Y Pwyllgor Cyllid
Finance Committee
18/01/2024Aelodau'r Pwyllgor a oedd yn bresennol
Committee Members in Attendance
Huw Irranca-Davies | yn dirprwyo ar ran Rhianon Passmore ar gyfer eitem 6 |
substitute for Rhianon Passmore for item 6 | |
Mike Hedges | |
Peredur Owen Griffiths | Cadeirydd y Pwyllgor |
Committee Chair | |
Peter Fox | |
Y rhai eraill a oedd yn bresennol
Others in Attendance
Andrew Jeffreys | Cyfarwyddwr, Trysorlys Cymru, Llywodraeth Cymru |
Director, Welsh Treasury, Welsh Government | |
Anthony Hunt | Arweinydd, Cyngor Bwrdeistref Sirol Torfaen |
Leader, Torfaen County Borough Council | |
Carys Lord | Prif Swyddog, Cyllid, Perfformiad a Newid, Cyngor Bwrdeistref Sirol Pen-y-Bont ar Ogwr |
Chief Officer, Finance, Performance and Change, Bridgend County Borough Council | |
Darren Hughes | Cyfarwyddwr, Conffederasiwn GIG Cymru |
Director, Welsh NHS Confederation | |
Derek Walker | Comisiynydd Cenedlaethau'r Dyfodol Cymru |
Future Generations Commissioner for Wales | |
Emma Watkins | Dirprwy Gyfarwyddwr Cyllid a Busnes Llywodraeth, Llywodraeth Cymru |
Deputy Director, Budget and Government Business, Welsh Government | |
Jacob Ellis | Cyfarwyddwr, Cysylltiadau Allanol a Diwylliant, Swyddfa Comisiynydd Cenedlaethau'r Dyfodol Cymru |
Director, External Relations and Culture, Office of the Future Generations Commissioner for Wales | |
Lance Carver | Is-lywydd, Cymdeithas Cyfarwyddwyr Gwasanaethau Cymdeithasol Cymru a Chyfarwyddwr Gwasanaethau Cymdeithasol Cyngor Bro Morgannwg |
Vice President, Association of Directors of Social Services Cymru and Director of Social Services at Vale of Glamorgan Council | |
Llinos Medi | Arweinydd, Cyngor Sir Ynys Môn |
Leader, Isle of Anglesey County Council | |
Mark Pritchard | Arweinydd, Cyngor Bwrdeistref Sirol Wrecsam |
Leader, Wrexham County Borough Council | |
Mary Ann Brocklesby | Arweinydd, Cyngor Sir Fynwy |
Leader, Monmouthshire County Council | |
Rebecca Evans | Y Gweinidog Cyllid a Llywodraeth Leol |
Minister for Finance and Local Government | |
Rhiannon Hardiman | Arweinydd Polisi, Natur a Newid Hinsawdd, Economi, Polisi Bwyd, Swyddfa Comisiynydd Cenedlaethau’r Dyfodol Cymru |
Policy Lead, Nature & Climate Change, Economy, Food Policy, Office of the Future Generations Commissioner | |
Sally May | Cyfarwyddwr Gweithredol Cyllid Bwrdd Iechyd Prifysgol Cwm Taf Morgannwg a Chadeirydd Grŵp Cymheiriaid Cyfarwyddwyr Cyllid |
Executive Director of Finance Cwm Taf Morgannwg University Health Board and Chair of the Directors of Finance Peer Group |
Swyddogion y Senedd a oedd yn bresennol
Senedd Officials in Attendance
Ben Harris | Cynghorydd Cyfreithiol |
Legal Adviser | |
Cerian Jones | Ail Glerc |
Second Clerk | |
Leanne Hatcher | Ail Glerc |
Second Clerk | |
Mike Lewis | Dirprwy Glerc |
Deputy Clerk | |
Owain Roberts | Clerc |
Clerk |
Cynnwys
Contents
Cofnodir y trafodion yn yr iaith y llefarwyd hwy ynddi yn y pwyllgor. Yn ogystal, cynhwysir trawsgrifiad o’r cyfieithu ar y pryd. Lle mae cyfranwyr wedi darparu cywiriadau i’w tystiolaeth, nodir y rheini yn y trawsgrifiad.
The proceedings are reported in the language in which they were spoken in the committee. In addition, a transcription of the simultaneous interpretation is included. Where contributors have supplied corrections to their evidence, these are noted in the transcript.
Cyfarfu’r pwyllgor yn y Senedd a thrwy gynhadledd fideo.
Dechreuodd y cyfarfod am 09:31.
The committee met in the Senedd and by video-conference.
The meeting began at 09:31.
Bore da, a chroeso i'r Pwyllgor Cyllid ar fore oer yng Nghaerdydd fel hyn, a chroeso i Mike Hedges, sydd lawr yr M4 yn Abertawe y bore yma. Mae hwn yn gyfarfod hybrid, felly mae pob dim yn gweithio fel arfer.
Rydyn ni wedi derbyn ymddiheuriadau gan Rhianon Passmore, sy'n methu bod efo ni y bore yma, ac mae gennym ni Huw Irranca-Davies yn ymuno â ni y prynhawn yma fel eilydd. Felly, fe wnawn ni ei groesawu fo pan fydd hynny yn digwydd.
Dwi jest eisiau gofyn os oes yna unrhyw fuddiannau i'w datgan. Dwi ddim yn gweld neb yn dweud hynny, so mae hynny yn iawn. Felly, jest er gwybodaeth, mae hwn yn cael ei ddarlledu yn fyw ar Senedd.tv a bydd yna Gofnod y Trafodion yn cael ei gyhoeddi yn ôl yr arfer, jest i'r tystion wybod eich bod chi'n gallu tsiecio'r Cofnod o ran cywirdeb ar ôl y sesiwn.
Good morning, and welcome to the Finance Committee on a cold morning in Cardiff, and I'd like to say 'welcome' to Mike Hedges, who's down the M4 in Swansea this morning. This is a hybrid meeting, so everything is working as usual.
We've received apologies from Rhianon Passmore, who can't join us this morning, and we have Huw Irranca-Davies joining us this afternoon as a substitute. So, we'll welcome him when that happens.
I just want to ask whether Members have any interests to declare. I don't see that they do, so that's fine. So, just for your information, this meeting is being broadcast live on Senedd.tv and the Record of Proceedings will be published as usual, just for the witnesses to know that you'll be able to check the Record in terms of accuracy after the session.
So, we move on to our second item, which is papers to note. We have three papers to note, so I think we'll note those if Members are agreed, and we'll move into our first substantive item this morning.
Croeso cynnes i chi.
A warm welcome to you.
A warm welcome to our witnesses this morning. I wonder if you'd introduce yourselves and your roles, and the roles of your team.
Bore da, Derek Walker, Future Generations Commissioner for Wales.
Bore da, Jacob Ellis, director for external relations and culture.
Bore da, Rhiannon Hardiman, arweinydd polisi.
Good morning, Rhiannon Hardiman, policy lead.
Gwych, diolch yn fawr. Croeso cynnes iawn i chi. Mae'n dda eich bod chi efo ni.
Great, thank you very much. A very warm welcome to you. It's good to have you with us.
So, we've got you, hopefully, for half an hour or so, and we were very pleased to receive your written evidence—very thorough, very well written, and some very interesting things in there for us to pick apart. So, in this session we'd like to understand a little bit more about where you're coming from, and maybe to put a bit of meat on the bone.
So, we'll start. This is your first Welsh Government budget since you took up your post as commissioner. Your evidence suggests the information provided alongside the draft budget is not sufficient to demonstrate that the Well-being of Future Generations (Wales) Act 2015 is considered comprehensively by Welsh Government in drafting its budgets. What's led you to that conclusion?
Thank you, and thank you for inviting us to give evidence. I wanted to say first of all that we all recognise, I think, the incredibly difficult financial situation and difficult decisions that are facing Welsh Government. This is not an easy budget to be making. And I also want to make clear that the Minister for Finance and Local Government and her officials have been proactive in engaging with me in my first 10 months in the role, in discussions around the budget. My colleagues have been talking to officials too, so there has been good engagement in those first 10 months.
It’s really important—it goes without saying, I think—that the well-being of future generations Act is applied to decision making, and particularly such an important decision as the Welsh Government's budget, because it provides the framework for us to consider decisions over the long term and not just to look at the short-term considerations. And it's a useful tool that should be applied legally across the public sector.
