincentivise behaviour, and the link between ill health and poverty among children has been highlighted further in the media today. First Minister, a staggering 70 per cent difference exists between death rates among children living in the most deprived areas compared to the most wealthy. If you’re not prepared to take a policy change as the one that I have proposed this afternoon, what other policy changes are you prepared to make in the light of today’s unacceptable revelations?
I think if we had the power to introduce such a tax, it might be something that we could look at. I’m not in disagreement with her on that, particularly. What I do think she has wrong is this idea that you can take an ever-decreasing pot of money to pay for the same policy year after year. It doesn’t work out. She’s right to say, of course, there are sin taxes, but the point is this: taxes on cigarettes and alcohol are not hypothecated for a particular purpose—with good reason. Because you’re trying to dissuade behaviour, the tax take drops over the years. If your tax take drops, the amount of money you have to pay for a particular policy is bound to drop as well. So, it’s the hypothecation that her party has wrong.
First Minister, we’ve never talked about hypothecation. I welcome your u-turn on this, and I’m glad now that you’ve had a change of heart. First Minister, overcoming poverty is the greatest challenge facing our country, and its impact on health outcomes is well known. We must give support to, and defend, those people who are living with poverty. Now, we know that you were at war with your party leader on limiting financial support to families with children, so what is your Government planning to do to defend those people who will suffer from regressive Tory policies, backed by the support of your old boss?
Well, I mean, there are a number of questions. First of all, I’ve just heard the most stunning public u-turn that I’ve ever heard from any party leader in this Chamber. It will come as news to all of us—even those on her own benches, from the expression on their faces—that, somehow, the ‘pop tax’, as it’s been called, was not meant to be hypothecated. The whole point was—and she’s said it time after time after time in this Chamber—it was going to pay for a certain number of doctors. All of a sudden, there’s been a complete u-turn and that’s no longer the case. I welcome it, because it shows that it was a fallacy to begin with and it shows the shallow ground on which that policy was actually based. She makes the point about benefits. She and I are in much the same position on that; that much I agree with her. I wonder if she’s in the same position as her parliamentary leader when it comes to fox hunting, given what Jonathan Edwards has said on that. [Interruption.] I know their blushes have been spared by the fact that the Conservatives have run away from having a debate on that. But she makes a serious point—[Interruption.]
Y Llywydd / The Presiding Officer
[Continues.]—and that is this: how do we ensure that those people who have been targeted by this UK Government are helped? We saw from the budget last week—it was a budget that had young people in its sights—a so-called living wage that was not a living wage, and not introduced to those under 25, who, for some reason, are not affected by the living wage, and attacks on housing benefits, attacks on student grants and attacks on student maintenance. It was a blatant attack on young people within the UK. We as a Government are, as we always have been, ready to do what we can to defend our people against what are unfair and unjust cuts. We saw £50 million removed from the Welsh budget. Imagine how many consultants, how many hospital beds, how many nurses could have been employed if the Tories hadn’t pinched that money from the people of Wales.
Y Llywydd / The Presiding Officer
I know it’s the last session before the recess, but I don’t want you shouting enough for the whole of the eight weeks that you’re not going to be here.
Y Llywydd / The Presiding Officer
We now move to the leader of the Welsh Liberal Democrats, Kirsty Williams.
First Minister, figures collected by the Welsh Liberal Democrats this week have revealed that, since 2012, 10,395 official staff complaints have been made to health board bosses in Wales about a lack of qualified staff available. In Cardiff, the number of complaints in 2014 alone was the equivalent of 12 per cent of the total number of staff working at that health board. Do you consider this level of complaints to be acceptable?
Well, it’s worth noting that the reported level of incidents represents a small percentage of total reported incidents. The overwhelming majority of reported incidents are incidents that lead to no harm. It’s worth pointing out as well that there are more doctors, more nurses, more midwives, more paramedics and more dental staff working in the Welsh NHS today than there were 10 years ago, and that, since 1999, the total number of staff working in the Welsh NHS has increased by a third. I know she has an interest in the issue, given the Bill that she’s promoted to the Assembly, and I know that the Minister has written to her with a view to offering another meeting as to how that Bill might be taken forward on a basis that’s satisfactory to all.
First Minister, I am aware that there have been increases in staff, but, as you remind me on a weekly basis as a reason why you can’t meet your own health targets, demand is also rising. Surely it cannot be acceptable to you that your staff working in the Welsh NHS are repeatedly telling—repeatedly telling—their managers that they don’t have enough colleagues around them to cope. That’s significant, because we do know that there is a link between staffing levels and patient outcomes. A recent report for the English NHS revealed a significant relationship between the number of nurses on duty in hospitals and 40 indicators of patient care outcomes. Therefore, given that evidence in England, do you regret, as I do, the decision by the English NHS to stop the National Institute for Health and Care Excellence’s work in this area that demonstrates the evidence for safe staffing levels, a decision that has been criticised by Robert Francis, nursing unions and workforce experts?
Yes, I do. There are many questions, of course, for the UK Government to answer about the English NHS. We want, of course, to make sure that the NHS is staffed at a safe and sustainable level, as does she. As I said, we are aware of the Bill that she has promoted in the Assembly and, as I say, I know the Minister is keen to discuss that matter further with her.
Talking about NHS England’s decision on staffing guidance, NICE’s clinical director, Professor Baker, said:
‘I think the reason they don’t want it is, if you don’t like the answer to the question, you don’t ask the question’.
In Wales, First Minister, would you agree with me that we must not be afraid to ask that question? In looking to promote safe staffing levels, firstly in the nursing profession, will you work with me and the health Minister to ensure that Wales is the first part of the UK to take this agenda seriously, as parts of Australia announced this week, and to ensure that we have safe nurse staffing levels on our wards, with a view to introducing that, potentially, to other sectors of the NHS workforce?
The leader of the Liberal Democrats is right to say that we should not be afraid of asking that question. She will know that the committee looking at her Bill did raise a number of issues that need to be resolved and, as I say, the Minister and she will be able to meet in the near future to see how and whether such a resolution can be achieved.
Y Llywydd / The Presiding Officer
We now move back to questions on the paper, and question 3 is from Russell George.
Investment in the Welsh NHS
3. Will the First Minister make a statement on investment in the Welsh NHS? OAQ(4)2411(FM)
Well, investing in our health service is a priority for the Welsh Government, as reflected in our budget for 2015-16.
Thank you for your answer, First Minister. In last week’s budget, the Chancellor confirmed an additional £8 billion for the NHS, underpinning the importance of the NHS to the UK Government. Given the Welsh Government’s record-breaking cuts to the Welsh NHS, will you confirm that the health service in Wales will benefit fully from the Barnett consequential in full?
Well, let’s see it, because there is no sign of the money, I can promise you that now. It’s lofty rhetoric, but no delivery yet from the UK Government. I would take him and his party more seriously if they had stood up for Wales and resisted the £50 million-worth of cuts that their own party imposed on Wales—£50 million that could have been spent on doctors or nurses or hospital wards; £50 million that could have been spent on the NHS in Wales, which has now been pocketed by the Conservative Party and the Chancellor.
The Welsh Government, on the other hand, has ring-fenced more than £20 million to support 1,600-plus people who receive the independent living fund in Wales, whilst the UK Government closed the nationwide scheme last month. First Minister, do you agree with me that, as well as record investment in the NHS, spending on social care will save us money in the long run as people are supported to live independently?
Absolutely. Health and social care run together. We know you cannot separate them both. We know social care has been absolutely wrecked in England—[Interruption.]—absolutely wrecked in England by the Conservatives—
Y Llywydd / The Presiding Officer
Can we have a little less noise so we can hear what the First Minister is saying? Apologies, First Minister. Carry on.
I know these answers are inconvenient to them, Presiding Officer, but the reality is that we know that health and social care spending in Wales is 5 per cent higher per head than in England, and so his party can hang their heads in shame.
First Minister, Plaid Cymru does believe that a pop tax could provide a useful revenue stream into the NHS. Andy Burnham, in the recent general election, promised to hypothecate a levy on cigarette makers to fund more staff in the NHS. Is that a hypothecation that you supported?
No. I don’t think hypothecation works in those circumstances either. She seemed to be suggesting that she was in a different place there from her own leader when it came to the pop tax—
No, you seem to be suggesting that you’re in a different place to your leader—
[Continues.]—but is it hypothecated or not? I was asked a specific question: did I agree with hypothecation in terms of a levy on cigarette manufacturers. The answer is ‘no’. That doesn’t mean I don’t agree with a levy, but I think it’s dangerous to have hypothecation for what is an ever-decreasing tax pot. That doesn’t make sense.
So, Andy Burnham’s policy is dangerous.
Well, I don’t agree with what he said.
Y Llywydd / The Presiding Officer
First Minister, you don’t have to respond to questions when people are seated. If they’re not standing up, they’re not asking a question, so they don’t deserve an answer. William Powell.
Diolch, Lywydd. First Minister, Powys Health and Wellbeing Action Group very much appreciates your Government’s support in their ongoing work to develop a wellbeing park in the grounds of Bronllys Hospital. Indeed, this Friday sees the official opening of the veterans garden, which has already been widely enjoyed by ex-service personnel. The action group is making real headway towards setting up a community benefit organisation. However, it would be much easier and progress would be greatly accelerated if the Welsh Government could consider seconding an appropriate officer to support their multifaceted work. First Minister, in this context, will you commit to discussing this matter with your Cabinet colleague the Minister for Health and Social Services so as to explore fully the potential that Bronllys park has to be a showcase for innovative care of UK and international status?
Yes, I will do that, and I’ll ask the Minister to write to the Member with an update.
The Future of Onshore Wind Energy
4. Will the First Minister make a statement on the future of onshore wind energy in Wales? OAQ(4)2407(FM)
Well, following the UK Government announcement on 18 June to close the renewables obligation support for onshore wind early, the outlook for projects in Wales looks uncertain.
You are quite right, First Minister—they certainly do look uncertain. In response to the announcement, the Minister in Scotland insisted on a meeting with the UK Minister. That meeting was held, and a further meeting has been arranged with the communities, the investors and the businesses that will suffer as a result of this decision. Also, of course, an emergency summit is to be held later this year. I wrote to you about a fortnight ago, asking what the Welsh Government’s response was in comparison. I’m still awaiting that response, so perhaps you could expand on that this afternoon in order to explain how you will respond to that decision and how you will stand up for Wales?
A letter has been sent to the United Kingdom Government, and a meeting is to be held today to listen to the concerns of businesses in particular, and, of course, we share the concern that this could meant that there won’t be sufficient electricity at the end of the day. That’s the problem in this regard. So, as to this decision and the decision concerning photovoltaic cells, it’s not very evident currently as to where we will get electricity from in the next decade.
First Minister, this announcement by the UK Government to curtail the subsidies for onshore wind has had an early and direct result in terms of the job losses at Mabey Bridge. Would you agree with me that, just a few months into this UK Tory Government, we see the green rhetoric already fading into history and that they simply do not understand the importance of a green economy? And, that will cost all of the UK dear, including Wales, in terms of job losses and lack of progress.
A hundred jobs lost in a Conservative-held constituency; yes, that’s right. I think it reminds us all that there are, in fact, livelihoods at stake here as a result of knee-jerk decisions that are taken by the UK Government. The Member’s quite right to point that out.
There are other examples, as well, that are unclear at the moment, in terms of what it means for our carbon emissions. One of the vaguest references I saw in the budget was over vehicle excise duty and what that meant. I suspect it’ll mean that the vast majority of cars that are now paying far less than £140 will find themselves paying that amount. So, the greenest cars will pay more while the most polluting cars will pay less. Surprisingly, we haven’t seen more detail on that yet from the current UK Government.
First Minister, over recent years, we have seen within our own communities massive opposition to large-scale wind turbine projects, be it onshore or offshore. These do have the potential to damage our countryside and, indeed, our coastlines. Now, there’s wide recognition across the industry that a broad range of technologies is needed to take our climate change programme forward. What plans does your Government have to review technical advice note 8 in order allow different and new technologies to come forward as a viable option?
TAN 8 is a land-based TAN, anyway; it doesn’t affect the sea. If we’re not going to have onshore and apparently, now, offshore wind as well, what do we have left? With the tidal lagoon, we know that the tidal lagoon has had permission to move ahead, but there’s no strike-price yet—no strike-price at all—and it’s absolutely crucial that the UK Government now tells the developers of the tidal lagoon what money is going to be on the table, because they haven’t done that yet. We won’t have marine energy, we won’t have wind energy in any form, so what else are we going to have, then? At the moment, there’s complete silence on this. A knee-jerk reaction and no plans. Just talk to investors, talk to businesses and they will say to you they have no idea what the current policy of the UK Government is, and that is a dreadful position for the UK to be in.
5. What steps will the Welsh Government take in 2015 to tackle domestic abuse in Wales? OAQ(4)2416(FM)
The Minister made a statement on 30 June, which informed the Assembly of the action the Government is taking to tackle domestic abuse following the Royal Assent that was given to the Act in April.
Thank you for that answer, First Minister. The Independent Police Complaints Commission recently called for all police forces in Wales to change the way they train officers and civilian staff who deal with domestic abuse cases in Wales. In particular, they are concerned that police forces are too reliant on staff learning online instead of interactive learning through case studies. Will the First Minister agree to raise these concerns with the police to ensure that training to deal with domestic abuse cases is appropriate and effective?
The Member makes a fair point, and I expect the police to follow the advice given by the independent commissioner to make sure that their response to domestic abuse cases is as effective as possible. It would be much easier, of course, if the matter was devolved. It isn’t, and his party resists that.
First Minister, in relation to violence within the family, do you think that changing the law to give equal protection to children as adults from assault is unenforceable nonsense, or do you agree with me that it’s high time we did it?
I think that these are issues that all parties will examine before the election. My party is on record as saying this is something that we would want to move towards, but there are a number of issues that would need to be resolved on that journey, if I can put it that way. It’s right to say that this is an issue that all parties are examining at the moment, although I do regret the fact that we could have had the opportunity to deal with this on an all-party basis, but that offer was not taken up by her party or by the others. [Interruption.]
Consultant-led Obstetric Services
6. Will the First Minister make a statement on maintaining consultant-led obstetric services on the three general hospital sites in north Wales? OAQ(4)2408(FM)
I expect the health board to consult with its staff and local communities, and to ensure that all women’s clinical services in the region are placed on a safe and sustainable footing.
Well, the strategy—if there is such a thing as an obstetrics strategy in north Wales—is in chaos following recent decisions. The question causing anxiety to many people in my area is: what will be the impact of establishing the sub-regional neonatal intensive care centre on services Ysbyty Gwynedd? The maternity services in Ysbyty Gwynedd have had a very good reputation over a number of years. Can you give assurances that the current maternity service, which is consultant-led in Ysbyty Gwynedd, will continue into the future once the new unit is established at Ysbyty Glan Clwyd?
Well, there will be some changes when the SuRNICC is established. The SuRNICC was something that was supported by his party. So, you can’t say, ‘Well, we now don’t wish to see the SuRNICC and see any impact on other hospitals’. That doesn’t mean that the service will deteriorate—of course not. But when you have one centre that can deal with the more serious cases, perhaps there might be some impact on other units, but that, of course, will be part of the assessment that will have to be made. But his party was very much in favour of the SuRNICC itself, and, of course, we will ensure that the SuRNICC will be established on the Glan Clwyd site.
Obviously, there’s a great deal of concern still in my constituency about the future of the maternity services at Glan Clwyd Hospital as a result of the uncertainty that was created by the health board earlier this year. The recent decision to not challenge the need to consult on the future of those services has indeed been very welcomed in north Wales. I understand that a consultation will now take place. What expectations do you have, as a Welsh Government, regarding that consultation and the involvement of the public and other key stakeholders? I was disappointed to learn about the consultation, not from the health board, but simply from a media inquiry yesterday, and it’s clear that the consultation is obviously not getting out on the right foot if local stakeholders such as Assembly Members are not involved from the start of the process.
Well, I expect the consultation to be full and open and transparent. The problems that still exist in that unit are still there. There’s no point pretending that all is well and that things can stay exactly as they are. We do understand the concerns of people in the area around Glan Clwyd, and I know that the health board is taking steps to look at ensuring that the service can continue for the time being. But there will need to be steps to make sure that the service is safe and sustainable in the long term. That means dealing with the issues that are identified by the royal college and others, which are not going to go away: the fact that no trainees can go there, they won’t go there, the fact it’s very difficult to attract middle-grade doctors there on a permanent contract. There’s much that needs to be done to improve the reputation of the department for the good of local people. But I do believe that the health board, with its new acting chief executive, has taken the appropriate steps. It’s absolutely crucial, as we have said, in terms of regaining the confidence of local people, that there’s a full consultation.
Do you think, First Minister, that a period of eight weeks of consultation over the summer months is sufficient? May I also ask you, in March, you said that the business plan for the SuRNICC was to include all services for north Wales and that that would be prepared by November? Given that there are eight weeks between July and September, will that original timetable, for the business plan to be in by November, be adhered to?
I don’t expect that. There are two distinct things here. First of all, two months, I think, is adequate as regards a consultation, but what is important is that the quality of the consultation is high, and ensuring that people are aware of the consultation and do know what kind of views they can input into that consultation.
The SuRNICC is different, because the SuRNICC is not just going to be imposed of the Glan Clwyd maternity unit. That’s not the objective at all, but having a different unit, staffed in a different way, and something totally new. So, I cannot see why we can’t proceed with the SuRNICC itself and prepare for that, and also consider the current situation at Glan Clwyd.
Promoting Tourism in Wales
7. Will the First Minister outline what the Welsh Government is doing to promote tourism in Wales? OAQ(4)2404(FM)
Yes, our tourism strategy sets out our priorities to support the tourism industry. Tourism in Wales is in a strong position—2014 was a record-breaking year, as the number of overnight visits to our country by GB residents alone hit an impressive 10 million.
Thank you, First Minister. I’m glad that you’re welcoming the improvement in the figures for tourism and recognising the importance of it. But survey after survey confirms that one of the major attractions for visitors coming to Wales is our stunning and unspoilt landscape. In light of the new Conservative Government in Westminster agreeing to scrap subsidies to onshore wind developments, which I warmly welcome, having seen the imposition of one of the largest windfarms in one of the most iconic bays in the UK in Llandudno, what is your Government doing to protect our beautiful landscape from those wishing to industrialise it by erecting unsightly pylons and turbines? Thank you, First Minister.
A moratorium on fracking—there’s a start—which her party was against. If her party had had their way we’d be fracking everywhere, no problem at all. They talk to us about industrialising the landscape, and then there’s that the obvious problem that they have in terms of—[Interruption.] You can shout about it all you want, but there’s that obvious problem in terms of fracking. So, windmills destroy the landscape—I understand there are people who believe that—and fracking doesn’t. And there they are talking about industrialising the landscape. If they had their way, that’s exactly what they would do.
I know that the First Minister will agree with me that sport is an exceptionally important tool in attracting tourists to Wales, and, in that regard, I wonder if the First Minister would agree with me that providing early Welsh Government support for a bid to bring the Island Games to Ynys Môn in 2025 would be an important tourism boost for the island. And how could I not, of course, take the opportunity to invite the First Minister to extend the warmest congratulations to the Anglesey team that returned from Jersey just over a week ago with 10 medals?
May I join the Member in congratulating the Ynys Môn team? And, of course, I’d be willing to consider any bid as regards attracting the games to the island ultimately.
Onshore Windfarm Developments
8. Will the First Minister provide an update on the Welsh Government's policy for onshore windfarm developments? OAQ(4)2402(FM)
Well, I think I refer the Member to the answer I gave some moments ago.
I think that’s a very sensible use of time, First Minister. But you will be aware that, after over 20 years of campaigning by constituents in my region and beyond, two public inquiries, a Court of Appeal hearing, and a judicial review, that the application for a windfarm at Mynydd y Gwair has failed, and I would like to thank the Deputy Minister for her recent decision, although developers seem unwilling to accept it at the moment. For a considerable part of that period, technical advice note 8 has been in force. Putting aside all the other arguments that have been put to you by Welsh Conservatives over the years about the balance of onshore wind energy production, TAN 8 could not prevent this lengthy and expensive saga. Isn’t that reason enough to review it?
The party opposite come from the basis that they don’t want any wind energy at all. At all: onshore or offshore. We’ve heard several denunciations of offshore wind in this Chamber, as well as onshore. So, they don’t want any kind of wind energy, and, of course, there has to be balance, I understand that, and we can’t have the entire landscape covered in wind turbines. That I understand. But they don’t want any at all, and they don’t want to give communities even the opportunity to have wind turbines should they wish. It’s quite clear to me now that what they want to see is an energy policy based on more mining, basically—more coal, more carbon fuel, they want to see fracking in place, they want to see as much use of fossil fuel as possible, and they haven’t made that clear to the people of Britain. So, it’s about time the Conservatives were absolutely clear about what their energy policy actually is, before we go after Russia and buy hamsters on wheels to keep the lights going. [Laughter.]
First Minister, do you anticipate that the Government’s spatial policy in relation to wind energy, for example, through technical advice note 8, will continue after the development of the proposed national development framework, which is due to come forward following the planning (Wales) Bill?
I believe that it will be the time to consider the situation as regards planning when we get the new powers. That, of course, will be the point at which to consider again what kind of guidelines should be in place.
The Effects of the Budget on Families (The Vale of Clwyd)
9. What assessment has the First Minister made of the effects of the UK Government budget on families in the Vale of Clwyd? OAQ(4)2410(FM)
Bad for families across Wales, and particularly bad for young people. Of course, we know that the budget will take some £37 billion out of public spending, and we know there are many hard-working families across the UK who will be hit especially hard by the loss of tax credits.