When we were looking at the documents, we could see that the Minister and the officials have said clearly that they have applied the well-being of future generations framework through their decision making, which I was pleased to see. Right up at the foreword you can see that the Minister makes a statement about how important the framework of the future generations Act is in her decisions around the budget. But what I was unable to see is the difference that taking account of the well-being of future generations Act made to the decisions themselves. So, the workings and the implications of the Act to the decisions that were taken, it was unclear to see from the documentation that we considered—and we looked at all the documentation available—what the implications were from considering the Act to the decisions that were eventually taken.
So, perhaps if I go into a little bit more detail, first of all, to say why this is important. It's important because if we don't consider the Act in the long term, we are storing up problems for the future. It's important for openness and transparency that we see how decisions are being taken and that assessments about impacts are considered when budget decisions are taken. But Welsh Government also has a leadership role here for the rest of the public sector in their budget decision-making processes, and being able to show how Welsh Government is doing it would be very helpful, I think, for the public bodies to do the same.
Okay. So, what do you see your role as within the budget-setting process? You've had meetings with Ministers, you've had meetings with Government. What do you see your role as, and where do you see yourself coming in to that sort of process, if you like?
Yes, well I want to take a very active role. So, as you know I'm relatively new in post. The approach that we've taken this time is not to look at individual budget lines in the evidence, you know, 'I want to see more on that preventative health budget there and more on that climate change budget there,' which I could have done, but that's difficult to do without understanding the impact of those different budget lines. And there are many others who obviously come in and argue and lobby for particular budget lines.
The approach that I've taken this time is to look at how the five ways of working have been applied to the decision making. So, this is the thing that I look at and the auditor general looks at when we're looking at public bodies: have the five ways of working been applied to the decision-making processes here, and what is the evidence of that taking place and what difference has that made?
So, as I say, we've had good conversations at a high level along these lines. I met with the Minister within my first month, I think; I met with the other commissioners and the Minister in September. We've met with officials. Officials contacted me even before I started the job to give me a briefing on how the budget process was being made, so I've had really good and proactive engagement from the Minister. I think they're committed to this agenda and the future generations Act, and are considering the long term when they're taking these decisions, but what we're not seeing is that—
So, you're not seeing those joined-up dots?
We're not seeing the evidence of how that is done. So, we can see that the Minister is saying that's happening, but can we see the evidence, can we see the workings to demonstrate that?
If I could just—?
Sorry, yes. Jacob.
These are important points and the committee will be aware that this isn't the first time that as a commissioner, or as an office, we've been making these comments. We've been scrutinising the Welsh Government's draft budget for several years now and some of these comments and narratives from the commissioner have been made repeatedly over those years. So, we're not seeing that progress happen or that response to the findings that we have as an office around the importance of meaningfully applying the five ways of working, the definition of prevention that you've heard us talk about often in this committee and the use of the budget improvement plan as an important document to articulate how the Government have considered the Act. It does feel a little bit like groundhog day, in the sense that we are repeating some of these findings back to Government, despite having made them in previous years.
Thank you for that. I fear that this is going to continue until there's a way forward and I'm thinking back to local government days, when we saw the need to put in equality impact assessments. Should there be a future generations impact assessment appended to decision making, like you would have with a financial impact assessment or an equality impact assessment? If it's that important to the Government that they've put it in the foreword and it's so important how we take things forward, should there be a lens that every decision is made thorough, formalised through an assessment?
Absolutely. I don't want to come back here next year and say the same things to you. We need to move from this cycle of asking for this information to get to the stage where the information is provided. I understand how difficult this is and the level of detail to provide on every decision around the budget might be very difficult to do, but we need to make progress in demonstrating how decisions comply with the Act.
What I'm suggesting to you today and in my written evidence is that we use the opportunity of the review of the strategic integrated impact assessment document, which the Government is already committed to, which is the key place where I would expect to see this information—and there is some information in there, by the way, but it's very short—that we use this opportunity to work with the Minister and her officials to review the document, to give clear advice on what we would expect to see in that document in future years, and to dedicate resources from my team to work with her officials to get that right, so that we're not in that situation next year.
The other specific recommendation that I'm making, and I would be keen for the committee to consider as well, is the budget improvement plan document, which is a longer term document looking at what Government will do to continually improve its budget decision making. We would like to work with them to review that too. So, for example, in that document, they do look at two of the five ways of working, which is great, but where are the other three? It doesn't make sense to me why those other three are missing. So, it's not easy, this stuff, but we need to model good practice at the Welsh Government level in order to do that for the rest of the public sector, and I think these are specific ways in which we can move on from this cycle of saying the same things and getting to a place where we can see how the impact assessment, against the well-being of future generations Act, is influencing those decisions.
That's an interesting point, and I think this committee is particularly interested in anything that will help budget documentation and help to bolster up some of those impact forms. So, if you've got anything further that you wanted to let us know about in writing, or—. Obviously, we're on a tight turnaround with regard to this report, but we'd be interested in anything that you've got that we'd be able to point out to the Minister, to be able to help you in that work.
Diolch yn fawr.
Anybody who listens to this committee regularly will know that 'show your working' is one of Mike Hedges's catchphrases, and I'm going to bring him in now around transparency. I'm sure he'll have something further to ask around that.
Diolch, Cadeirydd. Firstly, your evidence suggests that there is increased transparency in the budget narrative and the strategic impact assessment this year, but you also say that they lack analysis of the long-term impact and detailed evidence of how the involvement of public bodies and other people affected by the budget has helped with assessing its potential impact. What needs to change?
I think I perhaps covered that prematurely in that what I think needs to change is the SIIA document, the strategic integrated impact assessment document, because I think that is the place you would expect to see the workings, and that is the place that you would expect to see a more detailed understanding of the differences being made by the well-being of future generations Act. My reading of that document is it's largely a list of explanation of the decisions that have been taken, rather than an analysis or an explanation of the analysis that was undertaken to decide whether one budget was sacrificed or cut at the expense of another one that was increased or kept. So, that's where I think we need to see the detailed analysis, and, as I say, there are opportunities to look at the budget improvement plan too.
Thank you. The Welsh Government says that, through this budget, it has needed to act in the short term to protect the core services on which people rely to ensure they're sustainable into the future. With no indication of funding for future years, it's very difficult to plan for the future. Do you think the budget gives adequate consideration to the medium and long term?
This goes back to my general point, I think, that it's difficult to say, because we don't have the workings. It's not true to say that because we only have three-year budgets or one-year budget agreements with the UK Government, or the same for public bodies, you can't take a long-term approach to decision making. So, you can understand what the long-term vision is, you can understand what the long-term impacts are going to be of the budget decisions that you're taking, and you can monitor that progress. We're unable to see in the documentation that we have gone through that an assessment of the impact in the longer term has been taken.
Thank you for that. You suggest there is evidence throughout the budget of preventative spending being reduced. There's also political support for spending money now on things rather than trying to prevent them—dealing with people who've got health issues rather than engaging in preventative actions, for example. Do you think we should be embedding prevention into the budget process, so that we do spend money on prevention? Health far too often seems to mean hospitals, and the preventative work that can be done—improving lifestyles, stopping smoking, getting people to exercise more—seems to have lost its importance.
That certainly seems to be the case. It's difficult to make a full assessment, because we're unable to see what counts as preventative spend according to the definition around prevention, which we and colleagues previous to me have worked on with the Welsh Government. I know the Welsh Government are piloting an approach to look at how preventative spend is considered within the budget, but they're just at the piloting stage of that, so we know it's not a comprehensive approach that they're applying at the moment.
It is massively important, of course, isn't it, that we do get the preventative spend right, because otherwise we're not dealing with root causes and we are not doing the right thing for future generations. So, we're storing up even bigger problems for the future. The health service is the best example of explaining that, isn't it? If we're not getting ahead of some of these preventable diseases such as obesity, type 2 diabetes and so forth, then we're going to be expending increasing percentages of our health budget on these diseases in future at the expense of other healthcare needs. So, we have to get at the root causes, and we have to look at the prevention. We have to understand how cuts to budgets today may impact on the long term.
I think you've had evidence from the Institute for Fiscal Studies that said the budget hinted at preventative spend having suffered during this budget, and I would certainly agree with that. If you look at some of the budget lines that have been drawn to my attention—as Mike Hedges was saying, around smoking cessation, weight management and so forth—these are the areas where, if we're not investing in that now, they're going to cause greater demands on the health service in the future. That is, in some ways, a perfect example of where we need to see the workings—so, what assessment was made of these budget lines, what the cuts are going to do to numbers of cases and impact on the health service in future, and what is the judgment or the balance that's being made now of the benefit now to investing in our health service now compared to the potential burden on the health service, but also on the health of our future generations, more importantly. I think that those are really critical considerations. They're of course difficult considerations and they're political considerations, but that is the lens in which the well-being of future generations Act asks us to consider the budget, and what we need to see done on a comprehensive basis in future.
Thank you for that. I can think of two areas of preventative spend: one that is continued, which is Designed to Smile, which has reduced children's dental needs, but also Communities First, which has ended, which was helping in communities to try and get people to get a healthier lifestyle. I think it's so much easier to cut preventative, because you don't see it in this year, you see it in future years. Are you going to make a comment at some stage about the importance of preventative spend?
Absolutely. I think I just did, but absolutely. The preventative spend is essential for future generations, and it's essential for this agenda. We worked very closely with the Government to put together a definition of what we mean by 'prevention', and we want to see that applied and implemented into budget decisions. It's one of the five ways of working, it's absolutely at the heart of the well-being of future generations Act, and if we don't address it, as I keep saying, we'll be sewing up problems for the future. And we know we're not good in some areas in Wales, don't we? We know in terms of diabetes levels we've got some of the highest rates in the UK. So, we're not doing a good job of preventing some of these preventable diseases at the moment.
Sorry, I didn't express myself particularly well in the last question. What I meant was not in this committee here—although probably millions of people are listening to it—but going outside in public and saying we need to do more on preventative spend to reduce the demand in the health service.
Yes, absolutely. Sorry, I misunderstood; I thought it was in terms of the committee today. But absolutely, that's what I do do, and will continue to do so, because it's what I believe in, but it's also at the heart of the legislation, and I'm here to promote and advise on the delivery of the legislation. The preventative way of working is one of the five. We advise on it all the time, and we promote that it's adhered to and considered.
Thank you.
Diolch, Mike. You said that the preface to the budget talks in warm words about future generations and you talked there in your answers to Mike about 'hinted at this' and that sort of thing. You've used the maturity matrix to assess the Welsh Government's budget against the five ways of working. What does the Government actually need to do to make progress and better demonstrate? Because I think it's that demonstration. You've talked about the strategic impact assessment document; is there anything else that they need to do, or is it just going to always be warm words, and we won't see the impact on future generations until we get to future generations?
Well, I hope not. One of the things that I really wanted to flag to you today is the maturity matrix, because this is the first time we've applied it to a Welsh Government budget and we're now rolling it out to the public sector. Effectively, the maturity matrix—I always think we need to find a new name for it—is a self-assessment tool for public bodies so that they can assess where they are in terms of progress in delivering on the five ways of working in the well-being of future generations Act. It's a much more objective process that they can apply to themselves in understanding where they are and how they could do better. It looks at things like processes, people and culture and leadership. I can give you some examples in a second. We've got four levels within there, and at each level, we explain in there what we expect to see from a public body, or what they should be doing to get at level 1, which is 'simple change', right up to 'leading the way', which is the top level. That provides guidance to the types of behaviours, the types of activities, the types of things that they should be doing to go from the lowest level to the top level. So, it's a really useful document, and it says some specifics in there; I've drawn some of these out for you.
If you look at prevention, for example, because we were just talking about that, if you look at 'simple change', that might be demonstrating awareness of the root causes, but mainly addressing the symptoms in a budget decision. But if you go further along, looking at 'owning ambition', which is the third level, we would expect to see increased funding, as we were hearing, allocated to prevention, or, even further, top-slicing of budgets for prevention, so that it doesn't get lost to day-to-day and is safeguarded for the long term. So, huge credit to my colleague Jac and other colleagues who worked on it. It was really hard to produce the document, but I think it now provides us with a much more objective framework to give feedback to the Government about where we think they are, and public bodies more generally, and where we want them to get to.
It will be very interesting for the Welsh Government to do its own assessment. We’ve done the assessment based on the information provided to us. And as you can see, in, I think three of the areas—it's in the documentation—we’ve said we’re at the lowest level, and in two of the areas, we’re slightly higher. It might have been two and three—the other way around. But, yes, it’s a fairly low level on the basis of the information provided to us. The Government is saying that they are doing this, so that information may be available. Jac, I don’t know if you want to add to that.
I'm conscious of time—
I'm conscious of time and I want to bring Peter in, but it is fascinating and extremely good work on this. I think it does give an extra tool to be able to help benchmark and to help understand what's happening in Government, but also in other bodies. But I'll bring Peter in.
I can't help but reflect a tad on that, because I can absolutely see that there's a need for the Government to self-assess, and that means asking each department and each Minister to apply the maturity matrix to their own workings to see where the anomalies are. Because the trouble is, when they're setting budgets at the moment, if one department is applying a different set of principles or thinking around future generations, or they're not making decisions with that in mind, they don't know the implications for another department—say, education—of making a decision on, I don't know, economic development or something. There needs to be some overarching strategy that every department then can align to. It's a little bit like my thinking for the food Bill—that's exactly what I saw: a misalignment of policy that aspires to do the same thing, conflicting with each other.
Anyway, I'll move on to my more general questions. Given the financial pressures outlined by the Welsh Government, I wondered what you see as the key issues facing public services going forward into this next financial year.
I'm probably not going to give you any information here in any way different from what you've heard. What we know of and what we hear and what we read about is cuts to budgets, cuts to services, the potential for job losses. I know that some public bodies are looking at more commercial income streams. They're the kind of changes that are familiar to you—those are the implications that are being undertaken.
We did some work to speak to public bodies in advance of this, and wider, to get a sense of where they are with this. I guess what is, on an optimistic note, pleasing to hear in some cases is the view that they will use this to consider and transform services and think differently about how they deliver services—rather than trying to carry on doing the same things or looking at cuts, looking at new ways of delivering services in the current financial context. Powys county was one of the examples that gave that. I know that your previous council, in Monmouth, has taken that approach, and others too—the Vale of Glamorgan have talked about that as well. So, these are massively challenging times, but this is the time to really think differently and think about transformative services, rather than cuts in the more traditional way.
I accept that it's difficult to have to have a general perspective. I didn't know if there was one area that was really jumping out at you, that was really concerning you. Perhaps it is the preventative agenda from the health perspective and things like that. But I won't push you on that.
Generally, I guess we've taken the approach of not looking at particular budgets, projects and services. This time, we've looked at whether the decision-making process has applied the Act and the five ways of working. But, you know, what the budget seems to appear to be doing, and it seems to be the common narrative, is cuts to the culture and arts sector that seem to be significant, and that is one of the four dimensions of well-being. Again, and this brings me back to the workings, we would expect Government to tell us how the budget decisions they're taking impact on the four dimensions of well-being. My suspicion is that there's a significant impact on the arts and culture sector. I was just in a meeting with leaders of some of the arm's-length public bodies in that area yesterday and I know they're going through a really challenging time. So, that would be one of the areas, as I said, I think, earlier, around preventative spend. The budget certainly hints strongly at the fact that long-term preventative budgets have suffered at the expense of short-term decisions.
Yes, I accept that. Thank you for that. My only other question is—. Your evidence includes some suggested areas to follow up with the Minister for Finance and Local Government. In your view, what are the key questions that need to be asked of the Minister during the budget round? I think you've alluded to some of those for us, but if you want another opportunity—.
Yes, I'd love that opportunity, because I think the key question to ask the Minister is what difference to your budget decisions—. What is the difference being made by the well-being of future generations Act? So, if the well-being of future generations Act wasn't there, what is the difference now, because we've got the Act, that you can see in the budget as a result of this legislation?' I think that's the critical question and we've struggled to identify through the documentation and the analysis that—
We can ask her this afternoon.
Please do ask. And the other question is, I think, around the strategic integrated impact assessment. I think that is the opportunity for us not to be in the same place next year, when I'm saying the same things as my predecessor has in previous years, and we can get to the point where we've moved on and we are able to see far more of the Welsh Government's workings and their decision making so we can see how they are taking the well-being of future generations Act into account.
And you've got specific asks that you'd be able to work with the Government on on improving that documentation.