Thank you very much for that answer. Having spoken to some of the families, particularly some of the younger people who have got families themselves, I think there’s a double whammy there for them. Despite the cheers from the Tory group last week when the Chancellor was on his feet in the House of Commons, I think they should reflect that young people are our future. So, I’m proud that your Government has protected the education maintenance allowance and also tuition fees to allow our Welsh young students to go and reach that aspiration. Will your Welsh Government continue to stand up for the young people and those hard-working families within the Vale of Clwyd and across Wales, unlike the Tories?
Yes. We know that 238,000 families in Wales were in receipt of either working tax credits or child tax credits in 2013-14, and we know that they are vulnerable, because we know that for a lot of families the earners are under 25, so the living wage, for some mysterious reason, doesn’t apply to them, because 25, apparently, is some magical age that the Chancellor has picked out of thin air. We know the living wage will not compensate for the loss of tax credits—by some estimates, £12 an hour is the minimum that’s needed to make that level of compensation—and we know that the most cynical part of this budget is that a political calculation was made to hit young people, because young people don’t vote—that’s what was done. That’s what was done. So, what they think is that this is a pain-free way to save money, because young people won’t be bothered to go out and vote. If there was ever a reason for young people to go out and vote, the Tories provided that reason last week.
Well, what assessment have you made of the effects on families in the Vale of Clwyd, across north Wales, and in Wales as a whole, of the introduction of a national living wage to reach £9 an hour by 2020, giving 2.5 million people across the UK a direct pay rise, and raising the personal tax allowance, which will benefit 1.4 million people in Wales and lift a further 29,000 out of tax altogether?
There’s nothing more distasteful than hearing somebody well paid saying that £9 an hour is a magnificent wage, something that is a living wage. It is not a living wage at all; it is, in fact, the bare minimum for those over 25. What about those under 25? What have people under 25 done to the party opposite? Why are people under 25 being penalised? Why are they losing housing benefits? Why are they being penalised for being in work? Why is it the case that those who are losing tax credits are going to lose out? [Interruption.] They can scream and shout as much as they want; it hides the shame that they show for what they’re doing to working families across Wales and the rest of Britain.
Y Llywydd / The Presiding Officer
I’m sorry, First Minister, they can’t scream and shout as much as they like in here, although they appear to be doing that. Can we have a little quiet while we hear the replies, please?
First Minister, low-paid workers in the Vale of Clwyd, of course, have the same interests as low-paid workers throughout the rest of Wales. Many councils throughout Wales have started introducing a living wage, as has the Welsh NHS. Does the First Minister recognise that the policy that’s been introduced by the Tory Government is actually undermining the living wage? Many who thought they were getting a living wage, due to the removal of tax credits, will now find they’re back in low-wage poverty again.
Absolutely, because they thought that, if you take away tax credits, you could, in some way, increase the wage to a level that’s a living wage. It’s not a living wage; we know from the independent studies—many of them—that it’s £12 an hour, at least. We know that people will lose out because of tax credits, we know that younger people under the age of 25 are not being protected, for some reason, we know that children will lose out, and we know that the Tories don’t care.
Y Llywydd / The Presiding Officer
Thank you, First Minister.
Y Llywydd / The Presiding Officer
We now move to item 2, which is the business statement, and I call on the Minister, Jane Hutt.
Llywydd, there’s one change to report to the business statement for this week’s business: the First Minister will be making a statement on the publication of the Flynn report. Business for the next three weeks is as shown on the business statement and announcement, which can be found among agenda papers available to Members electronically.
Leader of the house, is it possible to have a statement—and I’ve asked for this before—on the Government’s proposals for upgrading the Five Mile Lane in the Vale of Glamorgan? To date, no statement has been forthcoming, although the Minister for Economy, Science and Transport has written to me on several occasions, outlining the Government’s position on this. We are now going into the long summer recess, and I think it would be beneficial to understand exactly what is going on with this flagship programme that the Government have brought forward, with considerable Government money allocated to it—£25 million, as I understand it. So, I’d be grateful to know what the obstacles are and whether those obstacles can be overcome before the Assembly election in 2016.
Well, of course, this is a matter for the Vale of Glamorgan Council, working with the Welsh Government. Of course, updates will be provided in due course.
Would it be possible to have a debate on the implications for Wales and for this Assembly of the English votes for English laws proposals from the Conservative Westminster Government, which I believe are going to be debated in Westminster later this year?
Well, of course, this is a matter for Parliament and for the UK Government. It’s interesting to see the impact of the influence that has been brought to bear. We’re very clear, although this is not devolved in terms of the ban on hunting, what our position is as far as this is concerned. But, of course, we await the outcome of this in terms of parliamentary process.
I was wondering if the Minister for Health and Social Services could give us an update on where he is at with the review of the eating disorders framework. We had a constructive cross-party group meeting today, and in his letter, the Minister said to us that a review of the framework would be completed by the end of the summer, but many of the users, the carers, families and professionals in that room didn’t know much about the consultation process with regard to the framework, and obviously, they really want to be part of it. So, constructively, I would just ask if we can find out more about the timelines of that so that we can all feed in to the process in a positive way.
My second question would be: can we have a debate in Government time, when we are back from recess, on the standards the Welsh Government expects and demands of organisations that lease land from it, and what the responsibilities are if any such organisations are found to be in breach of those standards? For example, I’m working with a group of leaseholders in Swansea’s SA1 development—Welsh Government land—and they’ve been refused permission to extend their leases by Coastal Housing on the grounds that their apartments are exempt. It would be interesting to know if there is a code of conduct, perhaps encompassing human rights and sustainability standards, that is affected when your land is leased to such organisations.
I’m very glad to hear that you had a useful cross-party group this morning. I think the framework, of course, and the information about how that will be handled in terms of all those affected by it will, of course, be made very clear for consultation opportunities, and thank you for that positive comment for the health and social services Minister.
Of course, your second point is clearly the responsibility of the local authority, taking into account, of course, guidance by the Welsh Government.
Minister, sometimes in the digital age, people forget the importance of a face-to-face tourism information service. No amount of apps or internet information can replace a warm welcome, a friendly smile, and advice from people who know and love the area in which they’re working. We’ve already seen the closure of the tourist information centre in the centre of our capital city, but I’m concerned about the sustainability of tourism information centres in my own constituency, especially those that are run by volunteers. In the Crickhowell Resource and Information Centre, somewhere I know that you know well, the volunteers there in the tourist information centre have been responsible for the establishment of the Crickhowell walking festival and a number of other community tourism events and strategies. Unfortunately, due to cuts by Powys County Council, that service could well end next year. What can the Welsh Government do, and will the Welsh Government’s Minister for tourism make a statement on the provision of tourist information facilities for people visiting Wales?
Well, of course, many of those local tourist information centres are, and have been, the responsibility of the local authority—including Powys County Council—to promote, and, indeed, for town and community councils as well. The role of volunteers is key, as you say, and I have been visiting some very successful community asset transfers over the past few weeks, and, of course, the Deputy Minister for Culture, Sport and Tourism has also introduced guidance, as I have, on those community asset transfers, which might help in terms of the tourism information services.
I’m someone who closely followed the outcome of schools challenge London, and I believe that Schools Challenge Cymru should be equally successful. Could I ask that the education Minister makes a statement on the planning being made for the second year of Schools Challenge Cymru?
Members, of course, are aware, as Mike Hedges is, that the Minister for Education and Skills is committed to providing regular updates on Schools Challenge Cymru and also the progress of Pathways to Success schools. He’ll continue to do so, and I’ve no doubt that he’ll provide a similar update to Members at an appropriate time in the coming months.
Minister, can we have an urgent statement from the Welsh Government on the viability of the construction of a new M4 south of Newport? Press reports last week suggested that flaws within the decision-making process now leaves the project wide open to judicial review, and that as a result, Welsh Government is privately planning to drop the scheme. Is it the case that the new M4 is about to be scrapped? If so, what contingency arrangements are in place to improve traffic flows at peak times? And isn’t it a shame that the Welsh Government didn’t listen to voices on these benches and elsewhere over many months to reopen the consultation with all options, including the more viable blue route, firmly on the table?
I’m very surprised, Nick Ramsay, that you raised this, considering it was one of the positive comments made by the Chancellor last Wednesday, when he said—and you will agree that it was very good—that the Conservative UK Government was committed to the funding floor, and also in terms of the infrastructure to the M4. So, where is your party? Where are the Welsh Conservatives in terms of the M4?
Minister, I’d like to reiterate those comments about the M4. We saw reports in the press last week that threw serious doubt on the project, and it’s only right that this Chamber should have an update as to the present situation. The public needs to know whether or not this plan is credible and whether or not the flaws that have been identified are likely to cause further delay and further cost to the public purse, should this project go ahead.
I would also like to request, if I may, a statement from the Minister for health on the career path for middle-ranking doctors in the Welsh NHS, given reports that I’ve had of doctors who are reaching the end of their house training period having to go overseas to make the next stage of their journey to becoming consultants, because there are no places at that point in their career progress. I wonder if I could have, as I said, a statement on career paths and where it is that we’re losing doctors from our NHS—whether it’s immediately post-training or further on in the system.
Eluned Parrott, I can assure you that nothing has changed as far as the M4 is concerned. Indeed, a judicial review on our decision-making process found in our favour, and there are no plans to drop the M4 relief road.
Your second point is a matter for the Minister for Health and Social Services in terms of his workforce planning for ensuring that our middle-grade doctors, particularly those we want to attract, are supported on that journey.
Minister, could I ask for a statement from the Welsh Government on the current state of discussions between the UK Government and the Welsh Government on the devolution of fracking licensing, and if we could also have an update on the status of current applications for fracking within Wales within the context of the Welsh Government’s moratorium on fracking?
Of course, Mick Antoniw, we have got a moratorium on fracking, which was announced by the Minister for Natural Resources earlier on this year. Clearly, the issues in terms of the licensing powers are ones that we are discussing in terms of the practicalities with the UK Government and the implications for Wales of devolving these powers, including issues relating to existing licences.
Could I ask, Minister, for a statement on what the Welsh Government is doing to preserve old and historic buildings in our city centres and around? In Newport, the Clarence Place area, when you travel there, Minister, you see the good old buildings, maybe over 100 years old, and right on the top, there are big blocks of stone rather than bricks, and we should learn lessons from the Severn bridge, when a big slab of ice fell, and caused some fatalities on the Severn bridge. So, a similar type of incident could easily happen in our city centres if there’s no health check on these buildings by the local government regularly, so that they are fit for purpose—otherwise the health hazard and the safety of the public is in danger in these areas. Also, what is the Welsh Government doing, in conjunction with the local authorities, to ensure such buildings are kept in a good state of repair in the interest of public safety, and how often are these buildings—whether in the hands of public or private sector—checked by the building inspectors, regularly or not? Thank you.
Well, I’m not sure what Mohammad Asghar is referring to. There must be a situation, perhaps, arising, in a town or city centre in his region. Clearly, this is the responsibility of the local authority and those landowners, but I would say that our commitment to town regeneration, and the funds that we’ve provided, not just through targeted match funding, but indeed through regeneration by the Minister for Communities and Tackling Poverty, indicates our commitment to support of those town centres.
Minister, I’ve been made aware that, due to concerns about sustainability of staff numbers and safety, Cwm Taf Local Health Board will be transferring the out-of-hours service from Ysbyty Cwm Cynon to Prince Charles Hospital. Obviously, this will be of concern to my constituents. I would like to request a statement from the Minister for health on out-of-hours services, and in particular on the numbers using them across Wales. And I would also appreciate information on how we are ensuring that people make the right choice about accessing the appropriate source of medical assistance—out-of-hours, accident and emergency et cetera—and what assessment the Welsh Government has given to the effectiveness of current programmes signposting people in these cases.
I thank Christine Chapman for that question. Of course, the delivery of out-of-hours services is the responsibility of Cwm Taf university health board. I think it’s important to say that no decisions have been taken at this point about where these services are provided from, but there is ongoing engagement with the communities involved.
Minister, last week’s budget was an absolute disaster for the people of Blaenau Gwent. You will be aware that some of the poorest and most vulnerable families in my constituency are already losing £30 million a year, as a consequence of the UK Government’s welfare reform programme. The issues raised last week over tax credits will only increase in-work poverty, which we’re already seeing increasing, and will cause extraordinary hardship to people in Blaenau Gwent and elsewhere. I’d like to ask Welsh Government if it could publish its assessment of the impact of these budget changes to people in constituencies across Wales, and then table a debate on the assessment, for us to take a view on how we in Wales can respond to the poverty creation policies being pursued by the UK Government.
Well, Alun Davies, I did issue a written statement last week, which I know you will have seen, expressing my concerns about the impact of this budget—they are I think well-rehearsed again this afternoon—and the particularly adverse negative impact on young people, and that, as Ann Jones has said, includes young working families as well as young people. As well as doing our own assessment, I think it would be worth while looking at the assessment of the Bevan Foundation, which of course is particularly serving communities like yours in Blaenau Gwent, which gives very clear concerns about the announcements last week, particularly in terms of the so-called national living wage, saying:
‘Unfortunately, not everyone will enjoy the benefits of the national living wage…. Give away and take away’.
Y Llywydd / The Presiding Officer
Thank you, Minister.
Y Llywydd / The Presiding Officer
We now move to item 3, which is a statement by the First Minister on the publication of the Flynn report. First Minister.
Thank you, Llywydd. Today I published the Flynn report into events in privately run care homes in the south-east of Wales. It’s a detailed and sombre account that is a difficult and challenging read. Llywydd, it’s a report I personally commissioned 18 months ago when it became clear to me that our legal processes, and, indeed, many of those tasked with protection, could not answer some of the most important questions that a family can ask: ‘Why were the residential services for my loved one so profoundly lacking in proper care and humanity?’
So, in December 2013, I asked Dr Margaret Flynn, an eminent figure in social care, and the author of an official review into the care scandal at Winterbourne View in Bristol, to undertake an independent report into events over a decade ago in care homes in the south- east. Some of these events have already been the subject of a lengthy police inquiry— Operation Jasmine—but because of a variety of factors, I felt that there were still questions to be answered and that it was right to undertake a full and detailed review. I asked Dr Flynn to set out what happened, what had been done since, and, crucially, what we could still do to prevent such events happening again.
Dr Flynn’s report sets out the events and failures that led to the neglect and abuse in several residential homes. But, for me, what this report is about, at its heart, is people—real people who deserved much, much better from those they trusted to care for them in their final years. There were many victims— over 100—who suffered unacceptably poor and often damaging care. These included Evelyn Jones, who would do shopping for her neighbour and loved to socialise; Pearl Cavell York, who had worked in a biscuit factory and was a member of the local ladies choir; Stanley Bradford, a former miner, who used to make dolls houses and castles for the children in the neighbourhood; and Megan Downs, who spent the second world war in the Women’s Royal Air Force after volunteering when war broke out. I’m aware that, today, it is 11 years to the day since Megan passed away. I am, however, pleased that I can make this statement, with Megan’s daughters, Loraine, Val, and Marilyn, along with other families, being here in the public gallery to listen.
Today is a day when our thoughts as a Government, as a National Assembly, and as a nation, are with the families of those who suffered so much in these events. I’ve met Loraine, Kelvyn and David, who I know can’t be here today, and the other families as this review has gone on and I want to say something about them now. They are some of the bravest, most resilient people I’ve met. They have, despite many years of being frustrated in their search for the truth, continued to press for answers to their questions, and to argue for change. Indeed, it was at a meeting with Loraine and Kelvyn in 2013 that it became clear to me that an expert, independent examination was essential if families were going to get the answers they rightly deserved. That’s why I asked Dr Flynn to undertake this review and why I have decided to publish it in full today without amendment or redaction.
Before I move on, I’d like to take this opportunity to thank Dr Margaret Flynn for the work she’s undertaken in preparing the comprehensive report that’s been published this morning to Members of the Assembly. I know, from meeting with her over the last 18 months, that it has not been easy. She has faced the challenge of gaining willing co-operation from a wide range of parties, some of which were less than co-operative. She has carried out that work with vigour and rigour. I know from my conversations with them that the families involved have full confidence in Dr Flynn, and I too thank her for the work she’s done and the way she’s done it. She never forgot that this is a report about real people with real families.
Llywydd, the report is a compelling and upsetting read. It does not flinch from laying out the events that occurred. Dr Flynn has included photographs that are truly shocking and bring home the reality of what neglectful care looks like. It’s a report that everyone involved with vulnerable people should read. It’s a testament to inaction and inadequate controls over the care of vulnerable people and must never happen again. Indeed, things have changed, and, in many cases, have got better, but Dr Flynn’s report is clear that there is more to be done.
I have asked Dr Flynn to lead a series of workshops around Wales this autumn with those involved in the care of older people, where she can talk personally through her findings and the lessons. In addition, I will return to the Assembly after the summer to set out in detail what we as a Government have already done, and what we intend to do in response to the points made by Dr Flynn, and, in particular, where we have influence over the recommendations she makes.
But, Dr Flynn’s report recognises that protecting and safeguarding those in care is not simply the responsibility of one body or one organisation. There are many organisations that Dr Flynn identifies in her report as contributors to a better and safer system. I don’t, as First Minister, have direct or indirect oversight of many of them; indeed, eight out of the 12 recommendations are directed towards non-devolved areas or organisations, such as the police and the Crown Prosecution Service.
I have, because of this, today written to the Secretary of State for Wales, to request that he uses his offices to make sure that those organisations within the UK Government’s remit respond meaningfully and speedily to those recommendations and conclusions. I will ask him to ensure that those organisations write to me as First Minister, to set out their intentions, following this detailed and important review, and I will, of course, share such letters with Members of the Assembly.
Finally, I believe it’s important to say something more. I don’t want those considering entering residential care to believe this is what to expect. The events described by Dr Flynn were truly terrible, but I want to reaffirm that the vast majority of care for older people in Wales is ‘good’ or ‘excellent’. The most recent annual review by the inspectorate showed that 86 per cent of adult care met requirements, and, of those that didn’t, improvements were made in most cases. Our systems of oversight have improved over the 10 years since these events, and will be further strengthened through the Regulation and Inspection of Social Care (Wales) Bill, currently undergoing scrutiny. We also have, of course, more avenues and opportunities for concerns to be raised by families and carers, and the inspectorate itself has a powerful channel to raise concerns, which allows, if appropriate, anonymity.
The delivery of care is complex and difficult. When it fails, it can be truly terrible. This report is a powerful reminder of how we must continually monitor services, challenge practice, and, most importantly, listen to those closest to it. I’m pleased that, after 10 years, we are able to give the families here today some of the answers that they have sought. My hope now is that we can work together to avoid such events being repeated ever again.
Thank you, First Minister, for your statement this afternoon, and, in particular, the briefing that was arranged this morning with Dr Flynn to be able to understand the report in greater detail. It is a very considerable report, which warrants a lot of thought, and, in particular, a route-map about the action to be taken from it, and the conclusions that Dr Flynn has arrived at.
And you are quite right, First Minister, as the report is quite right, to put so much weight on the issue of families and individuals. This isn’t about process—it is about process to a point, but, ultimately, this report has been put together because individuals were neglected, and severely neglected, over a considerable period of time, despite many warning signs flashing, and, ultimately, inaction, I would suggest, by organisations that should’ve known better.
It is a tribute to the fortitude of the families, and the strength of the families, that they have engaged in the process to seek answers over the loss of loved ones, and the dignity with which they’ve conducted themselves is to be commended. And, hopefully, from this report, ultimately, they will get an element of satisfaction that their actions and their tenacity in fighting for this report will stop other families going through the trauma that they have had to go through.
If I could touch on some of the points that you raised in your statement, First Minister. The ability to get the regulator, the General Medical Council, and other organisations, in particular, to actually monitor and respond when things do get highlighted, and there are conflicts of interests at stake here, is a clear problem area that the report identifies, and, in the briefing session this morning, was evident in Dr Flynn’s comments. I’d be grateful if you could highlight how you as a Government will be engaging with the professional bodies to try and make a stronger case, and a stronger regulatory environment, so that there cannot be these gaps for the proprietors of these homes to operate as they were able to operate over such a long period of time. I do also think that it is vital that the non-devolved agencies show a better understanding of the devolved settlement and, in particular, show greater co-operation when reports like this are commissioned.
Again, I would be grateful to understand from the First Minister how he will be taking forward some of the concerns that Dr Flynn has highlighted, in particular over some of the organisations’ unwillingness in the first instance, maybe, to engage fully in what is a report and a process that deserved complete and total commitment from those organisations, because they were so integral to that process. If, from these benches, we can assist in any shape or form—you closed your statement by saying you look across the Chamber for support in taking these recommendations forward—I can categorically assure you that we will be working with you 100 per cent to make sure that these types of examples are rooted out in the social care homes that we have here in Wales. I would work willingly with you on any aspect where you think that we might be able to benefit the families and people in the social care sector.
I’d also be keen to understand whether the First Minister believes that the Crown Prosecution Service, in particular, has a role to revisit some of the enquiries that they made. Obviously, in terms of the original prosecution, it is well understood why that was not taken forward, but certainly, from the report—and I’ve only very briefly read the report—and obviously from the briefing this morning, there are other areas that, in light of some of the evidence that has been put together, would warrant a fresh investigation, I would suggest. I would welcome the First Minister’s thoughts on that and whether his Government will be referring any aspects that have come to light to the CPS for their view and whether they will undertake a new inquiry into those new revelations that have come forward.
Above all, First Minister, you do make the point that the majority of people in social care have a very positive experience. In particular, there are many dedicated workers in the field of social care looking after some of the most vulnerable in society, and that is to be applauded and promoted, because, sadly, one rotten apple has a real danger here of making the whole barrel bad. This example really does show, when a process goes wrong, how cataclysmically it does go wrong. The photographs in the report and the pictures of the individuals who have suffered are quite horrific to say the least. I commend the Government for commissioning this report and I commend Dr Flynn for the tenacity she’s taken on the work. I would applaud the First Minister if he were able to meet with Dr Flynn again and ask her whether she needs to do any more work and actually unravel some more of the complex issues that are highlighted in this report, because there is a danger, sometimes, that reports tend to go on and on and they don’t ever report. But from the briefing we had this morning, it certainly did come clear that there are some areas that Dr Flynn felt would warrant further consideration.