We've got specific asks and I will commit resources to working—. Because I think this is so important, we'll commit resources to working with the Welsh Government to support them to get this right. You know, this review doesn't take place very often, so let's take the opportunity of the review to get this right and to make a difference for the long term.
Could I, Chair—?
Yes. Jacob.
Just finally, I think one thread of questioning that I think would be useful—. Peter Fox was just referring to the need for Ministers to work together to understand the impact of one element of the budget on another element of the budget in another portfolio. If we can expand that to the one Welsh public service, as well—. There is little to no evidence that we've seen that Welsh Government have been able to articulate how the budget would impact on the public bodies' ability to deliver on their well-being objectives and steps. It's really important in the five ways of working that integration isn't solely about one Minister to another, but, actually, from one public body to another. So, we now have a scenario where public bodies have now got to reassess how they're going to deliver their well-being objectives and steps in light of the draft budget, and, in some cases, that's going to dramatically have an impact. We can't see the evidence that Government have considered beyond the walls of Government into the well-being objectives and steps, which is, we would argue, a requirement under the ways of working.
That's a really key point. Thanks for reminding me.
Diolch. Diolch yn fawr iawn. We've come to time, so—
—diolch yn fawr iawn i chi am ddod y bore yma. Hynod o ddifyr, a gobeithio y gwnawn ni eich gweld chi eto, un ai yn ystod y flwyddyn neu'r adeg yma'r flwyddyn nesaf.
Felly, fe wnawn ni jest mynd i mewn i breifat am ryw ychydig o funudau ac fe ddown ni nôl efo'r gwesteion nesaf. Diolch.
—thank you very much for coming this morning. It was incredibly interesting, and we hope to see you again soon, either during the year or at this time next year.
We'll just go into private for a few minutes before we come to the next witnesses. Thank you.
Gohiriwyd y cyfarfod rhwng 10:04 a 10:12.
The meeting adjourned between 10:04 and 10:12.
Croeso nôl i'r sesiwn yma. Rydym ni yma'n edrych ar y gyllideb ddrafft, yn edrych o ongl iechyd a gofal.
Welcome back to this session. We're now looking at the draft budget from a health and social care perspective.
It's good to have you all with us here. I'm going to start on my left. If you could all introduce yourselves and where you're from, and then we'll start the session. If we start with Sally.
Hi. I'm Sally May. I'm director of finance at Cwm Taf Morgannwg University Health Board, and I'm here representing the director-of-finance community, effectively, for the NHS.
Wonderful. Diolch.
Bore da. Good morning. I'm Darren Hughes. I'm the director of the Welsh NHS Confederation.
Nice to see you.
Bore da. Good morning. I'm Carys Lord. I'm the section 151 officer at Bridgend, and I'm here this morning on behalf of the Society of Welsh Treasurers for local government.
Fantastic. Thank you.
Hello. I'm Lance Carver. I'm the director of social services in the Vale of Glamorgan, and I am vice-president of ADSS Cymru, which is why I'm here today.
Ffantastig. Croeso cynnes.
Fantastic. A warm welcome to you.
Welcome to this session and thank you for the evidence that we've had already from your bodies. We've got quite a lot of ground to cover, and we might not come to all of you for every question—we'll come in. If you've got something relevant that you want to add to something, if you could keep that brief on top of an answer, then we'll just try and get through the session as best we can.
So, if we start looking at your overall views. We'll probably come down the line again like we've just done. The Welsh Government says its priorities include protecting core front-line public services as far as possible, and its spending plans focus on the delivery of services that matter most to people and communities. What are your views on this, and are you clear from the budget documentation how the Welsh Government has reflected its priorities in its allocations? I was listening to the health Minister in committee yesterday talking a lot about financial stability, so you might want to comment a little bit around your understanding of what you've been asked to do within this. So, if we start with Sally. Diolch.
Okay, yes. I think we've recognised that the last financial year has been extremely difficult. We have appreciated the really difficult choices that were made to support the NHS in-year—so, the change in the October allocations—and that that has been supported again moving into the next financial year. So, the emphasis within the allocation letter that we've had—it was on 21 December, I think, or just before Christmas—has been on stability and protecting the front line, and that will roll into our planning for next year that we're already engaged in. So, if I look at my expenditure profile across my services, where we've seen excess inflation and cost pressures during the year, which have now been supported by the additional allocations, those have been primarily in our front-line services. So, that's been what we call our 'care groups'—which is how we organise our services—rather than in any other area. There are some pressures around things like primary care prescribing, which, obviously, sit outside the normal inflationary uplifts. So, we are focused on how we support our front-line services to continue to deliver services in difficult circumstances. The pressures on services remain high, and you can see that in the pattern of how the delivery works. We still have significant numbers of patients who are what we would call 'medically optimised' at any one time, and lots of front-door pressures. But our focus is on maintaining those services and maintaining the delivery to our people. So, I think the budget has allowed us to see a way through to that. It means that we can aim for a balanced budget, rather than, as we went into last year, with a very significant deficit. And I think that means that we can re-institute or re-engage with our front-line teams about financial discipline and about cost-saving opportunities, because it's clearer where they start from and then what we need them to deliver over time.
Diolch. Darren.
I'd acknowledge what Sally's saying—it's been an extremely challenging time for all bits of the public sector in the current economic situation, and appreciating, in conversations we've had with officials, and with Ministers, that some extremely difficult choices have had to be made to protect local government funding and to protect NHS funding. I'd just like to acknowledge that to start with.
At the same time as we're facing these financial challenges, we're also seeing an increase in pressure and demand at the front-door, and acuity of demand as well. When people are coming into the NHS, the problems they've got are generally more serious. And just as an example to illustrate that, if you look at the calls going to Welsh ambulance, the more serious types of calls—the red calls—have increased significantly. It's an incredibly challenging time, and I think it is fair to say that the Government have focused on protecting those front-line services, and, colleagues who know much more than I do about social care—. There are huge challenges there as well.
Okay. Carys.
I think what I would say is we welcome the fact that the 3.1 per cent provisional settlement that was made this time last year was kept in regard to local government, because we appreciate the significant financial pressures that we're all under in the public sector. So, we appreciate that that's coming down to local government. I think the issue about protecting front-line services and one of the concerns, I think, for social care is that they are part of that local government family, and, whilst we welcome the 3.1 average settlement, it's not meeting the cost pressures that local authorities are finding at the moment. So, with significant in-year pressures last year and again this year, I think authorities have tried very hard to protect front-line services over the last few years, but I think now it's more difficult to do that, and, in fact, I think it's becoming impossible, because those services which, maybe, are not front-line, or are not social care or education related, have taken the brunt in previous years, and it's more and more difficult now for local authorities to be able to protect those front-line services in the way that they would want to because we don't have the funding available.
Anything to add, Lance?
I concur with Carys. I think the real challenges we have in social care are around increasing demand, which is continuing and has been sustained significantly since the pandemic. We also have a real issue in terms of spiralling costs, and you'll be aware from—. No doubt you'll have heard from care home providers, and so on, that they've got rising costs of electricity, food, et cetera. All of those are far in excess of 3 per cent, and we only have 3 per cent in terms of what we have allocated to us. So, actually, we're not protected.
So, from your side of the table, if you like, then, obviously, that side has had quite a lot of money given to it in October, it's extra money going into the NHS. What's the knock-on effect on social services? Because you're not necessarily having the same sort of funding going into that side of things. Is it creating more of a gap? Is it creating more of a problem for you?
I don't think there's a direct knock-on effect of the NHS having had money and the local authority not. I think there is a gap, you're right, and I think if local authorities and their social services departments don't get sufficient funding, then that gap will materialise, I suppose, in terms of service delivery. So, we essentially commission probably about 75 per cent of the budget. So, 75 per cent of the budget, roughly—I'm sure it would be similar in other local authorities—is actually spent on care, and if we haven't got enough money to do that, then that means that care won't be provided and, potentially, people will end up waiting in hospital.
Peter, did you want to just come in on that?
We all welcome the additional money into health, but hearing what you're saying and what I perceive myself, do you think there is an opportunity lost to address the whole picture of health, including social care, where perhaps not so much money went to health, and a portion, even if it was hypothecated—and I know local government doesn't like hypothecation—but it was hypothecated to social care to address the three big elements of the health problem? At the moment we've addressed one bit, but it sounds like we're not going to be able to address the other bit in a way that matches that.
Either you, Carys, or Lance.