Can I thank the leader of the opposition for his comments? When I commissioned this report, I was aware that there was a prosecution that was, in effect, in limbo and that, if we were to wait for a resolution of that particular issue, then nothing would happen. I wasn’t prepared for that to happen. There are a number of points that he has raised with me. He raises rightly the issue of conflicts of interest, for example, where a GP is the owner of a care home and is also the care home residents’ general practitioner. This is, to me, an unacceptable conflict of interest. There are ways in which that conflict can be mitigated, but he is right to say that the GMC must look at the way that it regulates GPs in terms of what is, to me, an obvious conflict. There is also the need for Government in the future to look at whether there exists within the Assembly the ability to pass laws that would ensure that that conflict of interest is removed. But in the first instance, that responsibility lies with the GMC.
Of the non-devolved parties, this is the second occasion where there has been a review or inquiry. The Robbie Powell inquiry was another area where this happened, where co-operation from non-devolved bodies has not been what it might have been. In relation to Robbie Powell, there was no co-operation at all, or very little of it. In relation to Dr Flynn’s review, well, she has said what she has said in her report in terms of what she felt was not a full range of co-operation from some bodies. It is hugely important that, despite the fact that we don’t have the ability as an Assembly or as a Government to call to account non-devolved bodies, there is nevertheless an understanding and recognition by non-devolved bodies that they are de facto responsible for their actions to this National Assembly, even if in law they are not—or certainly not at this moment in time.
He talks about the need for further prosecutions. That’s a matter ultimately, of course, for the police and then the Crown Prosecution Service, but I do note that Dr Flynn, in her report, recommends that an inquest be held. Now, it may be that the inquest would be the first part of that process and a decision taken after that in terms of prosecution. That is a matter for the CPS, not for Government, but it does seem to me that the recommendation for an inquest to be held should be taken forward without further delay.
Finally, he asked me about Dr Flynn’s further involvement. He will have heard me say in my statement that she will continue to be involved. She will continue to host events where she will give her view based upon the report to providers in the future, and we, of course, as a Government will continue to engage with her to make sure that she is content that the recommendations in her review are taken forward.
I’d like to put on record my thanks to Dr Flynn for this report and my gratitude to the families who were able to contribute to it. I’m sure that the report will be widely read. I want to also put on the record, Presiding Officer, that my great-uncle was a resident for several years in the Bryngwyn home in Newbridge named in this report, but his experience there has not been the subject of any investigation that I’m aware of.
Now, it’s clear, First Minister, that commissioning this report was the right course of action, as we now have a way forward after all these years. It’s clear that the failure to provide proper care and dignity with humanity has been known about or suspected for at least 20 years in the Gwent area. Now, I realise you’ll be responding fully and in detail later in the year, but I’d be grateful if you’d tell us if your Government is aware of problems existing elsewhere in Wales, because I doubt that this is confined to Gwent. It seems to me that Dr Das’s company had a near-monopoly in the Caerphilly area and was able then to hold the council to ransom due to a lack of alternatives for those needing care. That rendered, I think, that local authority impotent to act. So, are you in a position to know if similar circumstances exist now anywhere else? Obviously, contracting with a poor provider cannot be right.
Now, some of the warning signs that were mentioned by Andrew R.T. Davies were not acted upon, but attempts to whistleblow were unsuccessful. Of course, POVA, the protection of vulnerable adults system, failed on many, many occasions. So, will you, when you respond to all the recommendations, be including measures that mean that you cannot ignore these warning signs?
Now, in this case, as mentioned previously, there was reliance on the criminal investigations, and of course they have not delivered justice to the families. Is it your understanding then that criminal proceedings might still be brought, some time in the future? I’d also be grateful if you’d reflect on the fact that it’s often the case that the untrained, poorly paid, under-resourced front-line staff are much more likely to be facing criminal proceedings than the managers, the directors and the owners, whose motivation is profit and greed. Justice cannot be served if it’s just the front-line staff who are brought to book. Will you be discussing this report with perhaps the UK Government, if it emerges that changes to non-devolved legislation are needed in order that those managers, directors and owners and so on can just as easily be brought to book as front-line staff?
Obviously, I’d be keen for the conflict of interest issue that’s been outlined in the report to be addressed as quickly as possible, and I think a coroner’s inquest should be encouraged, and I would urge you, if you’re able to do so, to encourage that inquest.
Your programme for government couldn’t possibly have envisaged this report, but will you prioritise the changes recommended so that there’s no delay in safeguarding those who are unable to fend for themselves?
Just to finish, for the families who have loved ones in residential care, they are unlikely to see those pressure ulcers and they may not see injuries that are underneath clothing, so even though they are regularly visiting, they may not be aware of the true circumstances. I wonder whether you would consider producing information to help guide us in what to look for in care settings, and what should perhaps trigger a suspicion in us that something deeply wrong is going on. As I mentioned, my uncle was fit and well, he was not bedridden, and he was able to get about, but he rarely had his own clothes on and his teeth were often lost, and reading this report, I can see that theme re-emerging over and over again—of people perhaps being unclean and so on, which should, perhaps, looking back now, have made me wonder whether there was something wrong there. So, would you consider publishing a guide for families so that they can easily see what they ought to look for?
Just to concur with Andrew R. T. Davies, I promise you our support in sorting out this vitally important matter.
Can I thank the Member for her comments? The difficulty, of course, that has emerged here is because of the criminal investigation and the stay, in effect, in the criminal proceedings, there’s been an inordinate delay. Now, whenever there is a criminal investigation, that has to take primacy, I think we understand that, but it can also lead to an enormous delay, as we’ve seen here, particularly in the circumstances of one individual and the delay that that’s caused.
It’s important, of course, not to prejudice any future criminal trial, and I don’t intend to do that this afternoon. I’ve never accepted the point that, by having this review, that would be the case, and I’ve never accepted the point that, by having this review, we would prejudice any proceedings that took place in terms of professional competence. I don’t accept that prejudice works in those circumstances; it applies in terms of jury trials.
The Member is quite right to say that we must make sure that there is a fair level of liability on those who own homes, as well as those who work, as it were, on the front line in those homes. She is right to point out that it tends to be those who are, sometimes through no fault of their own, not properly trained and who work very hard who take the blame; whereas those who are running the home—perhaps it is not as transparent or as clear what their responsibility is.
What we need to do as a Government is examine what might be done in terms of changing the law. Now, we run here against the devolution settlement and its vagaries. For example, if we were to look at changing the nature of care provision and changing the nature of liability within the care sector in Wales, would that be devolved or not? There’s an argument to say that it is; there are others who will take an opposite view. That is something we have to consider over the next few weeks and months. It’s important that the changes that are recommended are put into place as quickly as possible, and we’re mindful of that, as the response is shaped in the autumn—and the further information I will provide to the Assembly at that time.
She asked about whistleblowing, an important point. The report, it’s right to say, repeatedly cites the importance of whistleblowing, both in terms of the events at that time and in the preparation of the report. I think it’s worth thanking those who’ve been brave and principled enough to tell the truth and expose failure, despite the risks. I know that the Minister has already indicated he will seek to require providers of social care to have whistleblowing policies in place in regulations that will flow from the regulation and inspection Bill.
She further asked about pressure ulcers. Standard guidance on the prevention of healthcare-acquired pressure damage has been in place for a number of years, as part of the 1000 Lives improvement programme. I think she asked a wider question than that, namely, are families in a position where they can recognise pressure ulcers? That is something I know that we will consider as part of a fuller response to the review.
First Minister, I think all of us recognise that the vast majority of people employed in the health and social care sector would be just as ashamed of this report today as each and every one of us is. I have to say that I was even more shocked hearing that the complaints originated in 1995, and it took some 10 years before the criminal investigation was undertaken. It’s also heartbreaking to read the testimonies of the families, outlined in the report quite clearly. For an official report to have to have a cover, warning you of the photographs that are actually shown in the report, that’s something I’ve certainly never seen before.
There can be little doubt that these residents had their human rights severely breached, and I wonder whether, in that situation, our own consideration of the regulation and inspection regime and your response will actually outline why we’re not able to actually enshrine the UN Convention on the Rights of the Child and principles for older people within that regulation, because I think that we are facing here a situation, as we’ve done in other reports, where people’s human rights are being breached.
The report also clearly, in those 10 years, underlines the failure of an inspection regime, to all intents and purposes. I wonder whether your response in the autumn will actually further outline the Government’s view on whether or not we need, at this stage, to have an independent inspector for health and social care.
I note from the report itself that Dr Flynn actually wrote to the Government on 19 December 2014, outlining recommendations that could be considered in legislation going forward. I accept that many of those have been taken up in subsequent legislation, but clearly, I think, one of the issues that I read is whether or not, within the regulation and inspection regime by now, there is a need for us to look again at making health boards and local authorities assume greater responsibility with regard to their commissioning arrangements. There are certainly issues within the Tawel Fan report, which talks about weak commissioning arrangements within my health board in the north. I think the point was made earlier with regard to the pressure that local authorities and health boards are under to actually commission beds in homes that they might not necessarily be wholly content to commission those placements. Do we actually need to look at the statutory framework in which that occurs? I think, in your response, it would be interesting to know how many homes in Wales are currently subject to enhanced monitoring processes through the Care and Social Services Inspectorate Wales, because of the types of concerns that were outlined in this report that went on for years and years, and where changes to registration conditions were tried but the curtain was never brought down on the individual homes.
The photos of the pressure ulcers are really shocking. I don’t think any of us can imagine our parents or our grandparents actually being placed in such a situation. I wonder, in the weeks that you’re going to have to consider your response, whether or not you think the public health Bill actually allows us an opportunity to include the pressure ulcers issue as a notifiable issue, which is obviously referred to in the report.
Finally, there is reference in the report not only to a conflict of interest arising with regard to the GP’s role in the whole situation, but also a conflict of interest arising where a partner of an owner can actually be involved within the health board and actually be involved in the adult protection processes within the health board. Will your response actually include changing the regulations as they appertain to health boards in Wales currently? On the palliative care arrangements, which clearly were not sufficiently robust in these circumstances, there’s talk about pain management processes not being robust enough, and there’s talk about the use of opiates within the home. Given the update that the health Minister recently provided on the ‘Together for Health’ plan, and the fact that we have now a palliative care plan at a national level, I’ve been unable at local level to see how local health boards are actually ensuring, as is envisaged in the national plan, that the nursing home staff actually receive education through a structured programme with regard to their processes on palliative care.
Finally, given the reference to—and I think you touched on this earlier—the fact that, in most cases, it’s front-line staff who carry the can for a lot of these incidents, and the reference in the letter in December to the need to look again at the penalties that are imposed on registered care home owners, and the fact that many of the penalties depend on the capital that’s actually introduced into the home at the time under the Companies Act, I wonder whether you’ve been able to have any initial discussions with the UK Government with regard to changes in UK legislation in that regard.
There were a number of questions there from the Member. He’s right to point out again the horrific nature of the photographs. I spent 10 years in the criminal law, and I saw a lot of things in that time, and I’m not easily shocked, but these clearly are very shocking photographs.
There are a number of points that he makes. First of all, I should answer the question that was put to me by Jocelyn Davies: are we aware of anywhere else where this is happening at this moment in time? The answer is ‘no’, we’re not aware of that. We would expect, with the new systems in place, that this would not be repeated, but we can’t be complacent, clearly, and that’s why, of course, we have to take on board the recommendations of the report itself.
In terms of the independent inspectorate, the inspectorate is independent, but I think we recognise that we need to examine carefully whether that independence might be enhanced in the future. That is something that we’re open to.
He is right to point out that Dr Flynn shared with the health Minister and me her emerging findings that she felt would have a bearing on the regulation and inspection Bill, because she was aware of the timing of it. Those particular emerging findings were shared so they could be looked at and incorporated within the Bill itself.
I come back to a point that I made earlier on: that 86 per cent of homes are satisfactory or better. Of those that are not, in the vast majority of cases, work is undertaken to ensure that care improves. He’s right to point out the issue of the liabilities of those particularly who are company directors. Now, when we talk about company law, we immediately look at an area that is thought to be non-devolved. Company law, indeed, is non-devolved. But one of the things we have to consider is whether we would expect care homes in Wales to have a particular structure in order for them to be able to operate in the future. In those circumstances, of course, it doesn’t touch on company law, but it does mean that we have a greater understanding of what we would want to see in terms of the administration of care homes. There is an issue that will need to be examined by other authorities as to whether the liabilities of other directors have been properly examined. That is a matter for them, and I say no more than that at this moment in time.
The Deputy Presiding Officer (David Melding) took the Chair at 15:04.
I think that more or less deals with the issues that he has raised. He dealt with the issue of penalties that are imposed on care homes. Again, this is something that we need to consider in the future. He also, of course, dealt with the issue of the notifiability of pressure sores. That is something that, of course, as a Government, we will look at as part of any future legislation.
Y Dirprwy Lywydd / The Deputy Presiding Officer
Thank you, First Minister.
Y Dirprwy Lywydd / The Deputy Presiding Officer
Item 4 is a statement by the Minister for Finance and Government Business on the introduction of the Tax Collection and Management (Wales) Bill. I call Jane Hutt.
Dirprwy Lywydd, yesterday I laid the Tax Collection and Management (Wales) Bill together with the explanatory memorandum before the National Assembly for Wales. The purpose of the Bill is to establish the legal framework necessary for the future collection and management of devolved taxes in Wales, and in particular the Bill provides for the establishment of the Welsh revenue authority, the WRA, and confers powers and duties to enable it to collect and manage devolved taxes. Corresponding duties and rights are conferred on taxpayers, and much of the legislation will be familiar as the basic framework for a tax regime—for example, it requires taxpayers to keep records and it allows the WRA to make inquiries and assessments to identify and collect the amount of devolved tax due.
The Bill also provides that Welsh Ministers may prescribe the bodies to whom the WRA may delegate its functions. In light of this, on 30 June, I provided this Assembly with a written statement informing all Members about the organisations that are part of my preferred way forward for the collection and management of Welsh taxes. My intention is to review any delegations after three to five years of operation.
Finally, the Bill makes provision for the conferral on WRA of civil and criminal investigation and enforcement powers with appropriate safeguards. This includes powers allowing WRA to require information and to access and inspect premises. Alongside this, there are duties on taxpayers to pay penalties and interest in certain circumstances. Our primary policy objective in relation to this Bill is to provide a clear and strong framework in Wales that will support the efficient and effective collection and management of devolved Welsh taxes.
But, the Bill also addresses three much wider ambitions. First, I am sure that the whole Assembly would agree that the introduction of this Bill is another significant chapter in the story of Welsh devolution. The Bill is the result of a considerable body of work by many people in the public and private sectors, as well as our social partners, and I’ve sought to achieve a reflection of views across this Chamber. At its core, it represents our collective commitment to a self-confident and more prosperous Wales. This will be the first devolved tax legislation that the Assembly has considered, and it will pave the way for the replacement of stamp duty land tax and landfill tax with new devolved Welsh taxes from April 2018.
But, this is also an important time for the United Kingdom. To echo the First Minister’s recent speech, fiscal reform is in the best interests of the UK. There are clear merits in different parts of our union being able to decide on the balance between levels of taxation and the level of resources for public services to respond to the needs and preferences of citizens.
Secondly, our approach to this Bill, and the preparatory work on developing proposals for the devolved taxes, underlines the commitment of the Government to working with business to create a world-class economy, supported by a first-class system of public services. That is why, in developing the tax arrangements for Wales, I’ve pursued the following principles: fairness, simplicity, supporting jobs and growth, and stability and certainty. I believe that the Bill enshrines these principles.
To guide us in developing our policy and setting standards for how a tax authority might operate, the Welsh Government has looked at the experience of Her Majesty’s Revenue and Customs and Revenue Scotland, together with consideration of wider international best practice. We recognise that businesses and taxpayers in Wales deserve a system of taxation that is fundamentally simple and transparent. Such an approach will help minimise the burden on taxpayers and assist tax compliance. We also recognise the benefits of consistency. The Welsh Government has not diverged, and will not diverge, from the existing UK tax collection processes unless there is a good reason to do so.
Thirdly, and finally, the Bill protects our commitment to fairness that is central to this Welsh Government. Taxation must be fair, both to those who pay it and to the broader society that benefits from the services our taxes support, and that’s why the Bill includes the requirement for the WRA to prepare a charter of standards and values, and for the WRA to consult on it before laying it before the Assembly. The Bill also provides for taxpayers to request internal reviews of certain WRA decisions and to appeal to the first-tier tribunal against such decisions.
The Tax Collection and Management (Wales) Bill is about looking to the future. It provides us with the essential infrastructure for our new devolved tax responsibilities. Importantly, for the first time in some 800 years, it enables Wales to take the first steps towards putting in place taxes that are more suited to Welsh circumstances and Welsh preferences. In this way, the Bill can make a real difference to people’s lives, and I look forward to working with the Assembly on the provisions of the Bill during scrutiny over the coming months. I commend the Bill to the Chamber.
Can I thank the Minister for her statement this afternoon? I think we would all agree that this is, clearly, an important step forward and an important chapter in the devolution process, as you said in your statement.
We do know that, in 2018, a number of taxes are to be devolved to Wales, and now we have the bones of the very initial stage of the new framework before us today in the form of this draft Bill. I know we always say that it is important that we get these Bills right, but, in the case of this Bill, this is more true than ever. The new Welsh revenue authority that is proposed is going to have a number of responsibilities and it is absolutely vital that it carries the confidence not just of the Assembly, but of the people of Wales, too, Minister, otherwise we will be in a very dangerous place indeed.
Can I ask you firstly—and this must always be asked at the outset of the introduction of these Bills—do we actually need this Bill? Do we actually need a Welsh revenue authority? How closely have you listened to the consultation responses? I note that a number of organisations that did respond did question the need for the new authority in the way that you have proposed it. I’m sure you will agree that we don’t want any unnecessary quangos, so how sure are you that we need a Welsh revenue authority? If the answer is, as I imagine it will be—I’d be amazed if it wasn’t—‘yes’, that we do definitely need some form of agency, some form of body or some form of mechanism to do this job, then does this this Welsh revenue authority that you are proposing truly address the needs of taxpayers and businesses, first and foremost, and not simply provide a vehicle that is an off-the-shelf format, with the usual chair and members and all the trimmings, and is simply convenient to the Welsh Government?
Can I ask you about the costs? I’ve asked you on a number of occasions, now, with varying, but generally limited success, how much the new Welsh revenue authority will cost. I don’t expect on-the-nail costings at this stage, but the people of Wales are paying for this, so they have the right to expect to know how much it will cost them in the short and medium term. In the interest of transparency and openness, we need an idea of this. Have you considered alternative models that would have delivered similar outcomes but with better value for money?
Turning to the key issues of responsibility and accountability, I see from the draft legislation that the Welsh Government will be responsible for appointing the chair and the members of the new body. Clearly, it’s a very important role for whoever gets that. Who do you intend that chair and the body to be responsible to? We know that other bodies are responsible, to varying extents, to the Assembly or to a committee of the Assembly, but, in this case, this is effectively an arm of Welsh Government—albeit a long, detached one—so it looks as though you intend to be the monitoring officer in the Welsh Government. Is this appropriate? Should there not be a wider scrutiny element?
The Welsh Government is delegating its functions to the Welsh revenue authority. Who is the WRA going to be able to delegate to? I assume it will be able to bring in outside experience of tax collection. That is not set out in this Bill. Why not? I imagine it may be something to do with futureproofing, but that does leave question marks over certain aspects of these powers. So, we look for clarification on that.
Finally, Minister, can I ask you about the issue of investigation and enforcement? Clearly, this is an area where long-standing UK agencies have considerable experience and where the Assembly doesn’t. How are you going to ensure that fine balance that involves giving the authority the necessary powers of enforcement without overstepping the mark and giving the new authority over-the-top powers, on the other hand? How are you going to ensure that that balance is maintained, because, if we get that wrong, then, in some circumstances, that could potentially, in the future, threaten civil liberties?
Minister, as I said at the start of my questioning of you, this represents a major change in the way that Wales will finance itself in the future, and we cannot afford, literally, to get this wrong.
Well, I thank you, Nick Ramsay, very much for your opening remarks—for your positive remarks. We have discussed this on a number of occasions in order to ensure that we are moving forward together to make sure that this legislation provides a robust way forward for the principal purpose, of course, of this Bill, which is to establish the legal framework necessary for the future collection and management of devolved taxes in Wales. Of course, I think it is important that this takes us back to the journey that we’ve been on, which, of course, includes the all-important cross-party commission set up by the UK Government, and making sure that we also move forward in terms of implementing those recommendations, leading to, of course, the legislation that enables us to take this forward in terms of the Wales Bill.
I think your point is important in terms of the purpose of this Bill. It is about ensuring that the Bill does establish a Welsh revenue authority whose main function will be the collection and management of devolved taxes, and to ensure that Welsh revenue authority has those appropriate powers and duty to identify and collect the appropriate amount of devolved tax due from taxpayers. Through the consultation—and you’ve looked at this carefully, I know, in terms of supporting business—many businesses have emphasised, for example, the need for taxes and administration arrangements to be consistent on either side of the Welsh border. So, our approach, as I’ve said, has been not to change the existing administrative processes unless there are efficiency, effectiveness or Welsh priority reasons to do this, and also to look for the opportunity for certainty and stability—again, an important principle in terms of our new Welsh taxes. So, we’ve used UK and Scottish tax legislation as a starting point throughout the UK because of cross-border businesses, and also to ensure that we learn from, for example, the Scottish experience in terms of establishing their devolved taxes to replace stamp duty land tax and landfill tax.