I suppose we've probably both got a take on that, really, which is I think you've touched on a good point there, that any money that has come in is not hypothecated, and it goes back to the issues that I raised around the current pressures alone in social care in the current financial year are about £109 million, and the 3 per cent increase doesn't meet that, obviously. Therefore, local authorities are having very difficult decisions to make about how that money is used, and a lot of services are now facing significant cuts and, unfortunately for social care, I suspect all authorities would seek to protect them, but the level of that protection is probably not at the level that maybe it could be.
I'll bring Darren in, and then I'll bring Mike in. Yes, Mike, I can see you.
Thanks very much. We obviously speak regularly to colleagues in ADSS and in local government, and the challenges that they're facing, particularly in staff retainment at the pay rates that local authorities are able to pay at the current time, are hugely challenging. But what we're ending up with is—. Patient flow is something that we've talked about to many committees, the number of patients arriving at the front door of a hospital, and then the challenges in discharging. From a financial point of view, we're looking after people in the most expensive bit of the system, and in recent conversations that we've had, is it a case of moving money from the NHS to support social care? I think at the moment, and it's a controversial thing for me to say, we do need to be considering some of those things. If you look at the cost per day of looking after a patient in hospital when there's no need for them to be there, the cost of looking after them in social care is significantly lower. So, the cost to the taxpayer is more. But as important as that is the negative impact on those people in laying in a hospital bed deconditioning, more likely to come back into the NHS. And the unseen bit of it is the hugely important role that social care plays in keeping people well and keeping people safe, and keeping people well and keeping people safe is hugely important. Then, if that doesn't work, they come into the NHS. I think the two things are inextricably linked, and the challenges in social care have a knock-on effect on health, and the challenges in health have a knock-on effect in social care.
Mike, did you want to come in on this point?
Yes. We’ve talked about social care, and we've talked about hospitals. We've missed out what I think is the most important part—primary care. If we can get primary care right, then fewer people will be going to accident and emergency departments and fewer people will be ending up in hospital. This is a question for Sally May: are you going to protect the proportion of your budget that goes into primary care, because, year on year, across the Welsh NHS, more and more money has gone into secondary care and less and less has gone into primary care?
So, I suppose there are a couple of parts to that. So, primary care—effectively, we treat the contractor budgets as ring-fenced, and so they are protected, in that sense. If you look at the proportion of our spend, it does move over time, so that it's almost, counterintuitively, we spend more on the more acute side of it, and there are a couple of drivers for that. One is, as you say, presentations at the front door. If I'm on call for a weekend, I'll tell you by the time we get to Sunday we have extra patients on every ward and we're using every space. And for that we have to employ more nurses, usually on agency contracts, in order to keep it safe for our patients. So, that drives expenditure up in that area and, as Darren says, that's a little counterintuitive to how you would end up with a perfect system, but it is a driver.
But I think the other thing to remember is we are seeing a widening number of therapies, medicines and other things that become available in secondary care that people have a right to expect that they will have access to, but those have significant cost profiles. So, if you look at what's changed over the last year or so in terms of growth areas, secondary care drugs is a particular area of growth, and that's because there are more therapies available to treat people. People will live for longer with conditions like cancer, which have become more like long-term conditions, and we are now starting to see the development of genomics and personalised medicine responses, which are significantly expensive, but provide a real benefit to individual patients. So, that's what sometimes drives the expenditure in a different direction from the one that, if we were sitting there planning it out, we'd say, 'Yes, put more in primary care', but that's where the significant inflationary pressures are.
Okay, thank you for that. Looking at the specific outcomes that Welsh Government are expecting from the NHS organisations, maybe to Darren: what are the specific outcomes Welsh Government are expecting from all organisations to deliver for the additional investment? So, you've got the extra investment, what have they said are the outcomes? You know, because we've heard, in this committee, quite a few times as well, it's all well and good giving extra money, but what do we see on the back end? Have you got any thoughts around that?
The Government and the Minister have been quite clear in the expectations that they're setting. The additional allocations I think were ultimately to stabilise the service. As we've said, there are lots of things that we couldn't plan for, which were outside the NHS's control, inflation linked and the increase in demand. So, I think the clear message from Government is the additional allocations are dependent and need a commitment from the NHS to deliver on planned care and reduce waiting times. They have been clear that, 'This is what we expect from the allocation.'
And so, based on that funding coming through, the expectation is to see waiting times drop within the next 12 months.
Yes.
Okay. Thanks. [Interruption.] Yes.
Is there any indication of how moneys might roll forward in the same way? Because if you've got, now, new moneys so that you can address some of the issues, you can start putting interventions in place, you need to know you can sustain those. So, what's the outlook? I mean, could we expect another £450,000 next year? Is it in the base, or will it be, 'We've inflated your base, now you've got to make do'? What are the conversations around that?
So, clearly, whilst the additional funds are incredibly welcome, there is still a significant challenge. In the same way as Carys was talking about inflationary pressures within social care, we've got a large spend on continuing healthcare in associated areas, where we're seeing the same inflation levels in excess of the uplift. So, the expectation that's been clear to us as directors of finance is that we need to stabilise the financial position of the NHS, particularly across health boards, and to move that into a sustainable forward-plan look. Now, that takes quite a lot of different elements to look at. We know that services and the pattern of services has been hugely disrupted during COVID. You know, we moved things around, we put in place new responses. Now we need to think about what's the shape of the services for the future. And, certainly, within Cwm Taf Morgannwg, we're working on what our clinical services plan looks like, and that's partly about how do we best deliver the services to meet the needs of the population, but also recognising that one of the resources that's in shortest supply is skilled workforce. And we need to be able to make sure that we can cluster our services in a way that is safe for our patients and delivers effectively without us having to look either externally to agency doctors, nurses et cetera, or to have gaps.
So, it's about planning for the future as we work through, and we also have a huge focus on how do we start to deliver on the prevention agenda, thinking about long-term conditions, and thinking about the health of our population, and engaging with our communities to develop that resilience, to make a more sustainable position as we go through. Because what we know is we've got an ageing population and significant health issues across the piece that need to be supported.
So, how realistic is it to get financial stability within this financial year?
So, I think the position is different for each health board. So, in this financial year—as in, the one ending at the end of March—each of us has been issued with a control total. For Cwm Taf Morgannwg, that's break even, and that's what I'm working towards delivering, and that's what I'm forecasting at this point. There are clearly some issues that are outside of our control that do deliver additional costs. So, the industrial action over the last week has a significant cost impact, but we are looking to manage that. But there's a different position for each health board, but people are working towards delivering on that—
Is it a reasonable ask by the Minister?
So, if I look at my position—and I'll go with a really summarised bit—I came in to the year with a planned £80 million deficit; I've been given, conditionally, recurrent allocations of £72 million, and asked to improve my position by £8 million. That is what we're forecasting to do. We've had to make some really difficult choices in doing that. Some of those are non-recurrent, but we're working on a balance plan for next year. The position might differ by health boards, because some have more historical issues as well, but we are certainly aiming for a balance plan for Cwm Taf Morgannwg at this point.
Thank you. And Darren.
Just on the importance of that longer term certainty, Sally's mentioned the importance of staff development—you can't magic up staff overnight, so it's a consistent and a longer term plan for training and development, and developing the workforce. And colleagues have also asked me to raise the importance of that longer term investment in digital. If we are going to transform the way that we're delivering services in the community in primary care, which Mike has already touched on, we do need that continued investment in digital to be able to deliver services more efficiently, more effectively, and in a more timely way for patients.
Okay. Thank you very much. Looking at social care, the Welsh Government identifies social care and social services within core day-to-day local government-run services. It has reprioritised £11 million from the social care workforce grant, which it says will result in impacts for local authorities and social care partners. What are the consequences of this decision, and what impacts do you envisage for the services provided by your organisations and social care partners?
This money is used to fund social care staff and to ensure that they're sufficiently trained. And so, with less of it, there will be fewer staff, and they will be less well trained. It's almost as simple as that.
So, is it a cycle, then, of fewer staff means more pressure on the staff that are there and so on?
So, if in a local authority area it's £0.5 million less, that means you have £0.5 million less to spend on social services in your area. It's that simple, unfortunately. So, it will have a direct impact.
So, we're looking at extreme pressure, as the Government has said, and we're aware of it, and it needs to carefully consider—that's what it says—whether additional funding can and should be raised by increasing charges for a range of services, such as NHS dental care, domiciliary care. Would you support a decision to do so, given the pressures faced by the public with the increasing cost of living, and what difference is it likely to make?