Of course, you have raised the questions with me about costs, the financial impact and affordability of the Bill, and you will note the regulatory impact assessment that I have also tabled, accompanying the Bill. As you know, in terms of costs, the UK Government hasn’t been prepared to transfer the funding needed to cover this new area of work, so the additional cost of setting up and operating the collection and management arrangements for devolved taxes will fall to this Government. And I am committed, as I said, to providing as much robust cost information as possible to the National Assembly for Wales during the scrutiny process for the Tax Collection and Management (Wales) Bill. We can’t at this stage produce a robust estimate of the costs of set-up or operations, but I’m confident, based on the evidence available, that the preferred way forward that I set out in my statement on 30 June is the most affordable option. But I will, of course, ahead of the Stage 1 debate in the autumn, be able to provide the Assembly with an update on work that we’ve undertaken to establish collection and management arrangements. This will include initial estimates of set-up and operating costs.
Important questions in terms of the Welsh revenue authority’s relationship not only to Welsh Ministers but also to the National Assembly for Wales: I think, just in terms of, again, similarities with HMRC and looking at ways in which we’re trying to be consistent and learning from existing practice, section 14 allows the Welsh Ministers to give directions of a general nature to the WRA, and that’s consistent with the power that the Treasury has in relation to HMRC, although it’s different to the situation in Scotland, where the Scottish Ministers aren’t able to direct Revenue Scotland, but can give guidance. But, in terms of the Welsh revenue authority’s relationship, devolved tax policy is clearly for the Welsh Ministers. The Welsh revenue authority will be responsible for the delivery in terms of tax administration. The relationship between Ministers and WRA will be founded on this distinction. But, in terms of the WRA’s relationship with the Assembly, the WRA will be subject to scrutiny by the Assembly and, of course, the WRA is undertaking a function of Government but the Assembly will have full oversight of, for example, the funding through the Welsh Government budget process, and the WRA will also be identified separately in the budget for transparency reasons.
It is also important that we recruit through the usual Nolan principles in terms of the members to the Welsh revenue authority, and, indeed, the chair. You also raised an important point in terms of investigation and enforcement. In terms of Part 9, the powers available to WRA officers to undertake investigations into devolved tax offences will not be set out on the face of the Bill, but instead through regulations by the Welsh Ministers under a new provision that will be inserted into the Police and Criminal Evidence Act 1984. These regulations will be subject to the affirmative procedure, and they will provide Welsh Ministers with the power to specify the powers in the Police and Criminal Evidence Act—so, for example, those are powers of search, seizure and retention. I think, in terms of regulation of investigatory powers, it is important that we look to the ways in which we can plug into the existing Regulation of Investigatory Powers Act 2000. And, of course, in terms of enforcement as well, this will be key in terms of the responsibility in terms of the Welsh revenue authority. But we have been very mindful of and thank the Finance Committee for their contributions in terms of their investigations. I do think that the alternative disputes resolution system, of course, will be very much available to the WRA when it considers such an approach would be appropriate to help to settle a dispute swiftly for the taxpayer.
Thank you for the statement. At first sight, the legislative framework seems to be in order, and the establishment of a Welsh revenue authority is a sensible move, and much of the provision seems to reflect Revenue Scotland’s operations, and it’s good to see the Government learning from good practice and following what has happened there. We look forward to scrutiny process, of course, in order to ensure that the Bill is as robust as possible, and to the ensuing legislation on the devolved taxes, where further policy details will be set out.
Now, the explanatory memorandum notes, quite naturally, that the collection and management of tax is specialist work and, in a written statement in March 2015, the Minister confirmed that she is to establish a treasury function in her department, which will undertake a range of duties that include the implementation of the Welsh revenue authority, along with the management of innovative funding, invest to save and economic forecasting. We have welcomed this warmly. Therefore, will the Minister ensure—or how, rather, will the Minister ensure—that the revenue authority has the necessary range of expertise and that this is linked to the establishment of a Government treasury function?
Another issue, in looking to the future and the further devolution of taxation, is whether this Bill going to be appropriate for income tax, if and when that is devolved. I assume that the Minister has considered this issue and I’d be grateful for her comments on that.
Finally, the issue of detailed statistics on public funding in Wales remains a priority for Plaid Cymru. As I noted in a recent question to the Minister, Wales is the only devolved nation in these isles without a comprehensive series of revenue and expenditure figures. You had a recent meeting with your counterpart in Northern Ireland, but it would seem, according to your response, that you didn’t discuss this issue with him. The Bill doesn’t provide for the production of such statistics, but much of the policy discussion around the Bill refers to transparency, and the need for economic forecasting was noted in the Minister’s statement of March on the treasury function. So, when I raised these issues with the Minister, her response was to refer me to ‘Welsh Economy: in numbers’, which is a useful data set , but that is not what I was seeking, of course, and it certainly isn’t a set of public funding statistics. So, at present, Wales is very different to the other devolved nations. Therefore, in bringing this Bill forward, will the Minister now agree with us and provide alongside this beneficial Bill a full set of public funding statistics for Wales? Thank you very much.
Diolch yn fawr, Alun Ffred Jones. Thank you also, again, for your support and your commitment to robust scrutiny of this Bill. As I’ve said in answer to Nick Ramsay, I very much welcome the engagement we’ve had through the Finance Committee, and particularly with the scrutiny of the Finance Committee and the contribution from the inquiry by the Finance Committee, which has helped inform us in terms of the establishment of this Bill.
Also, I think, on your points and questions relating to the relationship between the development of the specialist work and role of the Welsh treasury and how that will be provided, and, of course, linked through to the work of the Welsh revenue authority in terms of guiding Ministers in terms of developing tax policy, I recognise your points about the fact that we will then have to be guided in terms of the development of tax policy, also by robust forecasting, which, as you say, doesn’t link to the record of economic statistics that we discussed most recently, but looks to the prospects in terms of the forecasting of tax in terms of the devolved taxes that are coming our way from April 2018, and recognise the importance of the expertise that has to be developed in the Welsh treasury to inform the Welsh Government and those who are going to be in the process of delivering those new taxes.
Of course, the Welsh revenue authority, through this tax collection and management Bill, is being set up for the purpose of collecting and managing just those taxes that are being devolved to us in Wales to replace the UK stamp duty land tax and UK landfill tax. HMRC in Scotland, of course, is going to be collecting in terms of any tax-varying powers that the Scottish Government use. So, this is for our first step in the journey of devolution to collect and manage our smaller taxes. I’ve already identified how I want to use current expertise in terms of the delegation and the ways in which the Welsh revenue authority will be using HMRC and the Welsh revenue authority for our new land transaction tax—and, indeed, the Welsh revenue authority and Natural Resources Wales in terms of our land transaction tax. I am meeting with the finance Ministers of Northern Ireland and Scotland in a couple of weeks’ time, where I will also want to be discussing, particularly with John Swinney, the ways in which they are developing that expertise in terms of advice and guidance to Welsh Ministers. I think it’s important just to look in terms of the process by which we’re taking this forward in developing and delivering tax policy. In terms of the ways in which we want to ensure that we are guided by this in terms of the relationship between Welsh Ministers and the Welsh revenue authority, as I said in my answer to Nick Ramsay, the Welsh revenue authority will be accountable to Welsh Ministers for the delivery of the Welsh Government’s tax policy. But the Welsh revenue authority will be operationally independent. Tax collection, of course, overall, is a function of Government.
I welcome the statement by the finance Minister, and the tax collection and management Bill. Obviously, following the devolution of some tax collection, it is inevitable that a Welsh revenue authority has to be established. I’m not quite sure what else could be done. The collection of taxes in Wales will cost money to the Welsh Government, but there’ll be a saving to the Westminster Government in the taxes that they are not collecting. So, can the Minister explain why the Welsh Government isn’t getting fully funded for it? If not fully funded for it, why is it not getting the difference between the cost that it is now costing the Westminster Government and what it will cost the Westminster Government, because the next saving should make its way to Wales?
I think, Mike Hedges, I did, in response to an earlier question, say that I’ve made a number of representations in terms of the costs of the transfer to Wales and the need for a transfer of funding to cover this new area of work. I wasn’t helped by the fact that the Scottish Government didn’t call for that transfer in terms of the funding, although the Scottish Government may be in a better place than us in terms of the Barnett formula, of course, in terms of their funding prospects. So, it is an issue in terms of the additional cost of setting up and operating this collection and management arrangement. You know, we are saving money in terms of the UK Government and their arrangements with HMRC. That is why we have to be very clear about the robust costs information—and I know that this will be scrutinised very seriously indeed by the Finance Committee, and the National Assembly for Wales, through the Finance Committee, I’m sure—and that we have to produce robust estimates, because one of the concerns that have been raised, in terms of consultation, and particularly by, not only taxpayers, but by business, is that this should be for a purpose. These are powers for a purpose, in order to ensure that we can shape these taxes to suit Welsh needs and circumstances, in support of communities in particular, when we look at the opportunities for the new land transaction tax and land disposal tax, and, indeed, householders and business in land transaction tax.
Minister, can I welcome the statement and welcome this Bill, which I think is a historic step forward in terms of the powers and responsibilities of the Welsh Assembly and the Welsh Government? One of the first principles of taxation is that it shouldn’t cost more to collect than you actually reap in the tax itself. Clearly, that isn’t going to be the case, but, of course, given that the UK Government, as Mike Hedges already pointed out, is not going to be giving us the cost of administering these taxes, and that we are, effectively, offsetting the revenue from these taxes against a cut in our grant, it is possible, of course, that we may well end up having a loss in terms of how much money we end up with as a result of collecting these taxes ourselves. Can you, therefore, give us some indication of exactly what the total cost is going to be of this Welsh revenue authority, and how much extra it’s going to cost us to collect those taxes?
You also referred during answers to the fact that the Welsh revenue authority would be answerable to the Assembly and would be scrutinised by the Assembly. Can you outline what the mechanisms are for that scrutiny to take place? As you know, when the Wales Audit Office was set up on its current basis, it was agreed that the Finance Committee would act as the scrutineer of that particular body. Are you envisaging any similar arrangement for the Welsh revenue authority, or do you have other scrutiny arrangements in mind?
Finally, Minister, you’ve already referred to these, but the Bill provides for Ministers to make regulations to specified powers in the Police and Criminal Evidence Act 1984 that may be used by the WRA when investigating tax offences. It also amends the Proceeds of Crime Act 2002, so that designated WRA staff can make applications under that particular legislation, and, of course, it also amends the Regulation of Investigatory Powers Act 2000 to provide Welsh Ministers with the power to designate the staff of the WRA by Order as being able to exercise specific RIPA powers. Can I ask you what process of oversight is being put in place to monitor the use of these powers, and what level of authority will be applied to ensure that those powers are properly scrutinised and allocated, and what specific role the Assembly will have in terms of scrutinising the use of those powers?
Thank you very much, Peter Black. And thank you for your acknowledgement that this is a point of historic opportunity, as you say, and indeed responsibility, in terms of how we manage this and develop this together, through the scrutiny of this important Bill. In terms of the Welsh revenue authority’s relationship with the Assembly, the Assembly will have full oversight, as I’ve said, in terms of the funding of the Welsh revenue authority by the Welsh Government. The Welsh revenue authority will be identified separately in the budget, as I’ve said, and, of course, that includes annual accounts, an annual report, an annual tax statement, a corporate plan, and a charter of standards and values, which will be laid before the Assembly. The Bill doesn’t specify how the Assembly should scrutinise the WRA, but those are arrangements for the Assembly to decide.
I think it is important, in response to earlier questions, that we need to make sure that the provisions in this Bill are future-proofed and do provide flexibility to respond to future needs and opportunities. We may, for example, want to amend the number of members that are on the board to respond to greater responsibilities in the future. And we also need to ensure that that board model represents good practice in Wales, which will be non-executive directors being able to hold the executive to account.
You raise an important point as well, Peter, in relation to the cost, and the regulatory impact assessment. If you look at what I have already indicated in terms of costs, I’ve presented the costs of establishing and operating Revenue Scotland as a best estimate of the potential scale of costs. And as they will fall to the Welsh Government, we really have to be very careful in terms of scope and scale of the WRA functions, to make sure that we do have that staff and infrastructure requirement. But, implying costs, in terms of the benchmarking of Revenue Scotland, implies setting out costs of approximately £800,000 in 2016-17, £4.3 million to £4.4 million in 2017-18 and 2018-19, and ongoing costs of £2.9 million a year from 2019-20. That is our best estimate at this stage, but, clearly, I have said, in response to earlier questions, that I will bring this back in the autumn, in terms of greater clarity on these points.
I think the points about the opportunity for the Assembly to be very involved in a full consultation in relation to the PACE criminal powers—that’s very consistent with the approach used by Her Majesty’s Treasury to confer powers upon Her Majesty’s Revenue and Customs officers. As I’ve said, we want to use the affirmative procedure, and make sure that the powers taken are more likely to be appropriate for the WRA, in relation to our devolved taxes.
Y Dirprwy Lywydd / The Deputy Presiding Officer
Thank you, Minister.
Y Dirprwy Lywydd / The Deputy Presiding Officer
We now move to item 5, which is a debate on the first supplementary budget for 2015-16. I call on the Minister for Finance and Government Business to move the motion—Jane Hutt.
To propose that the Assembly, in accordance with Standing Order 20.30, approves the First Supplementary Budget for the financial year 2015-16 laid in the Table Office and emailed to Assembly Members on Tuesday, 23 June 2015.
Diolch, Ddirprwy Lywydd. I’m pleased to present the supplementary budget I laid on 23 June to the Assembly today. Although this supplementary budget is mainly administrative in nature, it does include a small number of key allocations from the reserves that have been agreed since the final budget was approved. Adjustments have also been made to the Wales departmental expenditure limit budget, to reflect the limited consequentials to our budgets, as a result of the UK Government’s last autumn statement and the March 2015 budget.
In tabling this budget at this time, I’m continuing with our established practice—publishing two supplementary budgets, to a timetable, which allows scrutiny in this Assembly, and builds on our overall record of transparency around our budgetary processes. This first supplementary budget further demonstrates that our priorities remain focused on improving the delivery of our public services, investing in our health service, boosting economic growth and creating jobs, driving up educational standards and performance in our schools, and tackling poverty in all its forms.
This supplementary budget underlines this Government’s continued commitment to the Welsh NHS. It provides a boost of £90 million for the health service in Wales, includes £30 million allocated to develop primary care services across Wales, and £20 million to the intermediate care fund. In line with our commitment to public services reform, the supplementary budget also details an allocation of £8.4 million to the education and skills portfolio, to contribute towards a number of initiatives, including support for Schools Challenge Cymru, the flexible skills programme, and apprenticeships. Following the full devolution of business rates policy, and boosting economic growth, the budget also includes a revenue allocation of £16.5 million to the economy, science and transport main expenditure group, to increase measures to support businesses with their non-domestic rates.
Other changes include adjustments to our resources and capital baselines, as a result of consequentials and transfers received since the final budget, as well as revised annually managed expenditure forecasts. This budget also reflects the transfer of expenditure supported by business rates from our DEL budget into annually managed expenditure, following the devolution of responsibility to Wales on 1 April.
Dirprwy Lywydd, since the publication of this supplementary budget, Members will be aware that the Chancellor’s budget last week provided confirmation of the scale of the in-year cuts to our 2015-16 budgets. The £4 million positive consequential will do little to mitigate the £50 million reductions announced, without notice, by the Chancellor on 4 June. And, as you know, those cuts hit budgets for public health, further and higher education, transport, and communities. Now we have confirmation of the in-year cuts, and let me remind Members what we’re talking about. What the UK Government has imposed on us is a £46 million budget reduction this year in-year.
I had hoped to be here today giving you information of new investments, though small, in capital programmes and other projects, but this cut has put paid to that. What we hear from the UK Government is that the economy is on the right track—things are meant to be improving. How justifiable, then, is this in-year cut? It makes proper financial planning next to impossible, and added to the huge cuts we’ve already received it does put under threat the things we value but take for granted—concessionary bus fares, our free prescriptions, our support for infrastructure projects. These things are only deliverable if Wales gets a fair share.
But I am determined to protect our public services this year as much as I can against these needless cuts. After careful consideration and prudent management of our reserves, we will protect our key public services from the full impact of the UK Government policies by taking these cuts from reserves. The decision to reduce our reserves by this amount is not taken lightly. It reduces our ability to meet contingencies and limits opportunities to provide additional investment in the current financial year. However, against this, we have also had to consider what the impact would be if we were to defer some or all of the cuts to next year. It’s already clear that the coming spending review will further reduce our budget in real terms. Therefore, carrying further reductions into the 2016-17 financial year would present an even greater challenge and worsen the impact of austerity on Welsh public services.
Through this decision, we will protect the budget approved by this Assembly for 2015-16 and budgets in future years. This Government continues to do all we can to protect the people of Wales from these sweeping and unnecessary cuts imposed upon us.
As is our usual practice, an explanatory note, providing a detailed description of all the changes, along with a detailed schedule of budget transfers, has been published alongside the budget motion, and I’m sure this has supported Members’ scrutiny of this budget.
Y Dirprwy Lywydd / The Deputy Presiding Officer
I call the Chair of the Finance Committee, Jocelyn Davies.
Thank you, Deputy Presiding Officer. The Finance Committee met on 1 July to scrutinise the first supplementary budget for 2015-16. I’d like to thank the Minister for attending our session and giving the committee the opportunity to look in depth at the allocations of funding laid out in the supplementary budget. The committee’s report includes a number of recommendations, and I hope that the Government will take those into account both in delivering this supplementary budget and in the future.
The committee is pleased to recognise that the Government has delivered, or is on track to deliver, 95 per cent of their programme for government. However, we are concerned that the rest of the programme may not be met, particularly in light of the £46 million cut, which will need to be applied this year. The committee will look again at the delivery of the programme for government when considering the second supplementary budget for 2015-16, which should show the impact of these cuts and of the autumn spending review.
The committee was also pleased to see an additional £14.6 million of funding allocated to mental health services, but we are concerned that this additional funding has not been linked to targets. This is of particular importance for child and adolescent mental health services, which has received a disproportionately low level of funding in the past. Members would like to see clear targets set out, particularly in relation to referral-to-treatment times, to ensure that the increase in funding is benefitting those who need it most and to ensure that service provision is measurably improved. The committee welcomes the additional £8.4 million that has been allocated to the education and skills main expenditure group. However, there appears to be a shortfall in the funding allocated to Schools Challenge Cymru, and we are keen to see further details on how this shortfall will be funded.
Many of the other recommendations included in the committee’s report relate to spending on health services. All of the committee’s recent budget scrutiny reports have discussed the increase in the funding for health. As I have said previously, as a committee, we do not wish to comment on whether the health sector should be receiving an increase in funding, but we have concerns that this additional funding has still not been linked to outcomes, and we have not been presented with a clear idea as to how the health service will improve as a result. We recommend that the Government provide details on how this additional funding is being used to ensure that NHS finances become sustainable and what expectations the Government has of the financial performance of the NHS in 2015-16.
On behalf of the committee, I’d like to say that we were grateful for the opportunity to consider this supplementary budget and we look forward to scrutiny of the second supplementary budget, which we hope will provide clarity on the impact of cuts contained in the UK budget. Thank you.
I’m pleased to contribute to this debate today and I was pleased to hear the Minister, in opening, recognise that the UK Government is getting the economy back on track. I was surprised, Minister, that you didn’t seem to make the link with the UK Government taking those actions that then mean that here, of course, difficult decisions have to be made, certainly in the short term, Minister. But, you did recognise that the economy is getting back on track.
The Welsh Conservatives welcome the £70 million earmarked for the Welsh NHS that was announced in January. As the Minister knows, Welsh Conservatives have long been calling for additional funding for our health service. This £70 million does not, of course, make up for the hundreds of millions of pounds that have been cut from the health budget in Wales since 2011, but it is at least a step in the right direction.
During evidence to the Finance Committee, the Minister identified primary care developments and delivery plans as areas of increased spend and I’d hoped that the Minister could give us further details of these areas. I’d also like to hear from the Welsh Government why they still will not commit to the dedicated cancer treatment fund, which people in Wales are crying out for and which certainly fills my postbag, and I know the postbags of other Assembly Members.
I’d also be interested to know if the Minister is still requiring performance improvement as a result of this additional money. We know the confusion that arose over this when the funding was initially announced. Given that three LHBs overspent in 2014-15 and only five of the 10 NHS organisations have approved three-year plans for the period 2015-16 onwards, we certainly need assurances that the local health boards are in a position to make the most effective use of this funding and that it will not simply become yet another bail-out, absorbed into the health board debts and providing no real change for patients.
As the Finance Committee report points out, the Assembly will have dissolved ahead of the elections before the 2015-16 financial year, so we will need another update in time for that supplementary budget to make sure that this spend has been effective and we can adequately fulfil our scrutiny role.
In evidence to the Finance Committee, the Minister gave details of the transfer of £956 million from local government departmental revenue to annually managed expenditure—a consequence, as the Minister rightly said, of the full devolution of business rates. This is understandable. It is ironic that, as a result of the new system, Wales now has to bear the cost of even mirroring changes in UK business rate policy. But, it does at least allow for localism, so I suppose, ‘every cloud…’ as they say.
The Finance Committee also called on the Welsh Government to improve the accuracy of its monitoring and forecasts. We do need to know that the Welsh Government is making progress in this area. In evidence to the Finance Committee and elsewhere, the Minister has said that business rates forecasts would be presented to the committee, but in the committee, you did tell us in an evidence session that the Welsh Government were considering ways to make the information more meaningful. Have you reached any conclusions yet on this, and are you in a position to tell the Chamber exactly how you intend to make that information more meaningful? It certainly is important that the Finance Committee does receive that information and that this Assembly is in the best position possible to scrutinise this budget, and indeed budgets in the future.
The devolution of business rates and the future devolution of other taxes in 2018 clearly does require a robust monitoring and forecasting framework, otherwise the Welsh Government will be susceptible to an unnecessary level of volatility, which could potentially throw any future spending plans into chaos.
I was going to touch on the additional education allocations, but the Chair of the Finance Committee has already done that, so I won’t go over that ground.
In conclusion, Minister, we welcome this supplementary budget being brought to this Chamber, but I’m afraid we cannot support it. Whilst a number of the transfers are technical and necessary, Welsh Conservatives believe that the budget overall that this budget seeks to amend still fails to adequately reflect the priorities of the people of Wales, particularly in the area of the NHS. This budget is a missed opportunity, Minister, and, as I say, we will not be voting for it.
I, unlike Nick Ramsay, support this first supplementary budget. The first supplementary budget normally involves less movement of money than the second in the previous financial year. This is again the case this year. The Finance Committee has only made five recommendations, and three of them are on health.
In-year cuts make it difficult to manage budgets. We’ve seen a £50 million in-year reduction prior to last week’s spending review, whose effect we await. Of course, if the provision of funding for Wales was against the published formula, then taking the figures from the red book, it should be easy to calculate the changes. Now, we have to wait for the Treasury to inform us of the consequential changes to the Welsh budget. I’m sure a more meaningful first supplementary budget could have been produced if the details of the funding changes were available before the supplementary budget was produced so they could have been taken into account before the Finance Committee considered it.
Of course, these changes help make the case against income tax devolution. I can see that if income tax were devolved, the Chancellor would be saying, ‘If you do not want to make these cuts, then increase income tax; the choice is yours’. Looking at the NHS finances, as the committee report said, they will need to be put on a sustainable footing. We are in a situation with health where any additional expenditure is deemed to be good. No matter what it is used for, give health more money. How much you spend gets substantially more scrutiny than how it is spent and how efficiently it is spent. To take the most recent examples from the auditor general’s report regarding orthopaedic services in the Aneurin Bevan health board on 29 June this year, I will directly quote from page 4 of the summary.
‘High demand and a range of inefficiencies are resulting in an inefficient orthopaedic service with some outcomes less positive than elsewhere in Wales:…day surgery rates, length of stay and use of theatre capacity all need to improve;…higher rates of elective orthopaedic mortality and a lower rate of improvement following knee replacement surgery.’
Turning to the review of district nursing services in Cwm Taf University Health Board, pages 6 and 7:
‘A detailed workforce plan…to move services into the community is yet to be developed’,
‘Demand for district nursing services needs to be better managed’,
and this is one of my favourites:
‘there are no systems in place to collect, in a consistent way, information on the number and nature of referrals while referral criteria are out of date and not actively used’.
How much could be saved or reallocated if interventions that either did no good or actually did harm in the health service actually stopped? How much could be saved to be reallocated if every health board performed at the same level as the most efficient and effective? The cost of secondary care increases, and the relative expenditure on primary care decreases, every year. When people say they want more money for health, what they mean is more money for hospitals. It’s always hospitals and pumping money in to hospital services. Is this the direction of travel that we want health’s expenditure to go? Why should health boards be bothered to be efficient and effective when each health board knows they will get tens of millions of pounds each year to cover overspends? Of course—
Will you give way?
Thank you for giving way. Just for clarification, are you saying that you support the Welsh Government’s cuts to the health budget?
What I’m saying is that the Welsh Government haven’t made cuts to the health budget, and that’s a matter of fact. The second thing, which is also a matter of fact, is that giving health money, if it’s spent inefficiently and ineffectively, is of no good to anybody. I think that Nick Ramsay would say that if you employed somebody in the health service and gave them pound coins to pour down the drain, as long as that money was being spent in the health setting, that would be wonderful because there’s more money going into health. What it’s spent on appears to be immaterial.
We need a more efficient health service. The amount of money we’ve got can then be spent effectively, but all they’ll be saying is, ‘Give them more money. Give them more money. Health desperately needs more money’. Health desperately needs to be run efficiently in terms of the health boards. There are serious problems. I just gave two examples of the last two—
Will the Member take an intervention?
Can I just finish this sentence? The last two reports that came out by the auditor general. Certainly.
Thank you to the Member for taking an intervention. If you speak to many pharmacists—and we know from figures quoted—there is over £50 million wasted on unused prescriptions in terms of the free prescriptions that your Government imposes. What do you think your Government should be doing about that £50 million of waste money?
Stopping people dying because they can’t afford to get medicine. That’s what I think our Government ought to be doing. Stopping parents, when they go to the doctor, having to decide which medicine to get. That’s what I think we ought to be doing. If you lived in the type of community that I live in, you’d have seen people asking the pharmacist, ‘Which is the most important of these medicines I’ve got in order to know which one to take?’. That’s what the Government should be doing. Free prescriptions at the point of need are desperately needed, desperately important, and I believe it’s proving that the Government is going in the right direction.
My last point is: according to a Nuffield Trust report on the four health systems in the United Kingdom, they show there’s been a drop in in-patient admissions per HCHS service doctor and dentist from just under 140 to well under 100. The drop in efficiency is far greater than either in Scotland or the north-east of England. It’s efficiency the health service needs. It’s efficiency we need from the health boards, not just keeping giving them money, money, money.
I’m going to endorse a number of the comments that have been made already, because the financial forecast is still created by demand for national health services and the scrutiny by the committee reflects that. I do support a lot of what Mike Hedges said earlier. One of the main concerns that Plaid Cymru had with the current budget is: is the additional money that’s gone to the health service going to secure improvements in the service, or is it only going to continue with everything that’s gone previously? Previous Labour Ministers said that additional funding for the NHS would meet the findings of the Nuffield report. So, the basic question is: what does the Government expect for that additional money? That, I think, is what all of us are asking for here because, otherwise, the health service appears to be a bottomless pit. Even though there are many good things happening within the health service, it seems that we’re not seeing those improvements that we’d expect to see from those additional funds.
Another concern is that the Labour Government doesn’t have plans for managing demand within the health service. We’ve seen additional money for integrating health and social care, and Plaid Cymru has supported that, for example, through the intermediate care fund. But, we didn’t see anything beyond that, and there are problems such as obesity that need significant intervention by Government, and there are other examples of changes of behaviour in order to try and reduce the pressure on health services. Will the Minister, therefore, deal with the concerns of the committee regarding health expenditure, and also state whether the Labour Government is doing anything to manage future demand?
In terms of business rates, the supplementary budget is also moving £956 million of revenue from non-domestic rates to annually managed expenditure in order to reflect devolution. What are the arrangements for forecasting future income from business rates, and when can we expect a figure for 2016-17? Thank you very much.
I think, as Mike Hedges pointed out, a large number of the recommendations of the Finance Committee related to the health service, and I think that still remains the biggest concern in terms of the budget and this particular supplementary budget. It’s not because, as Mike Hedges said, the money is not being spent efficiently and effectively—although I think there is evidence it isn’t in many cases—but because, to us, in terms of scrutiny, that remains one line in the budget representing a huge proportion of the Assembly’s overall expenditure, which remains very difficult to scrutinise because it is not transparent at all exactly how that money is being spent, and it’s very difficult to actually get to the bottom of what the LHBs are doing with that money. If you look at the committee’s report, it notes that three LHBs overspent in 2014-15; only five of the 10 NHS organisations had approved three-year plans for the 2015-16 financial year onwards, although two of the remaining LHBs were providing updated plans. That does give everybody cause for concern, I think, particularly about the ability of the various NHS organisations to manage and remain within their budgets in the current financial year. Of course, we are in a situation where, effectively, we are plugging overspends and funding gaps without really knowing how well that money’s being spent, because the only person who has that detail at their disposal is the Minister, and of course the chief executive of the NHS in Wales.
I think it’s very important, therefore, that not only are the health service’s finances put on a sustainable footing, as recommended in the report, but also that we have more details of the impacts of these additional allocations in terms of how the NHS is changing the way it manages its resources, making sure that it is able to keep within budget for future years, and also making sure that the money that it is being given is spent effectively. I think, as Mike Hedges said—and I agree with the points he was making—it is fine to throw money at the health service and say, ‘This is a good thing’, but the important thing is to make sure that money is being spent effectively and efficiently, it is delivering a health service that meets the needs of the people of Wales and delivers services that people want to see, and ensure that, in spending that money, we get a health service that is accountable, transparent and that is the most effective it possibly can be; I’m not convinced that we’re anywhere near that point as yet. So, I think that there’s a lot more work that needs to be done in terms of how we monitor and scrutinise this expenditure.
Although, obviously, more money has been allocated—we very much welcome the fact that more money has been given to the health service in this supplementary budget—there is still that concern that the health boards are not delivering the plans that are being required of them, that we’re still having overspends, and that we still have increasing waiting times for a number of services within health, which people are finding more difficult to cope with. Of course, as an Assembly Member—I think every Assembly Member in this Chamber has people coming to us to ask us whether we can intervene to help them because they’re being asked to wait longer than the times that have been specified.
The other point I wanted to make in relation to this supplementary budget was in relation to mental health funding. I very much welcome the fact that extra money has been given to mental health. I think it’s very important that this particular area is given the recognition that it deserves and that the Welsh Government is funded adequately, and I think that we’ve made a start in that money going into the health service with this particular budget.
But there is a concern, of course, about how that money is being linked to targets, particularly in relation to referral-to-treatment times, and I think that we need to have some reassurance from the Minister that, if we are going to be putting all this extra money into mental health funding—£14.6 million—that there are proper targets being set and that those targets are being met by the health service. Particularly for children and young people, child and adolescent mental health services have been a concern for, I think, the entire time that this Assembly has been in existence, and we’re still not convinced that they are delivering properly. So, I would hope that the Minister is able to give that assurance that firm targets are linked with those additional allocations to ensure that the money directly benefits those who need it the most, and that, as a result of that, the provision of services in the mental health field is going to be measurably improved. Thank you, Deputy Presiding Officer.
Y Dirprwy Lywydd / The Deputy Presiding Officer
I call the Minister to reply to the debate.
Thank you very much, Dirprwy Lywydd, and I do thank Members who’ve contributed to this debate. Specifically, I’d like to thank the Finance Committee for their work in scrutinising this budget and for the Chair’s contribution this afternoon. I very much value the Assembly’s role in scrutinising budget proposals and will also, clearly, further consider the recommendations in the committee’s report, and will be responding accordingly.
But I’d like to touch briefly on some of the issues within the report that have been raised this afternoon. The report by the committee did make a number of recommendations regarding the impact of allocations made in this budget to the Welsh NHS. As I said in my opening remarks, the budget provides a boost of £90 million for the health service in Wales, including £30 million allocated to develop primary care services across Wales; £10 million is also included to implement measures and delivery plans, including cancer, cardiac, diabetes, mental health, stroke care and respiratory health, and taking forward service reconfiguration, and £10 million to create a fund to accelerate the adoption of new technologies in the Welsh NHS, and, also, and this was mentioned in the debate, the intermediate care fund—£20 million to the fund—supporting those projects that are effective across community and acute environments, linking up hospital care and social care to strengthen resilience of the unscheduled care system, very much responding to the modernising and way forward in terms of a primary care-led service, touching on Mike Hedges’s point.
Mental health services have featured this afternoon: £14.6 million will support mental health services, all of which will be directed at supporting the implementation of our mental health strategy, ‘Together for Mental Health’. Also, just in terms of the questions and the points that Jocelyn Davies made—and Peter Black—about CAMHS, I think that funding for mental health, it’s important to recognise again, including the child and adolescent mental health services, has been ring-fenced within the NHS since 2008. Following the recent announcement of the £7.65 million annual allocation, as well—and, of course, I have identified where that has been spent, and also that the CAMHS planning, in terms of health board responsibilities, is taken forward and clearly scrutinised.
I think it is important just to look at health and social services in terms of the funds and how we are delivering this. Its additional £20 million is very welcome. That’s together with the additional resources that we announced as part of the 2015-16 budget. This means that NHS Wales has benefited from an extra £500 million over the last two years. Those resources do actually help to go further than the requirements identified in the Nuffield Trust report, mentioned again this afternoon, ‘A decade of austerity in Wales?’, published last June. This investment demonstrates the Welsh Government’s continued commitment to the NHS in Wales. The Nuffield report confirmed the NHS will be affordable and sustainable in the long term—
Will the Minister give way?
[Continues.]—in terms of a share of funding. Nick.
Thank you for giving way, Minister. Yes, this new money is to be welcomed, but it doesn’t fill the gap that was left by the amount of money taken out by your Welsh Government since 2011, does it? At the time that money was being taken out, patients were suffering a wait that they needn’t have if you’d supported and defended the health budget in the same way that the budget in England was defended—in real terms, not in cash terms, like you did.
It is extraordinary, I would say, that you have got the gall to say that this afternoon, when I have had to deal with a £50 million cut in our budget in-year this year. No comment on the way that we’re having to manage that: because of the way we prudently managed our finances. No comment about—as the First Minister said—what that £50 million could do in terms of investment in our health service. In fact, also no comment, of course, on the fact that the way in which we have managed the health service means that we are spending at a higher level in Wales than in England, in terms of our spend on health and social care. In fact, spend per head on health and social services in Wales is 5 per cent higher than in England, and that’s testament to the value that we put in terms of our health and social care investment.
I think the report from the Finance Committee did recognise the additional support we’ve provided to the Schools Challenge Cymru programme, and Jocelyn Davies mentioned this. This budget does provide an additional £3.5 million to support the programme, adding to funds available in the education and skills main expenditure group. This is part of an £8.4 million package, also allocating money towards flexible skills, the new deal, and also care sector apprenticeships. So, I think, in conclusion, Dirprwy Lywydd, the supplementary budget I move today does uphold my commitment as finance Minister on behalf of the Welsh Government to be open and accountable to the Assembly on the management of our 2015-16 budget.
Nick Ramsay does tend to get excited when I think his Government in Westminster is wrong-footed, and it has certainly been wrong-footed by the Chancellor’s budget last week—not only depriving us of another £50 million, but not responding to my call to the Chancellor to invest in our infrastructure, which is what business said we should do, and to invest in our children and young people. It’s not a politician who is reacting to the budget, it’s the independent Institute for Fiscal Studies. Thirteen million UK families will lose £260 a year on average, because of tax and welfare changes. The Children’s Commissioner for Wales warns the budget will plunge children into poverty. That is why our supplementary budget, which you are not supporting—clearly because you do not share our values—
Y Dirprwy Lywydd / The Deputy Presiding Officer
You must finish now, Minister.
[Continues.]—of social justice, investing in health, education and boosting the economy. Those are our priorities as a Welsh Labour Government.
Y Dirprwy Lywydd / The Deputy Presiding Officer
The proposal is to agree the motion. Does any Member object? [Objection.] I defer voting on this item until voting time.
Voting deferred until voting time.
Y Dirprwy Lywydd / The Deputy Presiding Officer
Item 6 is the Care and Support (Eligibility) (Wales) Regulations 2015. I call on the Minister for Health and Social Services to move the motion—Mark Drakeford.
To propose that the National Assembly for Wales; in accordance with Standing Order 27.5:
Approves that the draft The Care and Support (Eligibility) (Wales) Regulations 2015 is made in accordance with the draft laid in the Table Office on 8 May 2015.
Diolch yn fawr, Ddirprwy Lywydd. I move the motion.
Section 32 of the Social Services and Well-being (Wales) Act 2014 requires that the National Assembly make regulations that set out the duty on a local authority to determine whether or not an individual with needs identified through an assessment is eligible to have those needs met by that authority.
Now, Dirprwy Lywydd, the regulations have been a long time in the making. The whole issue of eligibility was well rehearsed in the 2010 report of the Independent Commission on Social Services in Wales. When that report led to a social services Bill in the present Assembly, no issues were more extensively discussed and debated than the processes of assessment and eligibility. That focus has continued through the superaffirmative procedure.
The regulations in front of Members today have been developed by a technical group set up for this purpose, and which drew around half of its membership from the voluntary sector. In accordance with the superaffirmative procedure, the draft regulations were thoroughly consulted on over the last winter.
The approach to eligibility introduced through these regulations is very different from the current threshold-based approach. The process begins with an assessment and the Act creates new rights to assessment, both for users themselves and for carers. Where the assessment identifies a need, the local authority must consider what should be done to meet that need. Where the need can only be met with the support of the local authority, the eligibility regulations create a right for the person to receive care and support directly provided or arranged by the local authority itself.
I have read of the anxiety that has been raised that the Act somehow requires users to demonstrate exhaustively that they have explored every other possible avenue of support before becoming eligible for local authority assistance. That is emphatically not the case under these regulations. The responsibility here lies with the assessor, not with the person being assessed. More importantly still, it requires the assessor to discharge that responsibility in dialogue and a discussion with the person who has a need, to agree a joint response. That is why it is a requirement that the local authority must also consider the contribution that the person her or himself, or preventative services, can provide to meeting the assessed need.
That is because this is an asset-based Act. It starts from the point that all individuals have strengths, that every person can be a contributor to, as well as a recipient of, services. It is an Act, moreover, which directly recognises and encourages the contribution made by the many other partners in the social welfare field, a contribution that in this case will be underpinned by £20 million-worth of Welsh Government investment over three years in projects that support implementation of the Act and sustainable social services. Because this is the case, the Act and its statutory instruments place a duty on the local authority to inform and provide advice and assistance to people to give them far greater voice and control.
The consultation carried out on the draft regulations demonstrated support for the proposed change, and provided valuable comments on the detail within the draft regulations. As a result, changes have been made to them. There are several improvements to provide greater accuracy, but I’ll concentrate this afternoon on changes that have a material effect on the application of the regulations.
As a result of consultation, the regulations now have a definition of self-care added to them. The ability to communicate has been added as a factor to which the determination of eligibility may relate. The regulations have been amended to reflect that in many cases children, and particularly older children, will have an independent ability to access services available in the community. The regulations now in front of the Assembly provide that, for the purposes of determining eligibility for care and support, a person will be regarded as unable to do something, even when they can do that thing but only with a greater level of difficulty than would normally be expected. That’s a change that was particularly promoted by groups representing disabled people.
The regulations have been further amended to ensure that care provided by a carer is taken into account as a factor determining whether a person’s need is eligible for the purposes of the regulations. It’s now explicit in them that a need that is being met by a carer will become an eligible need if the carer is no longer able or no longer wishes to provide that care.
Dirprwy Lywydd, as part of the superaffirmative procedure, the Health and Social Care Committee has further consulted on the revised regulations. Inevitably, in an Act that provides for radical change, there are understandable concerns about its practical delivery. The committee has very helpfully set out ways in which these concerns can be addressed in the code of practice that will accompany the Act, and we will ensure that the codes are further strengthened to reflect the committee’s recommendations. And because of its radical nature, the new framework for assessment, eligibility and care planning will be subject to careful monitoring and evaluation. Local authorities are planning this at local and regional levels, but we will also as a Welsh Government evaluate at a national level, guided by a steering group. As part of the evaluation, data will be collected to identify the number of assessments requested and carried out, the number of such assessments that lead to a care and support plan, the number of those care and support plans that lead to a service provided or secured by a local authority, the number of reassessments and reviews instigated by users, and the proportion of those assessments completed within agreed timescales. And the purpose of all that evaluation, Dirprwy Lywydd, is so that we are confident that we can identify whether the new system is meeting the aims of the Act, or whether there will be a requirement for further refinement.
Dirprwy Lywydd, let me end, though, by being absolutely clear: as the use of the superaffirmative process implies, the care and support (eligibility) regulations lie at the heart of the 2014 Act. Those who are preparing very actively for its implementation in our statutory and voluntary services—its implementation on 6 April next year—they need the certainty that these regulations provide. I ask Members to follow the advice of the Health and Social Care Committee and those who gave evidence to it and ensure that these regulations reach the statute book this afternoon.
Y Dirprwy Lywydd / The Deputy Presiding Officer
And I call the Chair of the Health and Social Services Committee, David Rees.
Thank you, Deputy Presiding Officer. It’s a pleasure to contribute to today’s debate on behalf of the Health and Social Care Committee.
The committee didn’t have a formal scrutiny role in terms of these regulations, but we do believe that it’s an important issue that needs to be considered carefully. We wrote to the Minister on 7 July to convey the conclusions of our work. We hope that the evidence gathered and the conclusions we came to will have helped Assembly Members in preparing for today’s debate. We are grateful to everyone who contributed in written form or orally to our process of considering these regulations.
Access to appropriate social care that meets their personal needs is vital for many people—adults, children and carers—to allow them to achieve their wellbeing outcomes. Changing the eligibility criteria for accessing these services is an issue that deserves careful consideration, so we are pleased that these regulations are being made through this enhanced procedure, which has allowed us to dedicate time to doing just that.
I believe it’s important to highlight that during our evidence sessions, all witnesses indicated that in principle they supported the regulations. However, stakeholders also expressed some significant concerns to us, which I will briefly outline, and we believe that these concerns could be addressed by making changes to the accompanying code of practice. We note the intention of signposting people towards preventative services within the community, however this relies on the availability and appropriateness of such services. We have recommended that the code of practice should specify how a particular community service will be able to meet a person’s need and wellbeing outcome. Should that service no longer be available or be unsuitable, that person should become eligible for formal care and support services.
The ‘can and can only’ test is another issue that stakeholders expressed concerns about, particularly regarding the potential for creating delays in receiving support should someone need to demonstrate that they had tried all other options before becoming eligible for services provided by a local authority. I hear what the Minister says, and I appreciate very much the comments he’s made this afternoon in relation to that. We strongly believe that the code should be clear that this responsibility should be placed on the local authority rather than on the individual, as the Minister has again highlighted this afternoon—that the responsibility should be on the assessor.