I think the challenge we have across health and social care is one of rising demand and rising costs. Without sufficient additional budget to meet those demands, there are going to be cuts and changes to services. Sometimes, you can transform services, improve them, make them more efficient, and I think we've got an excellent track record of having done that. But I think, yes, we are going to end up in a position where, if we don't look to raise additional money from elsewhere, then those cuts are going to have to be implemented. I appreciate it's not where any of us would want to be, but I think that would make far more sense than allowing things to go wrong.
But it would have a knock-on effect on the most vulnerable and the poorest in society.
Some of them do and some of them don't. So, something like the domiciliary care cap, actually, if you're the most poor in our society, you don't pay. So, actually, it's arguably the more wealthy who benefit from that cap than the poorest. So, yes, I—.
It's very, very tough to answer, and everybody is in difficult situations at the moment. So, if we can move on to looking at a little bit of the financial pressures and the sustainability of the sectors, possibly to Darren, in January 2023, the Minister for Health and Social Services said she wanted the NHS
'to focus far more clearly on a smaller number of priorities.'
How has that worked in practice and how has it impacted on the health sector’s financial and operational performance in 2023-24?
I think there were lots of conversations and feedback from NHS leaders to the Minister and officials about the extent, the breadth and the hugely challenging number of priority areas. So, I think the conversations we've had with NHS leaders are that the number of priorities hasn't diminished. Essential services are needing to be provided everywhere across Wales. It's still hugely challenging from a staffing point of view. I think the number of priority areas might have reduced, but the number of things contained in each priority area hasn't. So, I think it is key. There are things that the Minister and the Government are asking for focus on, particularly people with long waits. I think in Wales there was a slightly different approach taken during the pandemic, that there was a focus on clinical need for people on waiting lists, rather than on the longest waits. And that doesn't mean there hasn't been a focus on the long waits, but those with the highest clinical need have been looked at first. I think the pressures are still coming from all directions, even if the list of priority areas has changed slightly.
Yes. So, if everything is a priority, nothing's a priority.
Well, I think everything is important, but dealing with the issues, particularly, of those with the highest clinical need is where the area of focus has been for leaders.
Right, okay. Thank you. So, in your consultation response, you say the allocation of an additional £460.2 million for local health boards in 2023-24, which the Government announced in November 2023,
'delayed collective action which could have improved the current financial position.'
Could you explain why this would have been the case?
I think that the challenge was that the extra allocation came mid year. Health boards submit their plans, their integrated medium-term plans—that's the technical name—early in the year, which were not where any of us wanted them to be, particularly in terms of the financial challenges that health boards had set out. There was a period of time then where the plans weren't formally approved, and I know there were hugely difficult conversations going on within Government to look at how the deficits that were set out in plans were going to be met. But the fact that they came perhaps later in the year than Government would have liked, than our members would have liked, did make it difficult to make the necessary changes and plan ahead in a way that perhaps we would have liked. I think I mentioned the last time we talked to the committee that that's a lot of the challenge—. And I appreciate it's a challenge of the UK Government's financial planning cycle, with a budget that then comes to Welsh Government, and then Welsh Government look at what they need to do; some hugely challenging times then come out to the service. It's that's sort of late in the day—. And it is something that I'd suggest the committee might want to look at in the future.
And you've talked a lot about managing down deficits by 10 per cent. How achievable is that, or was that? Obviously, you talked a little bit about it earlier.
Yes. I think it differs, as I say, by health board—different positions. In terms of our position, excepting, as I try and work through, what the costs of the last week have been, my forecast is now break even, which means delivering that £8 million or 10 per cent improvement target in-year. That’s not necessarily all recurrent, and so there is a challenge going into next year in terms of the underlying position that still needs to be addressed as part of our planning, which is what we’re doing now.
How do you compare to your colleagues in other health boards?
So, ours is the only break-even position. Others have got deficit control totals, but that works within the overall allocation of funds at this point. I think the challenge to all of us going into the next financial year is to deliver balance.
So, if anything, you're probably in the most favourable position of your colleagues at the moment, then, in a very difficult—
And that is difficult in some ways in itself. I think what we did was try to take some very early difficult decisions when we were planning at the start of the year. There are significant areas that we could invest more money into to deliver better services, but we had to temper that with were we delivering our cost efficiencies before we invested to make sure that we had a doable plan. So, I think the size of my deficit was around 12 per cent of the total, where you'd have expected it to be around 15 per cent of the total. So, that is the reason why we were in a slightly favourable position. So, we tempered our deficit to a greater extent, I think.
Thank you very much. The £336 million additional funding for 2023-24 allocated to the health board on a recurrent basis is conditional on making progress towards reducing the level of deficit. How will it work in practice? What are the consequences then to the local health boards that don't achieve that?
I think that's probably a question for the NHS executive and others as to how that will that work through. They've been clear it's conditionally recurrent and that 'progress towards' means getting very close to it. I think we're all working to deliver that. We have hugely appreciated the very difficult decisions that were made to reallocate funds and therefore I think, even internally, that's part of our dialogue with our services. These are the difficult decisions that have been made across Welsh Government to support the NHS, and we need to engage in doing our bit to deliver our efficiencies and to start to stabilise the financial position. It's not easy. There are many, many pressures within that, but that is the sort of dialogue that I think we're all having.
Lovely, thank you very much. And finally from me—and then I'll turn to Peter and then on to Mike—for social services, in the ADSS Cymru response to the consultation, you recognise the challenges the NHS are facing this winter, but note that local government social services had not, by the end of November, received any in-year budget support. What's your view of the Welsh Government's reprioritisation of funding for 2023-24, and what have been the consequences for related services, specifically social services?
The challenges in social care are exactly the same as they are in the NHS, so to just fund the NHS and not also fund social services doesn't seem right to me. I think what that looks like in reality is in the vast majority of social services—in fact, probably all of them—budgets are significantly overspent. I'm in an overspent position in my local authority the likes of which I have never, ever seen before, by a factor three times larger than I've ever seen before. So, it's a massive, massive problem, and I can't understand why, given that the situation is the same in social services as it is in the NHS, similar funding wasn't made available.
Thank you. Peter, we've got a quarter of an hour or so.
A quarter of an hour. Right, I'll rush through. Apologies if I ask questions that, actually, probably you've answered in some ways as we've moved through, but, for the record, I'll be going through some of them again. When we look back at last year's budget, you expressed the challenges that you were facing, and I think it was quoted, it was said, then that you were
'dealing with the most pressure it’s ever experienced.'
How would you describe the pressures for the year ahead? Can you quantify that, the scale of that financial challenge, for both health and social care and to what extent will this be met with the allocations in the draft budget? What's the deficit?
The work that we've done in relation to social care and budgets for next year, we're looking at pressures of about £260 million for social care alone. I suppose what we're seeing, and Lance can answer on this better than I probably, is an increased pressure across all of the service groups that social care support. And I think, when you ask how are we going to fund that, that's a really difficult question to answer. All local authorities will fund it differently, but I think the bottom line for all of us is we're not going to be able to fund pressures at that level going forward next year. We have reserves within the local authority but they're not going to be able to fund this level of pressure on an ongoing basis.
No, that's a really good point. I don't know if anybody else wants to add to that, but—.
I suppose the NHS will continue to experience significant pressures. Inflation is running above even the uplift that we've seen and we know we've got fragile services sitting alongside social care in particular: individual care packages, dentistry is particularly fragile. So, we've got significant pressures and health boards will come into the financial year with underlying deficits, but with an aim to try and address those as far as is practical. But there will be a need to shape services going into the future in a more sustainable way, which we're really conscious of.
So, the challenge will be there and will continue for some time as we look at the inflation rates running in the community. We know that pay inflation in those support functions outwith domiciliary care, care homes, is still running well ahead and so part of our challenge for next year is how do we manage that. Unlike local authorities, health boards don't hold reserves, which is one of the reasons why you have a slightly different funding position.
Thank you for that. I know in your submission you talked about the impact of COVID-19. Can you explain how that remains to be a financial pressure, because a lot of us are starting to think, 'Oh, hang on, this is a bit of an excuse now all of the time'? Does anybody want to reflect on that?
Shall I?
Could I just—?
You go first.
I'll come to the question, but I just wanted to reflect back on just the last point if that was okay.