We would be very concerned if the introduction of these regulations resulted in increased pressure on unpaid carers to fulfil care needs in place of local authority-provided care. We want to ensure that a loophole that could potentially be there is closed. We’ve therefore recommended that the code should make it clear that there shouldn’t be an over-reliance on voluntary caring arrangements and include a requirement for the willingness and ability of a carer to be recorded. We’ve also recommended that the ‘can and can only’ test should be interpreted in a way that meets the best interests of an individual and enables them to achieve their wellbeing outcomes.
Independent advocacy services are key to ensuring that everyone—adults and children—understand their situation and what support is available to them, so it’s vital that this assistance is available to everyone, whoever requires it. We believe that the code should be strengthened to reflect this. An individual’s ability to seek redress should they feel that the support they receive doesn’t meet their needs is an issue of great importance to us. We believe it’s essential that people can be confident that there’s a mechanism in place should they wish to request a reassessment. We have recommended that such a mechanism should be detailed in the code of practice and that, in requesting a reassessment, service users should not have to demonstrate that their circumstances have changed significantly.
I am pleased that the Minister has committed to looking at strengthening the code of practice and that he will give further consideration to our comments on this important issue. In particular, I hope he looks at how the codes under Parts 10 and 4 will address those concerns and make the necessary changes we’ve recommended, which we believe are important to safeguard the services people need to meet their wellbeing needs.
As we’ve said in our letter to the Minister, these regulations will result in a big change to the way social care services are delivered, so monitoring their impact will be crucial. No-one should see a reduction in the level of support they receive as a consequence of the implementation, so we believe that the Welsh Government and local authorities should monitor their impact at an early stage. We will also be recommending in our legacy report that our successor committee in the fifth Assembly takes the opportunity to review the implementation at an appropriate time.
So, to conclude, I will re-emphasise that the evidence we received supported the regulations, but that the concerns can be addressed through modifying the code of practice. We ask the Minister to ensure that takes place.
The Welsh Conservatives will not be opposing these regulations today. While we believe a national eligibility framework is long overdue, we have grave concerns about the way these regulations will be implemented. It is therefore our intention to abstain.
I would like to put on record my thanks to the Minister for keeping opposition spokespeople updated on these regulations and his clear indication that he will improve the code of practice. However, we do not feel the code of practice provide the necessary clarity at present. Our biggest concern, and the concern of many organisations, surrounds the ‘can and can only’ test. When the Health and Social Care Committee was taking evidence on these regulations, many of the organisations raised concerns that the ‘can and can only’ test would lead to instances where a person would have to prove that they had exhausted all other avenues before the local authority would provide an assessment and care package. Other organisations highlighted the risk that the test would lead to unnecessary delays in accessing services. I welcome the Minister’s assurances that the core assessment does not look at the level of support an individual has from family and friends. However, the code of practice is not clear enough and is still open to interpretation.
With local authority budgets under pressure, we are gravely concerned that social services departments will use the ‘can and can only’ test to abdicate responsibility. The Wales Alliance for Citizen Directed Support states that there is a risk that, without clear guidance on the ‘can and can only’ test, eligibility could become a barrier in itself. They are also concerned that the requirement for individuals to exhaust all possible family and community-based options for support before becoming eligible for statutory services could widen the gaps that people can fall through.
We also agree with Age Alliance Cymru that needs assessments should not include a consideration of the willingness or availability of a carer to provide care and support. Age Alliance Cymru, in evidence to the committee, stated that the ‘can and can only’ eligibility test contradicts this by stating that consideration of the availability of others who are willing to provide that care should be included.
Minister, your original draft regulations stated that a local authority should disregard care given by a carer when assessing need and eligibility, and you have told us that this is still your intention even though this has been removed from the face of the regulations. We are deeply concerned that a carer should be placed under undue pressure and be denied the support they need to care adequately for a relative or a friend. Therefore, Minister, we ask you to rewrite the code of practice to ensure that your intentions cannot be misinterpreted. The guidance must be clear to local authorities that the ‘can and can only’ test is not a way to pass the buck and place undue pressure on families, carers and community support services.
Our other major concern about these regulations is around the right of appeal. I welcome your assertion that individuals have the automatic right to review and reassessment. However, once more, the guidance is unclear. We can foresee situations in which individuals refused care by a local authority would have absolutely no redress because the same local authority is responsible for deciding whether a person requires a reassessment of whether their needs are being met. Minister, the Care Act 2014 in England gives individuals and their carers a right of appeal. It is unfortunate that people living in Wales do not have the same rights. The only avenue open to those who feel they are not getting the care and support they need is via a formal complaints procedure. I understand the point you make that having an appeals process and a complaints process would be confusing. However, when we have a situation where the same social services department can be both judge and jury, we must have processes in place to ensure there is provision for redress. Minister, I ask you to listen to the concerns of the third sector organisations, plus those of the wider public who have care needs or are caring for family and friends. There must be clear guidance to ensure that the aims we set out in the Social Services and Well-being (Wales) Act 2014 are implemented.
And finally, Minister, I ask you to reconsider the need for an independent appeals process for both individuals and their carers, or, at the very least, clear unambiguous guidelines on the automatic right to review and reassessment and for carers to receive the same right.
I want to start by welcoming the fact that we’re having this debate and superaffirmative vote. This is something I and colleagues on the health committee argued very strongly for during the passage of the Bill, and it is to the credit of this Assembly as a scrutiny body and to the previous Deputy Minister, Gwenda Thomas, that we have this opportunity. Indeed, the detailed way this legislation has been examined at every stage of the process speaks volumes and gives the lie to the assumption that, somehow, we’re not up to the job when it comes to scrutiny here in Wales.
Unfortunately, due to my recent bereavement, I wasn’t able to attend the committee session where we took evidence from stakeholders on these regulations, but I’ve read the transcript carefully and, broadly speaking, I concur with the main points the committee set out in our letter to the Minister last week. For example, I agree with the evidence from the Wales Carers Alliance, cited directly in the letter, that, while a shift towards community preventative services may very well be a laudable aim, it means nothing if there isn’t the infrastructure of services in place that people can fall back on. I also share the concerns about the ‘can and can only’ test and the sense that the onus should not fall on the individual to somehow prove to the local authority that their needs cannot be met by whatever preventative services may or may not be available within their own particular community.
I do welcome the assurances from the Minister on the ‘can and can only’ test and the fact that they were repeated today, but it is essential that there is absolute clarity given to local authorities via the code of practice on this point, or there is an obvious danger that we could see individuals either falling through the gap completely or facing long delays before they can access the support they need, particularly given the concerns that have been expressed around access to advocacy.
But it’s the points raised in relation to review and reassessment that particularly stand out to me, despite the clear commitment from the Minister back in June that an individual can request a review or reassessment at any time if they do not feel their current care package meets their needs. I concur with my colleagues that there needs to be absolute clarity from the highest level, both in terms of the process by which an individual can challenge eligibility decisions as well as the timescale by which they can expect to have their needs reassessed. I welcome the Minister’s commitment to addressing this within the code of practice.
I’ve recently been involved with a number of cases where constituents have approached me because their care packages have been cut in response to changes to local eligibility criteria that the council has been forced to make due to cuts handed down from Westminster. The most worrying of which involved a severely disabled lady whose care package has recently been reduced from 30 hours of direct payments to just 10, at the same time wiping out her eligibility for ILF funding. She has had to fight vociferously every step of the way just to ensure her request for review and reassessment was handled properly by the local authority. So, it is crystal clear to me that we really have a lot of work to do before we get this right.
But, it’s also brought another even more troubling point home to me, because at times it’s felt like this legislation has existed in a vacuum, immune to the financial reality facing local authorities up and down Wales. Out there on the ground, and because of massive funding pressures handed down from the Tories in Westminster, councils like Torfaen are drastically cutting back the support for people like the constituent I mentioned, simply because they do not have the resources they need to continue providing them.
While I see that this is a point that was made forcefully by a number of colleagues during scrutiny, at times over the past two years it’s felt like the elephant in the room, despite me having raised the issue on numerous occasions in this Chamber, in committee and in private conversations with Ministers. Yes, I will be voting for these regulations, because, in the end, I do believe this is the right direction of travel for the future of social services in Wales if properly resourced, if effective preventative services truly are in place, and if there are clear procedures that local authorities must follow, to the letter, if an individual asks for a review or a reassessment. But, it would be disingenuous to pretend for one moment that, in this era of Tory-imposed austerity here in Wales, life for everyone who relies on adult social care is somehow going to magically get better these next few years as a result of this Act, when, in Torfaen and elsewhere, care packages are being cut back for people who really rely on them. As elected representatives, I think we all have a duty to be crystal clear about that. Thank you.
I will say at the outset that we are supporting the regulations, and I congratulate Lynne Neagle on the latter part of her speech; I agree with every single word you said.
The issue of eligibility criteria is extremely important in making sure that people in need of care and support can get access to the help that they require. I cannot overemphasise that point. Having heard from key stakeholders and people’s representatives during the committee sections, there are, however, some questions that do need answering. For example, Minister, we need to know what exactly is meant by ‘preventative services’; who will be responsible for providing them and what cost will there be, if any, to the service users and/or their carers?
My second question is a question I raised during the debates on amendments to the social services and wellbeing Bill: what happens if the person, whether eligible or not, is not happy with the decision made by the local authority? We’ve heard from the Minister that that person can ask for a re-assessment. On that matter, I fully support the committee’s recommendation that an individual should have the right—and I would add, be made aware of the right—to challenge the eligibility decisions and be told clearly the timescale within which a reassessment should take place.
Also, Dirprwy Lywydd, I’m not totally convinced that these new criteria will prove to be any more of a national framework than the current system. Will they really remove any inconsistencies across local authorities, and how will they assess people’s needs and how best to meet them? But, we are where we are and I have to support them. If these new criteria do away with local authorities waiting until an individual reaches a critical level before they provide the service, then they will indeed, of course, be helping to reduce costs and also helping to keep people in the community. On this last point, we need to be reassured that there will be enough preventative services in the community to cope with the demand for services.
Finally, Dirprwy Lywydd, I want to endorse the point made in committee on behalf of the directors of social services in Wales that the Welsh Government and local authorities—and I think you did answer this, Minister, but I’ve written it, so here it is—closely monitor the implementation of these regulations to make sure that the needs of the individuals are indeed being met.
It is with pleasure that I rise to support the regulations now before us. It was a privilege to steward the process of social services reform from the first Green Paper, ‘Sustainable Social Services for Wales: A Framework for Action’, through to the final passing of the Social Services and Well-being (Wales) Act.
As we near the date of that Act’s final implementation, I am glad to see each new jigsaw piece of subordinate legislation falling into place—many, as I promised you at the time, through the superaffirmative procedure. The regulations concerning eligibility are arguably one of the most important pieces in this jigsaw that is now nearing completion. The principal reason is in the title of that Green Paper: our social services must be sustainable, and the way that we make them sustainable is to centre service provision on the citizen. That is what these regulations achieve. This new model is about creating a rights-based approach to eligibility. It will ensure that people have a right to a core assessment of their needs before consideration of what help is available. And importantly, in the event of a breakdown of any support arrangements, the original core assessment must be immediately reapplied.
There will be a right, at minimum, as the Minister has said, to information and advice that must be provided free of charge. For the first time, carers will have the same rights to assessment and support to meet their needs as adults and children. These regulations will mean that service users’ and carers’ voices are heard and listened to throughout this process. I am confident that the eligibility criteria can be applied consistently to adults, children and carers. I am confident that the new system will ensure that people and families get the right support in the right place at the right time. Fundamentally, I am confident this is a more open and bespoke approach that will allow local authorities to help more people and not less.
The central logic of the new system we are building is sensitivity to context. It is then, I feel, rather ironic that certain critical voices have extracted one sentence from one document, not even the regulations before us today, and read this in isolation. The criticism of the ‘can and can only’ test conflates two distinct stages in a far wider process. One part of the eligibility process is to assess if care and support interventions can address the needs, risks or barriers that stand between an individual and their wellbeing. This is only following the assessment of core needs. It is only once these stages are complete that a decision will be made as to whether the individual’s wellbeing outcomes cannot sufficiently be met through care and support co-ordinated by themselves, their family, carer or others, but can only be met through a care plan co-produced—and that’s very important—with service users and, where appropriate, carers. As I say, this is about writing into the heart of the system an understanding of context of the real situation in which real people live. The person in need of care and support is not an isolated input into a bureaucratic machine; they are our mothers, fathers, our neighbours, and friends, our siblings and children. They are human beings embedded in complex networks of familial and community ties. The role of the state itself is not to extract them from this social context, but to bend itself to support them within it. That, Llywydd, is precisely what these regulations will do.
As other speakers have already mentioned, these regulations are absolutely key to the future of what social care will look like in Wales for the years to come. As has already been stated, they set out the tests to be applied to adults, children and carers in establishing whether or not an individual who has a need identified is then entitled to have those needs met by a local authority. That is: will they receive a care and support plan to access and manage the ways to meet their care and support needs?
For those who do not satisfy the test, they will be signposted to preventative and wellbeing services in their community, and, as the Government’s own document states, encouraged to build on their own strengths and those of their networks to meet their needs. The Government’s rhetoric around these regulations is all about early intervention and prevention, without the need for formal planning. Of course, that is very seductive, and of course we should be promoting independence, of course we should be promoting early intervention. That is the right thing to do, and there is much in that approach that I would agree with. But I believe that can be achieved, Deputy Presiding Officer, in a way that does not deliver what I regard as the sting in the tail of these regulations, that you will only be deemed eligible if your needs can and can only be met by the local authority.
So, let us be clear and upfront about what this means. It will reduce the number of our constituents who have the safety net of a formal care and support service plan. I believe that these are real concerns about ‘can and can only’. They’re not just my concerns; they’re concerns of a number of voluntary organisations the length and breadth of Wales. The Wales Alliance for Citizen Directed Support, Age Cymru, the Alzheimer’s Society, and those campaigning for those living with learning disabilities who want to live independently of their families are just some of the organisations that have expressed these concerns, as well as leading academics in the field such as Cardiff University’s Luke Clements. Let us be absolutely clear that, in an age of cash-strapped social services departments so eloquently described by Lynne Neagle, I believe that they will only be too tempted, only too pleased, to be absolved of an eligible client. Indeed, already, as we speak today, some councils—and Lynne Neagle again referred to it—are currently re-assessing and reducing packages of care, in line, they say, with the direction of travel of national legislation.
With regard to carers, we know that carers consistently overestimate what they can do for their relatives and loved ones. These aren’t people who are grasping at services. They overestimate what they can do. Despite the reassurances of the Minister, whose intentions I absolutely accept—and I certainly accept the intentions of the former Deputy Minister—they will not be in that room when that assessment is carried out. What confidence can we have that that desire by carers to do everything and more for the ones they love will not be misinterpreted by local authority social services workers who want to be able to not go through a formal assessment?
Of course, they will then be signposted on to preventative services, and there are many excellent such services across Wales. But let’s be honest: we’re asking them to do more at a time when they themselves have never been so vulnerable. Only yesterday I was hearing about the difficulties maintaining meals on wheels services in Crickhowell and the fact that Powys County Council is going to close all of their day centre facilities.
The Minister says these processes will be done in conjunction with an individual, but as we’ve heard, that individual will have no right of appeal. They will be able to ask for a reassessment, but let’s face it, that reassessment will only be carried out if they can demonstrate a material change in their circumstances. The Government acknowledges in their own documentation that there is a massive risk to this process in terms of training and development of staff, and once again we’re being asked to kick the issue down the lane by saying that all these problems will be resolved by the code of practice. Well, when I was raising these concerns during the passing of the primary legislation, I was told they were all going to be resolved by these regulations, and now they will be resolved by a code of practice later down the line. Maybe they will, maybe they won’t, but that’s not a risk I’m willing to take on behalf of my constituents.
Most of the points I intended to make have already been made, and the Minister has covered some of those points in his opening remarks, but just to reiterate the concerns that have been expressed to me by constituents, one of the major ones is that they thought the regulations would make it more difficult to access direct payments, and I think the Minister has addressed this. I also received concerns about the ‘can and can only’ test, and I understand that the assessment will be carried out by a trained professional, and that the Minister has said in his opening remarks that the responsibility lies with the assessor in dialogue with the person who has a need.
Concern has been expressed to me by one particular carer who said, ‘At what point would the carer be part of the dialogue as well?’—when would they be involved in the actual debate?
The final point that I wanted to reiterate was this concern about, if the individual or the carer does not agree with the decision, what means there actually are there to challenge the decision, and whether a right of appeal may be the simplest way to go about that. Thank you.
The eligibility criteria in these regulations contain, as we’ve heard, the so-called ‘can and can only’ test. The sector’s reading of this is still that a person will have had to prove that they’ve tried all that is available, and prove that this has failed to meet their needs, before a person meets the eligibility criteria. So, someone, for example, on the autistic spectrum, with so-called low-level needs, such as help with washing, could be excluded, even though they have needs.
The Social Care and Wellbeing Alliance Wales support the establishment of all-Wales eligibility criteria and hope that this will help ensure parity of provision regardless of where people live. They also note that the ‘can and can only’ test
‘will not apply when the need derives from abuse and neglect or the risk of abuse and neglect.’
They are, however, concerned that the ‘can and can only’ test is
‘difficult to understand and has the potential to exclude people who have low-level need such as help getting dressed, getting washed or preparing food’,
defined as moderate needs under the old system. They’re also concerned that the ‘can and can only’ test:
‘suggests that “need” will be based on what services are available not on the person’s needs. The test must meet the person’s needs and well-being outcomes. A community service that is only relevant in part will not meet specific needs in the way a more personalised care and support plan would.’
Age Cymru are concerned that the restrictive nature of the ‘can and can only’ test creates potential for its application to become a barrier to accessing personalised services. The Wales Alliance for Citizen Directed Support are concerned that the requirements for individuals to exhaust possible family and community-based options for support before becoming eligible for statutory services could widen the gaps that people can fall through.
The Motor Neurone Disease Association said that the ‘can and can only’ test could
‘leave people at risk of receiving low quality or inadequate support for a significant period before the local authority is able or willing to step in.’
People with motor neurone disease
‘will often have specialist and complex needs, requiring a particular level of expertise that may not be available in community services. However, they may have to show that they have exhausted the capacity of local, more generalist services, to meet their needs before they can access the appropriate services. This creates a serious risk that people with a rapidly progressive condition could face unnecessary delays in accessing services.’
The Wales Carers Alliance raised concerns that it was unclear whose responsibility it will be to demonstrate that a person’s assessed needs can or cannot be met with the assistance of services in the community. The disability reference group cited an example of a young adult with learning disabilities who may benefit from living independently of their family, but a local authority could use a ‘can and can only’ test to determine that that young person should remain living at home.
The Royal National Institute of Blind People Cymru states that the ‘can and can only’ test suggests that need will be based on which services are available, not on the person’s needs, whereas:
‘A community service that is only relevant in part will not meet specific needs in the way a more personalised care and support plan would.’
This, they say, leaves individuals at risk of receiving low-quality or inadequate support or potentially facing long delays to access support, because they first have to demonstrate they’ve exhausted all possible support available in the community. As they say, the responsibility for demonstrating an individual’s needs and wellbeing outcomes can be met through community services should therefore be placed on the local authority, not the individual.
When making decisions about a person’s needs, it’s therefore vital that the local authority interprets the ‘can and can only’ criteria in a way that meets the best interests of that individual and enables them to achieve their own wellbeing outcomes, putting the needs of the individual at the centre of the assessment and care-planning process, applying the principles of person-centred and citizen-directed support and of co-production, enabling, reabling, building stronger communities and better lives, and delivering maximum value for the public pound.
Y Dirprwy Lywydd / The Deputy Presiding Officer
And the Minister to reply to the debate.
Diolch yn fawr, Ddirprwy Lywydd. Can I begin by thanking those political parties in the Assembly this afternoon that have indicated that they will not seek to derail the social services Act at this point in its implementation? This is, as Gwenda Thomas said, one of the most important pieces in the jigsaw that is the 2014 social services Act that will come in front of this Assembly—an Act that will produce more help for more people, not less help for fewer people, an Act that regards people as equal partners in the business of identifying and organising their care.
Dirprwy Lywydd, I’ll try and address five or six specific points that Members have raised in the debate. Let me begin with the ‘can and can only’ test, a test that, as Gwenda Thomas pointed out to Members, is not in the regulations. It’s one sentence in one document that accompanies the regulations. I’ve done my very best this afternoon to be clear with Members that the burden of responsibility in relation to the ‘can and can only’ test falls on the person carrying out the assessment, not the person for whom that assessment is being carried out. When Mark Isherwood identifies the concerns that have been raised about it, I recognise those concerns, but let’s be clear: people are raising their anxieties about it. They are not saying that this is what will inevitably follow from the ‘can and can only’ test, only what would happen if it was wrongly applied. We will use the code of practice in the way that David Rees suggested to make sure that that will not take place.
We’ve heard concerns about carers here this afternoon, and yet this is an Act that provides new rights for carers and which carries the rights of carers further than any other Act has done—of this Assembly or in any other part of the United Kingdom. New rights for the first time—
Do you agree with me—If I understood Kirsty Williams rightly earlier on, when she said carers would not be in the room—that the Act gives carers a right to be involved in the assessment, to be in the room for the assessment, provided the service user doesn’t object, and that that is the position with regard to carers being involved?
That is exactly the position with the assessment regulations—regulations, may I remind Members, which have already been passed.
Can I clarify, for all concerned, that I didn’t say that the carers wouldn’t be in the room? I’m concerned, Minister, that you and Gwenda Thomas are not going to be in the room to ensure that your interpretation of how this will work in reality will be reflected on the ground. That’s my concern.
I have difficulties with the leader of the Liberal Democrats’ position on this whole matter. In one breath, she tells us that, for her, the test of the success of our social services system will be if we could devise it in a way that would propel as many people as possible, and as fast as possible, into the arms of Powys’s social services department, and then, in another breath, she tells us that the anxiety about the system is that you couldn’t trust those people to interpret the regulations in the way that this Assembly would require them to be interpreted. I don’t share her anxiety on that. There’s been an enormous set of goodwill towards this Act and these regulations in the social services sector. They understand what we are trying to achieve here, and I believe that they are genuinely committed to doing so—in terms of carers and of people who provide and use services, too.
We’ve been asked a lot this afternoon about an appeals process. Dirprwy Lywydd, I think I need to be clear that it is not for me as Minister to try and create through the back door, as it were, through secondary legislation, a proposition that was put in front of this Assembly twice in the primary legislative procedure and rejected twice by this Assembly. This Assembly had in Stages 2 and 3 an amendment that would have created an independent appeals procedure, and on both occasions the Assembly voted against that amendment and in favour of an amendment, which we have now put at the heart of the process, which allows people an automatic right to reassessment—not a reassessment because they have to prove that they need one, but a reassessment when they say that they believe that that is needed. That’s why we will have a monitoring system, which I outlined, which will very specifically record how many reassessments are asked for by users, how many of those lead to a change in a care package, and how many are completed within time.
Let me directly deal with Julie Morgan’s point about direct payments. This Act liberalises direct payments. It provides for direct payments to be used in more circumstances for more people, for more purposes and by employing a wider range of people than ever before. There’s nothing in these regulations that gets in the way of that.
Let me end by just assuring Lindsay Whittle that the national assessment and eligibility tool is designed to do exactly what he asked for—to make sure that we have a common set of procedures and principles so that decisions that are made in one part of Wales are directly comparable to decisions made elsewhere, while always being rooted in the needs of the individual in the particular social circumstances that Gwenda Thomas highlighted in her contribution.
Dirprwy Lywydd, I ask Members very seriously to support these regulations this afternoon.
Y Dirprwy Lywydd / The Deputy Presiding Officer
The proposal is to agree the motion. Does any Member object? [Objection.] I defer voting on this item until voting time.
Voting deferred until voting time.
Sandy Mewies took the Chair at 16:57.
Item 7 is the debate on the general principles of the Regulation and Inspection of Social Care (Wales) Bill. I call on the Minister for Health and Social Services to move the motion—Mark Drakeford.
Motion NDM5814 Mark Drakeford
To propose that the National Assembly for Wales in accordance with Standing Order 26.11:
Agrees to the general principles of the Regulation and Inspection of Social Care (Wales) Bill.
Thank you very much, Chair. I move the motion.
I’m pleased to open this debate on the general principles of the Regulation and Inspection of Social Care (Wales) Bill. I am grateful to David Rees, David Melding and Jocelyn Davies and their committees for the constructive approach they took to the scrutiny of this Bill at Stage 1. I would also like to acknowledge the important contribution of the range of people and bodies who have assisted with the committees’ consideration through their oral and written evidence.
I believe that the scrutiny process has demonstrated support for the Bill, which creates an effective regulatory and inspection system, a system that concentrates on improvement and outcomes for people. There is an opportunity today to improve it and to strengthen it further. The Bill will endorse the Social Services and Well-being (Wales) Act 2014. It will update the way we regulate the services provided in the area of social care. In addition, the Bill will develop our ability to adapt to changes in the sector in the future, and to respond effectively to examples of best practice that emerge.
Chair, while I firmly believe that there are very many examples of excellent practice in the sector, we have been reminded earlier this afternoon by the First Minister’s statement and the publication of Dr Flynn’s report about what happens when there is failure in the delivery of care to elderly and vulnerable people. It’s natural, therefore, that one of the first questions about this Bill will be, ‘How does it respond to the Flynn report?’ and I want to say a few words about that shortly.
Let me begin by saying, however, that this is not a Bill shaped around a presumption of failure. It is a Bill that seeks to tackle poor practice and to tackle it more quickly, but it also seeks to turn the satisfactory into the good and the good into the excellent. It is very much about how we bring about improvement in our social care services, raising the bar as well as responding swiftly, clearly and effectively when things go wrong.
The fundamental test of this Bill is how it protects the vulnerable and how it safeguards those receiving care and support. That is why it must help to provide answers to the questions that the Flynn report has raised. I’ve met Dr Flynn on a number of occasions over the past 18 months. I know she has also worked with officials throughout her review and so her emerging thoughts have regularly and consistently informed the development of this Bill. She wrote to the First Minister and me outlining her views in December last year—a letter that was shared with the Health and Social Care Committee during their scrutiny. She has also commented directly and supportively on the Bill in the executive summary of her report, and that extract reflects that from the very outset, there were three clear lessons that Dr Flynn regarded as essential issues arising from Operation Jasmine—issues that are pertinent to this Bill.
Firstly, her report demonstrates, page after page, that it was virtually impossible to hold those who profited from care to account. In her report she says:
‘Businesses need be made accountable for their trading practices. Directors should be subject to the same rules and accountability framework as other sectors.’
This was a point raised in the First Minister’s statement by Jocelyn Davies and by others. A major priority for this Bill has therefore been to shift accountability within our legislative system, so that those who own and gain from providing services are held properly accountable for them. This Bill achieves that with the requirement to have in place a responsible individual and through the duties that will now be placed on responsible individuals in law. This is new, Chair, and this is powerful, I believe. It will mean the directors of companies can no longer claim that they were unaware of the events going on in their name and can no longer offload their responsibilities onto the shoulders of people who happen to have been employed at the spot and at the time.
Secondly, Dr Flynn was clear that our legislative system must allow action by regulators to go beyond a single setting or service, so that failed providers can be removed from the register in their entirety. Providers will no longer be able to move resources from one home to another, to shore up a failing service in order to escape the regulatory gaze. The Bill provides the flexibility for the regulator to take enforcement action against either individual services or across an organisation as a whole, and I think that answers one of the fundamental points that the Flynn report highlights.
Thirdly, the report emphasises the importance of openness and transparency. The fact that families of victims did not know what was happening or what had happened to their loved ones simply cannot be right. This Bill will place in statute the access by users and families to information about the services and care that they or their loved ones receive. It places a requirement on all providers to produce and publish an annual return, setting out the bad alongside the good. That, together with the power to introduce ratings and the emphasis on outcomes, will mean a system driven not by service providers, but by those in need of care and support themselves.
There are other legislative issues that Dr Flynn has raised and we are keen to reflect on them. I’m confident from my conversations with her that this Bill does tackle some of the weaknesses in the system that her report sets out. Her endorsement of much of what we are doing in this Bill, I think, can give us confidence that lessons are being learned, and that those lessons are being translated into legislative action.
Chair, the National Assembly has taken a very thorough approach to the scrutiny of this Bill during Stage 1, as can be seen in the detailed analysis contained in the committee reports. I will reply formally to those reports, but I’m able to confirm today that we are likely to be able to respond positively to well over 30 of the 46 Health and Social Care Committee recommendations, and we’ll bring forward a number of Stage 2 amendments, including a power for service regulators to interview carers in private during an inspection with their consent, as a result of the committee’s report. I will also bring forward Stage 2 amendments in relation, for example, to public engagement, consultation, and in relation to commissioning—an issue that Aled Roberts raised during the earlier debate—where we will place a duty on the regulator to include commissioning in its annual review of each local authority’s performance. In bringing forward those amendments at Stage 2, Chair, I believe that this is an area where Stage 1 scrutiny by the health committee will have materially assisted in strengthening the Bill.
There are also a number of recommendations by the Constitutional and Legislative Affairs Committee, to which a positive response will be made, including those relating to the use of the superaffirmative procedure. I’m happy to confirm that it will be our intention to follow the procedure set out in section 33 of the 2014 Act for a number of substantive recommendations made by the Constitutional and Legislative Affairs Committee, including those relating to ratings, offences and penalty notices. I have also noted the committee’s views in other areas and am mindful to consider an amendment to apply the affirmative procedure to regulations made under section 135(2), which deal with the disclosure of the undertakings, and an amendment to set out on the face of the Bill some of the standard information to be included in annual returns to be submitted by providers.
Chair, today’s debate marks another important milestone in the journey of the scrutiny of this Bill. I believe that the reports we have seen so far have been of significant assistance in making sure that the Bill can be the best Bill that we can make it, and I look forward to hearing Members’ contributions to that process this afternoon.
I call on the Chair of the Health and Social Care Committee, David Rees.
Thank you, Chair. I’m pleased to be able to contribute to today’s debate on behalf of the Health and Social Care Committee. The committee’s role was to consider and report on the general principles of the Bill. Our report was laid before the Assembly on 3 July. We hope the evidence we gathered and the conclusions we drew have helped Assembly Members when preparing for today’s debate. We’ve given detailed consideration to the evidence received, and we’d like to thank all those who contributed in writing or orally to our Stage 1 scrutiny process. I’d also like to put on record my thanks to the clerking team and the Research Service in terms of their support for the committee.
As a committee, we unanimously support the general principles of the Bill and its aim of improving the quality of care and support available to people in Wales. We welcome its intention to revise and simplify the legal framework for the regulation and inspection of social care services and the social care workforce. Our report makes a total of 46 recommendations and I’m grateful to the Minister for indicating that he’s minded to accept the majority of those recommendations. I would also like to place on record my thanks to the Minister for the constructive and collaborative way that he has approached working with the committee. I look forward to this continuing during the further scrutiny of the Bill, should its principles be agreed by the Assembly today. I appreciate there will not be time during today’s debate for the Minister to speak to all of our recommendations—he’s clearly pointed that out. I hope, however, that he will be in a position to provide a detailed written response to our report by the end of the summer recess.
Many people in Wales, including some of the most vulnerable in our communities, rely on social care services and the people who deliver them. It is therefore vital that these services are provided compassionately, to the highest standard and in ways that respect people’s dignity, wellbeing and preferred outcomes. Sadly, we have all seen and heard examples of people being let down by poor care. The distressing details that the Justice for Jasmine campaign group shared with the committee about the experiences of their relatives make that only too clear. Only this afternoon, as the Minister has pointed out, we have heard from the First Minister that the report from Dr Margaret Flynn into these cases has been published, and it makes sobering reading. This Bill is an opportunity to learn lessons from such experiences and protect others from facing similar experiences in future.
Our recommendation 2 calls on the Minister to set out his responses to Dr Flynn’s recommendations. He’s actually discussed some of those aspects this afternoon. But where her recommendations are relevant to the Bill, we have asked that he sets out either how the recommendations are already reflected in the Bill or where he will bring forward amendments to address those upon his reflection as he’s indicated.
The Bill was described to us by the Minister as a companion to the Social Services and Well-being (Wales) Act 2014. Our recommendations seek to strengthen the regulatory and inspection framework set out by the Bill, make sure that it truly is a companion to the 2014 Act, and ensure that it supports the development of a robust and sustainable social care sector in which the people of Wales can have confidence.
One of our key recommendations, recommendation 38, relates to the regulation of the social care workforce. During our scrutiny, the Minister did inform us that, while the Bill will provide him with regulation-making powers to extend the requirements for who is to register with Social Care Wales, he did not intend to extend registration on the face of the Bill beyond those who are already required to register with the Care Council for Wales. We acknowledge the Minister’s view that regulation is not, in and of itself, a guarantee of care standards. And we appreciate that there is a cost associated with the extension of registration. However, we must also take account of the impact on individuals and the personal cost to them of receiving poor care. We are therefore firmly of the view that domiciliary care workers who provide intimate personal care to vulnerable people in their own homes without supervision should be required to register. We also take the view that adults’ residential care workers should be required to register, to ensure that there is parity of protection for adults in residential care with that for children.
It is very likely that the public actually believes that such workers are regulated, particularly because of the use of the broad and generic term ‘social care worker’ to describe those subject to regulation by Social Care Wales. I hope that the Minister has reconsidered the views that he put forward in his evidence to the committee and that he will therefore bring forward amendments at Stage 2 to extend the registration to domiciliary care workers and adults’ residential care workers.
Another strong theme in the evidence that we heard relates to the regulation of local authority and local health board commissioning of social care services. The regulation and inspection of social care services is, without doubt, vital. However, we believe that improving the standard of local authority and local health board commissioning is also key to the improvement of social care services. And I am pleased that the Minister has been able to accept this recommendation, and that he intends to bring forward amendments to place an explicit duty on CSSIW in relation to local authority commissioning functions. As a committee, we look forward to considering those amendments in due course.
There is much in the Bill that we, as a committee, welcome and which should serve to provide a more accountable, more transparent and more stable social care sector here in Wales. For example, there is the identification of senior responsible individuals who will be personally accountable for the standard of regulated services, particularly at director level, and the new duties for local authorities and the service regulator to oversee and shape the social care market. However, there is more that needs to be done to strengthen the Bill. We must make sure that the regulatory inspection regime in Wales is robust and that it provides a sound basis for a well regulated social care sector in which high-quality services are delivered by a properly trained, qualified and regulated social care workforce. In the event of the Assembly agreeing the general principles, we look forward to scrutinising the Bill further at Stage 2.
I call on the Chair of the Finance Committee, Jocelyn Davies.
Thank you, Chair. I’m very pleased to contribute to this debate as the Chair of the Finance Committee. The committee is responsible for considering the wider financial implications of the Regulation and Inspection of Social Care (Wales) Bill as it makes its way through the legislative process.
We held an evidence session on 13 May that focused on the methodology used to calculate the costs and the benefits in the regulatory impact assessment and the accuracy of the costs that were presented. I’d like to thank the Minister for attending that session to give evidence and for writing to the committee beforehand to give us prior notice of changes made to the costs in the impact assessment.
The committee was pleased to hear that the Minister is in continual discussions with the Care and Social Services Inspectorate Wales and the Care Council for Wales, and has committed to keeping the impact assessment under review. It was reassuring to hear that the Minister will update the financial implications of the Bill to take account of issues identified by stakeholders as the scrutiny process continues.
The committee considered evidence from the Auditor General for Wales, which he gave to the Health and Social Care Committee, regarding the appropriateness of the five-year time period over which costs in the Bill were analysed. In response to this concern, the Minister told us that five years was a reasonable time frame and the committee agreed with the Minister, and believed that this time period gives reasonable certainty. To extend the analysis beyond five years could make the costs too unreliable to rely on.
Members raised concerns that transitional costs for Care and Social Services Inspectorate Wales may rise. They had particular concerns about costs relating to the move to a service model of registration, the provision of training and information across the whole sector and changes to IT. The Minister confirmed that if these transitional costs do rise, he has a budget line available from the social services and wellbeing Act to cover them. As a committee, we feel that this is reasonable due to the connection between these two pieces of legislation.
One of the areas of concern for committee were the two provisions within the Bill that give Welsh Ministers the power to make subordinate legislation on the protection of title and prohibition Orders. These provisions have not been costed. During our evidence session, the Minister told us that while the Bill provides an opportunity to include subordinate legislation provisions, he didn’t currently intend to use them, although they could be used in the future.
Whilst we appreciate that legislation needs to be futureproofed, Members firmly believe that all costs in relation to legislation should be accounted for, whether the intention is to use them or not, and we would urge the Minister, and indeed the Welsh Government, to ensure that all provisions included in Bills are properly costed.
In conclusion, the committee believes the overall cost to be reasonable and we hope our considerations will be helpful to the Assembly in its continuing scrutiny of this Bill.
I call on the Chair of the Constitutional and Legislative Affairs Committee—David Melding.
Thank you, Chair. We reported on this Bill on 3 July and the Minister briefed me on the recommendations he was minded to accept last week. I welcome this open and collaborative approach, and indeed I thank him also for his courtesy. It has allowed us to focus on this debate in what is a wide-ranging and important Bill.
It is pleasing to see that 10 of the committee’s 14 recommendations have been, in some form, accepted. In particular, I welcome the clarification provided, including the Minister’s letter to the committee today, on recommendation 1 regarding the analysis undertaken to ensure the Bill is compatible with the European convention on human rights. I thought that letter was very helpful indeed and largely reassuring. Obviously, it can be further scrutinised in the legislative process, but I do thank him for that.
It’s also pleasing to see that all four recommendations advocating the use of a superaffirmative procedure to make regulations have been accepted.
I would now like to say a few words on some of the recommendations that have not been accepted. Can I turn to recommendation 5? This relates to section 19(6) of the Bill, which provides the Welsh Ministers with the power to specify circumstances in which they may designate a responsible individual, despite the individual not satisfying the requirements under sections 19(2) and 19(4). I can understand the logic for this, as I’m sure the subject committee could, but we recommended that some of these circumstances should be identified on the face of the Bill, with the power to add further circumstances being retained through regulations subject to the negative procedure. I’ve noted the Minister’s comments on this and, again, it’s a matter that can be further explored during Stage 2 proceedings, but it would help, I think, if some of these circumstances were on the face of the Bill. Otherwise, it does seem, to some extent, to go against the actual focus of the Bill, though for reasons that occasionally could be demanded by particular circumstances.
Recommendation 11 concerns section 110 of the Bill. Subsection (5) enables the Welsh Ministers to amend the bodies listed in subsection (4) of the Bill that maintain a relevant register. The Minister has acknowledged that these regulations amend primary legislation, but the Minister believes that the powers are so very narrowly conceived that any changes to subsection (4) would simply be of a factual nature. I have no doubt that that is his intention, however, the powers are drafted very widely and could permit changes that are more radical in nature.
As our report emphasises—and I do so now again—it is important to consider how powers could be used by a different Minister in the future, not just how they are intended to be used at the time a Bill is introduced. It remains an important point of principle that any regulations that amend primary legislation, however minor they are perceived to be by Ministers, must be subject, at the very least, to the affirmative procedure. Indeed, this is a principle that the Welsh Government has adopted in some of its Bills. To amend an Act that has been through a four-stage scrutiny procedure in the Assembly by means of a statutory instrument subject to the negative procedure is, in our view, not acceptable. I therefore urge the Minister to reconsider his decision on recommendation 11, and to apply the affirmative procedure to regulations made in accordance with section 110(5) of the Bill. Thank you, Chair.
I’m very pleased to contribute to this debate, above all because it’s so good to see a Welsh Labour health Minister grasping the nettle of regulation and inspection of social care in Wales. Countless examples spring to mind that show why this legislation is needed: the landmark report into residential care, published by the older people’s commissioner; the allegations facing domiciliary care providers avoiding paying their staff the minimum wage; the truly shocking abuse and neglect at care homes across south Wales, investigated under Operation Jasmine and laid bare in Margaret Flynn’s report, published today—a report that I really welcome; or the national crisis sparked by the sudden collapse of Southern Cross and other private sector providers that we’ve seen cut and run from their responsibilities since then.
Let’s face it, the root-and-branch reshaping of our whole approach to this sector is long overdue, and I applaud the health Minister for taking on this arduous but absolutely vital task. Clearly, though, by its very nature, this Bill is wide ranging. Indeed, that’s reflected in the fact that the health committee’s report makes 46 recommendations. It’s impossible to cover everything within five minutes, so I just want to pick out a few areas. Perhaps foremost for me is this question around recommendation 38 of the committee’s report, which calls for the registration of domiciliary and residential care workers to be included on the face of the Bill.
I’ve listened to the Minister’s arguments carefully in terms of the financial implications that mandatory registration is not, in itself, a panacea when it comes to driving up standards, and that the door would remain open for doing this in the future, using the powers set out in section 78 of the Bill, but I really feel that the time is now right to put these professionals who, after all, do such an important job, providing care for some of our most vulnerable citizens, on the same footing as the nurses, the children’s residential care workers and the social workers for whom mandatory registration has for so long been a given. Not only would registration linked to a common code of practice and mandatory training help boost skill levels and professionalise the sector, but I believe it would do a power of good for the general esteem and morale of the workforce themselves who, let’s face it, have been under the spotlight over many years and deserve this opportunity for professional development and parity with their peers in other key areas of social care delivery. As the committee report says, while this may have financial implications, that must be balanced against the huge potential benefits in terms of protecting vulnerable adults from harm or neglect, and a huge boost in terms of public confidence that only a registered and regulated workforce can provide.
Although I obviously haven’t had a chance to fully digest Margaret Flynn’s report, it is very apparent that there is a direct synergy between her key recommendations around staffing in residential care and these calls for mandatory registration. I hope that the Minister will give that due consideration as this Bill continues on its legislative journey.
It’s my memory of the shocking situation exposed more than a decade ago at the Beeches care home in Blaenavon, operated by Dr Das, that underlines for me just how important the fitness-to-own test could be in improving standards in residential care. The tribunal report that was published at that time was one of the most upsetting documents I’ve ever had to read in my time as an Assembly Member. I really welcome the fact that the Minister is seeking to finally tackle this issue head on, particularly as he’s made it clear that he intends to go much further than simply looking at an individual’s financial viability.
I do, though, also agree with the committee’s view that consideration must be given to how these provisions would work in relation to UK-wide or multinational organisations operating in the sector, as I’ve seen first-hand in relation to St Dunstan’s care home in my constituency, and the extent to which these companies can very badly let down the people they’re meant to care for.
Finally, while I’ve already said that I’m very supportive of what the Minister is seeking to achieve through this legislation, I would urge him to consider looking again at the use of lay assessors on the face of the Bill, so that they are central to the new regulation and inspection regime we’re seeking to establish here in Wales. I respect what the Minister has said in terms of not wanting to tie the hands of the regulator when it comes to their approach to public involvement, but on balance I agree with our committee’s conclusion, backed by the older people’s commissioner, that there is a wealth of evidence that suggests extending the use of lay inspectors could be hugely beneficial, and that they should be integral to the new approach to regulation and inspection that this legislation seeks to establish. Thank you.