I think the challenges that Lance and Carys have set out in social care, particularly the financial ones, are a concern for us and we work very closely with ADSS—Alwyn and I meet regularly, one of Lance's counterparts—. Lots of the challenges in social care are unseen, whereas we've all seen, unfortunately, the ambulances outside hospitals regularly in the media, waiting lists. And I think it's hugely challenging and I've said many times that the two services, health and social care, are so intrinsically linked, if the challenges in social care are not met then things are going to get worse for citizens, for social care and for health.
Thanks for that. Any points on the COVID?
So, I think what happened during COVID is that we stood up a range of services. So, for example, if you looked at Cardiff and Vale, the Lakeside unit was created to provide additional bed capacity at that point. That is still there and those costs are now intrinsic. We also are still running vaccination campaigns, we've got health protection, we need to respond to and recognise the gaps that were there pre COVID, and we are still seeing pressure on wards. And we still need to manage the infection-control risks in a different way, even now, around a range of diseases, including COVID 19, but also flu and other winter viruses in particular. So, it is still affecting the pressure on services and at various points it creates that response. But I think I'd say we changed the shape of services and we put in capacity during the time of COVID that is now baked in, if you like, to our cost base.
Yes, yes.
Just one really brief point on the infrastructure point, and things like the importance of air quality in hospital buildings, regular air change, those things needed capital investment to put in the kit to keep people safe, which, it became apparent as soon as COVID struck, we needed more than ever. So, the running costs as well as the capital costs of just ensuring that air quality was safe to prevent infection, prevention control, it's a relatively unseen aspect and an unseen cost.
Thanks for that. Moving on to ADSS, probably more so, you identified contributing factors to the challenges faced by the social care sector in Wales, including issues with continuing healthcare, which you say local authorities are having to fund in the majority. Why is this happening and can you quantify the impact? I think I know why it's happening, but the impact.
It's difficult to quantify, and I'm sure there'll be a different view held by health colleagues, but I suppose eligibility or otherwise for continuing healthcare versus eligibility for social services funded care has always been an area, I suppose, of some contention. There's a strong feeling, I think, across social services that, over time, that has moved so that more and more things have been required to be funded by social services, because the health boards won't fund them under continuing healthcare. I think you'll have seen—and I think we might have mentioned it earlier—some of the pressures in the continuing healthcare budget, and I understand that there's an express saving associated with that that the NHS have agreed across Wales, so there's a real risk that that impacts on the social services budget if we're simply transferring the funding stream. If we're actually looking at how we provide the care, which I hope is what we will do, we could potentially look to make sure that the care is being provided in the most economical way.
Thank you for that. The last question—. Oh, sorry.
Sally wanted to just come in on that.
Yes, sorry. So, continuing healthcare and section 117 and associated individual packages of care is an area of significant pressure for the NHS as well. It's grown significantly over recent years. The work that's going on as part of the value and sustainability board is looking at the effectiveness of packages of care and monitoring our providers, but we're really conscious of the need not to just transfer issues to social care, so that is explicitly precluded as part of the work. It's about, 'Are we getting value for money and good packages of care that support people potentially to improve and be rehabilitated?' But not always, because we've got a range of different services within that designation. But, yes, we are not aiming to transfer pressure into social care through that work.
Before we move on, we've got the Welsh Local Government Association coming in in the next session and they've said that there's a real concern that the same level of protection for social services for much longer and it puts good-quality social services at risk. Could you tell us what that means in practice? What does it actually mean to individuals or communities out there in practice?
I'm sorry, I'm not sure what the question actually is.
Basically, they're saying that there's a real concern that it will not be possible for local authorities to give the same level of protection to social services, so, budget protection, basically, to be able to pass on. So, what will the practical impact be?
It's really difficult, isn't it? If we don't have money to meet the additional care needs of more people as they come into the system, because, essentially, that's probably what we're really talking about, then the only way to make the money that we do have go around is to eek it out further, isn't it? So, actually, what you would see is a rising of thresholds across adults' and potentially children's services as well. There's nowhere else to get the money from; there's no income mechanism, it's very prescribed in terms of where we must get involved and where we shouldn't. We're under significant statutory responsibilities, so there's no wriggle room. I suppose the only thing that you can do is how you interpret an assessment and how you then choose to provide the services, so you could meet the need and instead of meeting it through, I don't know, a 28-hour care package—that's four calls a day, seven days a week—maybe we could try and see if we could do it on just two calls. It would be that, and I wouldn't say that that was unlawful, and I think we do a good job of trying to make sure that we are—it's a horrible word—rationing the carers as much as possible. We have to, there's no alternative. But if the money isn't there, those decisions become even starker, even sharper and even harder.
One last point from me, and it's this, focusing now on the health and social care workforce, I just wondered if there'd been any significant improvement in recruitment and retention, so you can start addressing this issue where we've been having to use so much agency staff. Have we seen progress in that way now?
It won't be an uniform picture across Wales, and I think that it probably needs to be subdivided in terms of the description of the problems. So, the issues relating to qualified social workers are very different to the issues, I suppose, relating to agency staff in a care home or commissioned domiciliary care. They're all quite different. A piece of work that ADSS Cymru has done is create a pledge across Wales in terms of children's agency social workers. That's fairly recent, but I suppose the early indications are that that is having some improvement in retaining people in local authority jobs, rather than them moving into agency. It's not going to be the whole answer. It doesn't stop somebody moving to Bristol and becoming an agency social worker on a much higher pay rate. So, it's a continually moving feast.
Yes. Thank you.
Just following on from that, I suppose it's agency workers in social care, but then looking across into primary care and locums, is there a way of not using as many locums, but salaried GPs? Is there anything like that that's going on in your aspect of looking at that side of things?
I think building the resilience of primary care is key, and it may not just be about locums or the recruitment of other GPs, it's about broadening the primary care workforce, using different skill bases. Pharmacists, for example, working within practices can start to meet people's needs in a different way than simply seeing the GP. I know there's a lot of work through our cluster development around that and providing that across.
But it is a challenge in terms of, a little bit like social care, the problem for medics, nursing, qualified health professionals is different to some of the other areas. We know that, particularly for medical colleagues, that's an international career. There are international shortages, and we see people moving around, and we need to work really hard to retain people within our system. We know we've also got an age profile issue that works its way through.
So, we have focused as health boards, there is some national work around variable pay and how we look at agency workers, but, internally, we've also had a focus, and we've started to see some benefits around nursing and, particularly, healthcare support workers, by proper recruitment, by planning that on a very active basis and moving away from using the more expensive agencies and trying to really focus on retention as well. We've got a workforce that has been tired as a result of the pandemic, but by starting to introduce things like flexible working patterns, even where we've got clinical services, we are hoping that we can change some of that dynamic and retain people. There have also been changes to the pension scheme—
So, managing shift patterns and trying to do a little bit more rather than just traditional 12-hour shifts and that's all you can have.
Yes, and working with the individual. When they say, 'I'd like to work flexibly,' we start to work with them to do that, rather than there being a, 'I'm sorry, that's not possible.' So, we have seen some reductions in healthcare support worker spend and in the use of high-cost nursing agencies. The medical workforce, I think, is a whole other issue that we are working through, we are analysing, we are understanding and, clearly, some of the industrial action over the last week or two also adds complication into that.
And when you talk to junior doctors who say, 'Well, we'd get paid an awful lot more if we went to Australia or New Zealand, or even to England,' that's the—. They don't have to go that far away, they can potentially—
Yes, there are opportunities for people to move around, and that'll be very enticing.
I think Sally's touched on it a bit. It's meeting the needs of the population with the staff team that you've got, and it might not be the traditional, 'I need to see a doctor for x, or a nurse for y, or a pharmacist for z.' In many parts of Wales, particularly outside the more urban areas—rural areas in particular—this is more challenging, and there does need to be a lot of that service design. And I think all of us are aware of the sort of age profile of the Welsh population compared to other bits of the UK. You know, on average, it's two years older, which doesn't sound a huge amount, but if you look at the clinical workforce, there are some worrying things coming down the tracks quite quickly there, with the age profile of medics in some of the more challenging specialities—ophthalmology, orthopaedics, ENT—where the age profile of the senior clinicians shows that over 60 to 70 per cent of the workforce are over 55. So, they're not going to be around for much longer.