The Welsh Conservatives support the general principles of the Regulation and Inspection of Social Care (Wales) Bill and will therefore be supporting the motion before us today. We do have some concerns, however, and will seek to strengthen the Bill during its progress through the Health and Social Care Committee.
For the vast majority of people the care and support they receive from social services is excellent, but we have seen examples of truly shocking poor care that has let down some of the most vulnerable in our society. We welcome the Welsh Government’s commitment to learn the lessons of Mid Staffs, Winterbourne and Southern Cross, as well as the lessons from Operation Jasmine, which looked at abuse and neglect at care homes in south Wales. I would like to thank Margaret Flynn for her report today and look forward to working with the Minister in implementing her recommendations. This Bill must ensure that such appalling levels of abuse and neglect can never happen again.
The intentions behind the bill are to transform the social services sector to ensure users and carers have greater control over the services they receive. This is an aim we all support and Welsh Conservatives will seek to strengthen the voice of service users and their carers throughout the passage of this Bill. One of our biggest concerns, and that of the majority of stakeholders, is the lack of a section on commissioning within the Bill. Age Alliance Wales and others have pointed to the trend for local authorities and local health boards to commission services in place of providing them themselves. There is a clear need for a new regulation and inspection regime to take account of commissioning. Many witnesses to the committee stated that there are too many examples of commissioning on the basis of cost rather than the quality of the care provided.
If we are to achieve the intentions of this Bill, we must ensure that commissioning is not influenced by the need to cut costs. We therefore hope that the Minister accepts the Health and Social Care Committee’s recommendation that CSSIW has a duty to review commissioning against quality-of-life outcomes. Welsh Conservatives would also like to see greater emphasis on joint commissioning between local authorities and local health boards. We welcome the committee’s recommendation that the Minister amend the Bill to place a duty on local authorities and local health boards to work collaboratively with each other in the preparation of market stability reports. We need to encourage closer working between the NHS and social services.
We also welcome the recommendation that market stability reports should include consideration of the role of the third sector and social enterprises in service provision. Welsh Conservatives would like to see a greater role for the third sector, co-operatives and social enterprises in the delivery of care. The public sector cannot be the only provider of public services.
Another area of concern is the lack of redress contained within the Bill. As I mentioned earlier when responding to the care and support eligibility regulations, the Care Act 2014 in England gives service users and carers a right of appeal. Welsh Conservatives support the concerns of stakeholders that there needs to be a robust method of redress within the Bill. There must be processes in place to allow individuals to challenge decisions over their assessment, their care or the support they receive. There also needs to be a right for carers to challenge the support they receive. We do not accept that the process should be via the local authority complaints procedure. There needs to be a truly independent avenue open for people and their carers to challenge decisions made about them and their care.
In summary, there is much about this Bill that we support. Welsh Conservatives will work with you in order to strengthen the legislation to ensure we have a robust regulation and inspection regime that puts high-quality care and the rights of the individual above all else.Thank you.
Can I say, first of all this afternoon, I very much welcome the way in which the Minister introduced this Bill and the debate this afternoon? I very much welcome the way in which he referred to the Flynn report and the way in which that had influenced and guided his thinking in introducing the Bill in front of us. Clearly, he has the advantage of having been able to spend more time studying that report than others here, so I think all of us will wish to take some time to read through that report and think through some of the implications of what has been written in it before we reach our own conclusions.
But we have seen, and I think it’s extraordinarily disturbing to have seen, both the history of Operation Jasmine, the Flynn report, and, also, the older person’s commissioner’s report, ‘A Place to Call Home?’, published last year. Taken together, they do build a very compelling picture of failures of care in many places and all too often. If this Bill is to succeed, then it must address both of those reports and it must address the failures in the current regulatory regime that have allowed such things to happen.
I hope that this will do so. I hope that the Minister will approach this scrutiny process in the positive way he has done so up until now, because if there is a common thread that I’ve seen running through both Flynn and ‘A Place to Call Home?’, it is a lack of common humanity in dealing with people’s fundamental human needs. That is not an easy thing to write into legislation, and I think one of the most fundamental and important parts of the committee’s report was that which focused on a rights-based approach for care and the nature of care, and, also, the definition of what care is.
Too often, we define care in terms of a task-based orientation, whereby people are ‘toileted’—that’s an appalling thing to say—or people are ‘provided for’—are fed. But what we do not do, and what we have failed to do, is to determine and define care in terms of a human being with human needs. We need to find a way of doing that, and then we need to ensure that regulation delivers that—doesn’t deliver it most of the time in most places, but delivers it all of the time everywhere—and that we have the structures in place to recognise where that is not delivered and then to be able to do something about it. We must not allow it to continue for weeks and for months and for years, turning a blind eye to significant failures, pretending it isn’t happening and pretending it’s on somebody else’s watch, but fundamentally not addressing those failures.
So, we do need, fundamentally, the rights-based approach to ensure that people do have the right to excellence of care. We need care defined in a way that meets their needs as humans, and not simply the needs of those providing the care. Then, we need a culture of regulation that actually ensures that those things happen.
Sitting through and taking part in the scrutiny process, I found myself and I felt myself coming to the conclusion that one of the most fundamental failures that we have in Wales is not simply the structures and framework of regulation, but the culture of regulation. I found myself thinking that regulation was too easy and too cosy, that we wanted to co-operate and to collaborate so much that we weren’t prepared to say ‘stop’ and we weren’t prepared to make the hard calls. That is a culture of regulation that needs to change and must change.
So, yes, we need structures, new regulations and new frameworks, but we need a culture that recognises failure and is prepared to do something about it. That culture is something, I hope, that this Bill will help deliver.
Finally, let me say this. The Welsh Government clearly needs to both understand and manage the market of care provision in a more proactive and intelligent way. I welcome initiatives such as the appointment and identification of a responsible person, although I recognise some of the weaknesses that have been outlined this afternoon. I also understand the demands of market analysis and market stability reports. Again, none of these analyses and none of these reports really matters unless the Government and regulators are prepared to act on the consequences of the information and analysis that the system delivers. It is the action that must be hardwired into this new system of regulation that I believe will be the true test of whether it succeeds or fails.
Diolch. Speaking in last November’s Welsh Conservative debate on older people and residential care, I detailed some shocking examples of failings in the care system in north Wales. A daughter, whose father was left without pain control and crying out in pain, asked how did the Care and Social Services Inspectorate Wales, CSSIW, not see these things during their inspections, which she said were not patient focused? She told me that when they’d raised concerns with the protection of vulnerable adults team, POVA, and CSSIW, it took over two months for CSSIW to inspect—two months of residents possibly suffering further pain and neglect. She added that CSSIW are supposed to publish their reports online for the public to view, but 2012-13 reports were not put up until she rang and wrote to the inspectors, and the February 2014 report was only put online after CSSIW were contacted by ITV Wales. As she said, ‘What did they have to hide?’
Findings by the CSSIW’s reports on this care home included failure by the registered person to make any suitable arrangements or measures to prevent people at the service being harmed or suffering abuse, or being placed at risk of harm or abuse, or to ensure that people working in the home were fit to do so. My constituent’s advocate added that dreadful things that were witnessed have still not been heard in the way they should’ve been, and actions that should’ve been taken immediately were not. The culture continues regardless of statements to the contrary.
Adult protection strategy meeting minutes for another resident recorded that she had hurt her arm and an ambulance had taken her to the hospital. However, the subsequent minutes recorded that she had passed away and that, when admitted to hospital, she actually had a urine infection, a chest infection and blood sugar levels off the scale. The constituent’s daughter there asked why, despite annual CSSIW inspections and social services and health reviews, it had taken a family member to raise their concerns before anything was done.
The independent sector, voluntary and private, provides the great majority of care in Wales. Care Forum Wales have said that:
‘Radical reform of the planning and delivery of services is long overdue and we need to create a culture where the independent sector works in true partnership with public sector bodies.’
It added that:
‘If we have that shift, we can achieve a great deal but if we don't I'm afraid we're going to fall short and this would be deeply disappointing for those requiring services.’
It’s therefore concerning that the explanatory memorandum to the Regulation and Inspection of Social Care (Wales) Bill details a continued hierarchical system, in denial of the mutual benefits that real co-production can bring. Because private and voluntary providers play a crucial role in social care, co-designing and co-delivering with them is about seeing everyone as equal partners in local services, not enabling the market to determine priorities. Co-producing public services with users and communities goes beyond models of service-user consultation to better delivery of health, social services and other services to an ageing population, to people facing illness and disability, to the economically inactive, and to those living in social isolation. As Co-production Wales says, the key issue is the genuinely transformative nature of co-production—not just a nice add-on but a new way of operating for Welsh Government as well as for public services, professionals and citizens themselves, sharing responsibility together.
In welcoming the Minister’s announcement of new law to strengthen the regulation of inspection of social care, the chair of Care Forum Wales warned it won’t work unless there is a fundamental change of culture to ensure everybody involved is working together in collaboration. He added that people in Wales are not working in partnership in the way that the Joseph Rowntree Foundation has shown in other parts of the UK makes a real difference in terms of efficiency of resources and quality of service delivery through relationship-centred care. As he concluded, if we don’t fundamentally change the way we do business, if we don’t fundamentally change the way we work collaboratively, and if we don’t fundamentally value providers and their workforce and just hit them when it goes wrong, then, quite frankly, this will not make the progress and provide the framework that the Minister wants it to.
In general, I’m fully supporting the ambitions and principles of the Bill in helping to avoid vulnerable people being let down by the very services that should be protecting and supporting them. The committee’s come up with 46 recommendations, as we’ve heard. This seems to suggest we’re not happy with the Bill, but, in my opinion, that’s not the case. The committee supports the principles of the Bill and what it’s setting out to achieve: a stronger regulation and inspection of social care services, with an emphasis on a high-quality workforce to deliver high-quality care.
On the issue of a high-quality workforce, the Bill does make specific reference to proper training and professional development for social workers and social care workers. Perhaps the Bill could also include, under regulations, a duty on employers to ensure that trained staff are employed on secure contracts and not, for example, offered posts on the basis of zero-hour contracts.
I want to draw the Senedd’s attention to one or two of what I consider to be the key recommendations from the committee. The first is a requirement for service providers to have appropriate whistleblowing policies and procedures in place. It’s absolutely essential that social care workers, for example, are given not just permission but encouragement to bring to the attention of a provider—whether it be a local authority, the private or third sector—what they in all honesty consider to be unprofessional and harmful practices. If this had been the case, then who knows? Some of the scandals in care homes that have been brought to light in this very Chamber today maybe could have been avoided.
The second recommendation I want to highlight is a requirement for advocacy services to register with the Care and Social Services Inspectorate Wales. The importance of advocacy services was an issue that we in Plaid Cymru strongly argued for to be included in the Social Services and Well-being (Wales) Bill, and I’m pleased to say it was indeed included.
The other recommendation that I want to strongly support refers to preventative services. I would argue that these should definitely be required to register with the key inspectorate body, the CSSI Wales. We know the Minister strongly supports the need to prevent people entering hospital or having to receive major treatment when they could be supported and cared for in the community. So, I suggest that the recommendation should not just ask the Minister to consider this step as an option, but that he should make it a requirement. I would add that reablement services should also need to register.
I’m particularly pleased that the Minister has stated that lay assessors will play a key role in assessing and inspecting services. Other submissions the committee have received relate to the impression that the Bill focuses on physical needs at the expense of the need for emotional care and support. The question of whether there will be adequate finances to implement the more stringent regulations and inspections, and perhaps even more important, the right of individuals to appeal against the decisions made by a local authority, is something that we in Plaid Cymru campaigned to be included in the Social Services and Well-being Act (Wales) 2014.
There are, of course, a number of important issues that will need to be resolved, possibly through some amendments, Minister, such as what form the rating system will take, the charging of fees to be registered, the sanctions to be applied for breaches of regulation and, above all, for health and social care organisations to work much more closely together—in our view, through perhaps a truly integrated health and social care organisation.
So, finally, we can offer general support for the principles of the Bill, which aims to be implemented by April 2016, when shortly afterwards—and I use the word ‘we’—may we be back to monitor its progress. Thank you.
Could I begin by thanking the Minister for his opening statement, but also thanking the Chair of the Health and Social Care Committee for his leadership in scrutinising the Bill to date?
As has been said by previous speakers, we will be supporting the principle of the Bill, i.e. to improve the system of regulation and inspection we have in social care, to raise standards, and make it fit for purpose. But I believe that there are a number of recommendations that have been brought forward by the committee that we would be looking to see included in the Bill at a later stage. The first of which is recommendation 4, and that is
‘that the Minister for Health and Social Services brings forward amendments to require all those who exercise functions under the Bill to have due regard to the United Nations Convention on the Rights of the Child, the United Nations Convention on the Rights of Disabled People, and the United Nations Principles for Older Persons.’
As mentioned earlier by Alun Davies in his contribution, I think it’s absolutely important we have from the outset this overarching principle of a rights-based approach, and rights-based care. And I think that that message would be greatly enhanced if the Minister was to bring forward amendments in that regard.
If I could then turn to recommendation 9, and that relates, once again, to the comments that have been made by previous speakers with regard to lay inspectors. Now, like Lynne Neagle, I hear what the Minister says about not wanting to tie the hands of the regulator with regard to the use of lay inspectors, but the Minister is happy to tie the hands of the regulator in lots of other regards in this legislation. The issue is, if we see value in lay inspectors—and I personally see huge amounts of value in lay inspectors—then we should say so quite clearly that it is our expectation as legislators that that is included in the regime. As I said, we’re willing to dictate in other aspects—why are we not willing to dictate with regard to the inclusion of lay inspectors? We either think they’re a good thing or we don’t, and if we do we should legislate to make it happen.
If I could then turn to the issue of recommendation 38, and that is the requirement for the registration with Social Care Wales to include domiciliary care workers and adult residential care workers, I too believe that this is absolutely essential if we’re to drive up quality, and if we are to change the dialogue around how we value these workers and this service in our community. The domiciliary care workers I meet want to do more, they’re anxious to get better training—they see huge value in what they already do, but they also see the opportunities to do even more for the people whose homes they work in. They need a system around them that will support them to do that and actually will help create the step change in the industry about what we value and to look to employers to up rates of pay, up rates of training and to really potentially expand the work that these individuals can do.
But the most important thing for me is the issue of recommendation 28 and the issue around commissioning, which has exercised me greatly. We are prepared to inspect the outcomes of commissioning but not the process of commissioning itself, and I was heartened to hear what the Minister said, that he’s willing to look at this again. If local authorities get commissioning wrong, services will be wrong. We cannot expect services to be fantastic if the basic premise on which they’ve been commissioned has been fundamentally flawed. Therefore, we should require inspection of commissioning processes within local authorities. But recommendation 28 also refers to the health service, and the health service representatives that gave evidence to the committee recognised themselves that this is an aspect of their work that they are not questioned on, they’re not quizzed on, and yet they are responsible for commissioning a huge number of beds within the residential care settings for people in Wales, and yet this is one aspect of their work that nobody ever asks them about.
The Flynn report today makes some very clear recommendations about both health services and local authorities working together on commissioning to create a step change in the quality of services that are available. Whilst I note that the Minister said he was willing to look at that with regard to local authorities, I’m concerned about health services also. My other concern is that there is nothing currently to stop a local authority commissioner today handing out a multimillion pound contract and then working for that company by the end of the week. I have seen it happen with disastrous effect, and I believe we should use this opportunity to legislate to ensure that doesn’t happen. The Minister couldn’t do it, the Ministers in London couldn’t do it. There is a cooling off period that is required because of those conflicts of interest, and, if it’s good enough for those sectors, I believe it’s good enough for this sector too.
I call on the Minister for Health and Social Services to reply to the debate.
Thank you, Chair, and thanks to everyone who has taken part in what I think has been a very interesting and fruitful debate.
It’s entirely a matter of chance rather than design, but, in this final week of the Assembly before the summer break, we have ended up talking both about the Flynn report and Stage 1 of the regulation and inspection Bill, but I think having them on the same day has thrown this Bill into very sharp relief and demonstrated its importance in a way that, maybe, we otherwise would not have done.
I thought Alun Davies got to the heart of a lot of what the Bill is about when he asked, ‘How is it possible to regulate to create humanity?’ And the answer is, of course, that you can’t. Regulation, by itself, cannot do that and regulation is a series of balancing acts between a focus on those task-based things, which are very important to people—how many years ago in this Assembly did people debate the need to make sure that a door was wide enough to allow a wheelchair user to get through? Without some attention to those things, you can’t get a culture of care. But how do you balance that with a focus on outcomes for people and what matters for people for their own welfare? How do you balance a need for proper collaboration between players in the field for improvement without that collaboration turning into collusion? How do you make sure that you’ve got the analysis you need without having paralysis of analysis that stops you from taking action on the basis of it? I think the Bill attempts to balance those and a series of other things in order to create the culture that Alun talked about.
He said something as well about making sure that we have people regulated where we need them to be regulated, but, as he and others here will know, in Winterbourne View, which was Margaret Flynn’s first major report, there were people there who were regulated, and all the staff in Tawel Fan were regulated. Regulating the profession, by itself, does not guarantee the outcomes that we are looking for, but I’ve heard what people have said, of course, this afternoon.
He mentioned as well, as have others, the business of lay assessors, and I do intend to bring forward an amendment at Stage 2 on the business of public involvement in the assessment process, which I think is just slightly different to what, sometimes, people mean by ‘lay assessors’. I am not attracted to the idea of creating a cadre of professional lay people. I am in favour of making sure that the inspection process always has, involved at the heart of it, members of the public who see with fresh eyes things that other people have stopped seeing because they are there every day, and day in, day out. So, greater public involvement in the assessment process, quite certainly, I want to do more on that.
Can I very briefly turn to the three chairs of committees who’ve spoken in the debate and thank them, once again, for the work that they have done in helping to improve the Bill already? I can give David Rees an assurance that all those recommendations that the health committee have made asking for further information and written responses, we will accept all of those recommendations. We will set out a detailed written response to all the recommendations and we will certainly set out how we see the Bill responding to the recommendations of the Flynn review.
I was grateful for what Jocelyn Davies said about the Finance Committee’s view that a five-year horizon is a sensible horizon against which to try and set out costs and benefits. Other people here may not be as close to the detail of the Bill as her committee became. Protection of title and prohibition orders are included in the Bill because the Law Commission very firmly recommended to us that we ought to take this opportunity to include them; we have no policy intention to use those powers, but we do include, within the Bill, a commitment that, if we ever did, it would have to be through regulations made under the affirmative procedure when a regulatory impact assessment would be part of what we would provide.
Can I thank David Melding for what he said on the information that’s been provided on the first recommendation of the Constitutional and Legislative Affairs Committee report? I know the recommendation asks that I should set that out in the debate this afternoon, but I felt the pressure of time meant it was better to set it out in a letter, which I provided to the committee. And, of course, as David Melding said, there will be further exploration of any outstanding recommendations as the Bill proceeds. Lindsay Whittle and others set out, I thought very usefully for the debate, a long list of other things that this Bill includes and that are important. Professional development is the responsibility of Social Care Wales, as we will create it—a responsibility that extends to all social care workers, registered or not. And there will be more to say, as the Bill proceeds, on zero hours, on whistleblowing, and on advocacy and reablement.
Let me just return, to close, to the point that Kirsty Williams raised at the very end, which Altaf Hussain raised earlier. I have followed very carefully the evidence that the health committee has taken on commissioning. As I said in my opening speech, I think it’s one of the places where its Stage 1 scrutiny will make a real difference to the Bill. I’m persuaded by lots of the things that the committee has heard about the need to strengthen the Bill in that regard. If it receives the go-ahead by the Assembly today, I look forward to being able to bring forward amendments at Stage 2 to strengthen the Bill in the way that the committee has suggested.
Thank you, Minister. The proposal is to agree the motion. Does any Member object? The motion is therefore agreed in accordance with Standing Order 12.36.
Motion agreed in accordance with Standing Order 12.36.
The Deputy Presiding Officer took the Chair at 17:56.
Y Dirprwy Lywydd / The Deputy Presiding Officer
We now move to item 8, which is a debate on the financial resolution of the Regulation and Inspection of Social Care (Wales) Bill. I call the Minister for Health and Social Services to move the motion—Mark Drakeford.
To propose that the National Assembly for Wales, for the purposes of any provisions resulting from the Regulation and Inspection of Social Care (Wales) Bill, agrees to any increase in expenditure of a kind referred to in Standing Order 26.69, arising in consequence of the Bill.
Y Dirprwy Lywydd / The Deputy Presiding Officer
I have no speakers. The proposal then is to agree the motion. Does any Member object? The motion is therefore agreed in accordance with Standing Order 12.36.
Motion agreed in accordance with Standing Order 12.36.
Y Dirprwy Lywydd / The Deputy Presiding Officer
The next item is voting time.
Y Dirprwy Lywydd / The Deputy Presiding Officer
Before I conduct the first vote, are there three Members who wish the bell to be rung? There are not. So, we are voting on the debate on the first supplementary budget. I call for a vote on the motion tabled in the name of Jane Hutt. Open the vote. Close the vote. There voted in favour 34. There were no votes against. There were 16 abstentions. Therefore, the motion is agreed.
Motion agreed: For 34, Against 0, Abstain 16.
Result of the vote on motion NDM5798
Y Dirprwy Lywydd / The Deputy Presiding Officer
We now vote on the Care and Support (Eligibility) (Wales) Regulations 2015. I call for a vote on the motion tabled in the name of Jane Hutt. Open the vote. Close the vote. There voted in favour 34. There voted against five. There were 11 abstentions. Therefore, the regulations are approved.
Motion agreed: For 34, Against 5, Abstain 11.
Result of the vote on motion NDM5813
Y Dirprwy Lywydd / The Deputy Presiding Officer
That concludes today’s business. Thank you.
The meeting ended at 17:58.