And it relates back to the much earlier point, really, about the danger of making short-term cuts and decisions. We need to invest much longer term across the whole of the UK, not just in Wales on this. For the first time in medicine, in the last couple years, there are more people coming onto the register who trained outside the UK, so you're competing on a world market then, rather than training and developing. And very much related to the retention point: people very often tend to work where they're from, and even if they go away and train and develop, particularly the clinical professions, they tend to come back. So, I think that longer term investment is needed in recruiting people into the NHS workforce locally. And similarly in social care—I've talked to colleagues in Social Care Wales—people sort of train and grow within those communities, and that's really important that we're getting recruitment from all parts of Wales. Apologies for losing my voice. [Laughter.]
I'll pass on to Mike to finish our questioning this morning. Mike, you've probably got about a quarter of an hour if you need it, so—
I'll prioritise the questions, in my view, anyway. How are the allocations in the draft budget driving digitalisation, and the use of IT transforming the way in which health and social care are delivered to aid sustainability? And what savings and efficiencies are you getting through the use of digitalisation and the use of ICT?
In terms of putting a figure on this, it's an incredibly difficult thing to do, because lots of times, investment in information technology, it's making things simpler, but also making things safer. Using the electronic prescription service as a point there, it's not just an efficiency point of view, making things quicker, making things cheaper, making stock ordering simpler; it's about having that information available to all clinicians involved in a patient's care. It's very difficult to put a figure on, Mike, is the honest answer to that.
There's a tension in Government spend, and I would assume in health board and social services spend, on the ground, between doing things that are described as 'preventative spend' and doing things that you believe have to be done now. Have the Welsh Government got it right in the split between preventative spend and health spend? We know how much money could be saved if we could halve the number of people having type 2 diabetes, for example.
In terms of priorities, something that you'll hear us at the Welsh NHS Confederation say a lot is, 'Unless we do something to address demand, we're doomed to fail.' There are huge amounts of work being done by colleagues in Public Health Wales on the importance of living well. Obesity is the most prevalent example, the health complications that people get if they are obese, and diabetes leads to all sorts of other issues later in life, and it's a big part of a health board's responsibility and Public Health Wales's responsibility. But one of those things that I say regularly is that things like the quality of people's housing has an impact on their health, so disinvestment in housing could have a negative knock-on impact on people's longer term health, resulting in pressure on the NHS, and also the types of jobs that people have got. One of the things we haven't talked about today is the jobs and the salary spend in social care and in health, and the value of that to local economies, because I think the thing that's driving demand up more than anything else at the moment is the state of the economy and the cost-of-living crisis. So, it isn't just a preventative in the health budget, it's about everything that all public sector bodies do.
Can I say I agree with you entirely? If you've ever listened to my speeches, which you probably haven't, I talk about, 'Is it any surprise that people who live in cold, damp houses, who have poor nutrition, tend to have a poorer health outcome than those who don't?'
Yes. I do listen to your speeches, Mike. [Laughter.]
And you agree. [Laughter.] Okay, moving on, what's your understanding of the funding position for 2024-25 for the additional costs of paying the real living wage for care workers? And is paying the real living wage to care workers actually stopping care workers leaving to find other jobs that pay more?
I'm not aware that there is funding from the Welsh Government to pay for the real living wage next year, quite simply—3.1 per cent doesn't translate into funding the real living wage, so, it isn't there.
But does funding the real living wage stop people leaving?
Funding the real living wage and paying care staff properly makes a massive difference. We significantly increased our fee rates for domiciliary care staff, having had massive problems in my local authority. Within months, the position massively improved—they were able to recruit staff. We're not going to be able to increase those rates by very much at all next year and so it's likely that the position will deteriorate and we could end up in the position that we were in before, which was people delayed in hospital because there aren't domiciliary care workers to do that care. It's unfortunate that anybody can go and work in Aldi or wherever—sorry to choose a particular example—and get paid more. They don't run the risk of being arrested if they get their job wrong, they don't have to go through professional requirements to do their job. I'm not saying that Aldi checkout people aren't in highly skilled jobs; I'm sure that they are, but they don't carry the weight and risk that our domiciliary care staff do.
Yes, the point is it's not just about getting out of hospital, is it? It's about not going into hospital. If you have sufficient social care provision, then people are getting their adaptations, they're getting care early on rather than waiting for them to be so ill that they end up in hospital. And as somebody who was quite ill over Christmas, the amount of strength you lose in three or four days of being in a bed, I just think, is phenomenal.
Exactly, I couldn't agree with you more. I'm sorry, I was just using the hospital issue to highlight what will happen if we end up in that position again.
Finally from me, does the Welsh Government—this is to ADSS—allocate sufficient resources in the draft budget to deliver actions set out in the initial implementation plan, which runs to 2025, for the creation of a national care service?
I think it's difficult to say at this stage, because we still don't have detail of what the national care service would do and how it would operate. So, I don't think I can really comment in any detail, I'm sorry.
Okay. Can I, just finally, say on this last point, on social services, the more people who can get early interventions so that they don't end up ill, using both primary care, getting to see a GP early, which can be incredibly difficult in some practices, getting social care provision early, doesn't that reduce the demand in terms of people ending up in A&E and in hospital and having to be discharged at the end of it?
I think you're right—yes, it does. I think what you probably heard this morning in terms of evidence is that this budget position is going to end up doing the reverse of what you've just said, and that's really unfortunate.
Thank you very much.
Darren.
It was just a brief associated point, really. The Welsh Government published a consultation on their health impact assessments over the Christmas period, and it's something that we at the Welsh NHS Confederation have called for for a significant period of time relating to the wider determinants of health—the things that Mike has touched on. I know you heard from the future generations commissioner earlier today, and I think lots of the lines of questioning have been about the consistency of funding and enabling us to plan and develop, recruit and retain the workforce for the future. I think, with that eye to the horizon, however challenging things are today, there are some things that we know need sorting out and that is the fair pay, fair work for colleagues in social care. We've seen from the industrial action that's going on that there are staff in health who are not happy with their pay as well. There are big challenges ahead, I think it's fair to say.
Thank you very much. I'll bring the session to a close, but, just very quickly, the future generations commissioner was talking about how, with a view to the well-being goals being delivered across Cabinet, Ministers need to talk to each other, but then how that would be a model for public bodies to also work to, so that you're not working—. That you have an eye on the impact on—. What happens in social care has an impact in health, and I think it's probably one of the 'easier' things to actually try and align because you get each other's—. You know, you understand the link. It might be more difficult in other situations. But any comments on how that might work and how that could work in practice?
I think it's a critical way of working. Just using the example of social care and primary care, things are intrinsically linked and it seems daft to be looking at any one bit of the public sector in isolation. We've had conversations with colleagues in social care that financial challenges in social care could potentially lead to bigger financial challenges in healthcare. But, ultimately, it's public money and we've got a duty to work—as everyone is trying their best to do, and even more so in these challenging times—together to deliver the best services with a finite amount of money, irrespective of which bit of the public budget the money is coming from.
Okay. Thank you very much for that session this morning. Diolch yn fawr iawn. It was really interesting, and I know we do appreciate all the work that you do in your respective organisations and everybody that you represent here today. We know it's very, very difficult out there and we do appreciate it.
I'll bring this session to a close. You'll have a transcript of this to check for accuracy, and then you'll have the opportunity to look at that.
So, we'll stop there for a technical break just to do a changeover, but we'll see everybody in a few minutes. Diolch yn fawr.
Diolch yn fawr. Thank you.
Thank you.
Gohiriwyd y cyfarfod rhwng 11:12 ac 11:20.
The meeting adjourned between 11:12 and 11:20.
Croeso nôl i bawb i'r drydedd sesiwn y bore yma o sgriwtini ar y gyllideb ddrafft. Rydyn ni yma efo arweinwyr cynghorau sir. Buaswn i'n licio mynd rownd ac ichi gyflwyno eich hunain a lle rydych chi'n cynrychioli. Os gwnawn ni gychwyn yn yr ystafell—.
Welcome back, everyone, to the third session this morning of scrutiny of the Welsh Government draft budget. We're joined by leaders of county councils. I'd like to go round and for you to introduce yourselves and to state where you represent. If we start in the room—.
Shall we start in the room with Anthony?
Hello, good morning. I'm Anthony Hunt. I'm the leader of Torfaen council and also the Welsh Local Government Association finance spokesperson.
Fantastic. Great. Who have I got? Mary Ann.
Good morning. I'm Mary Ann Brocklesby and I'm leader of Monmouthshire County Council.
Welcome. And then over to Mark.
Bore da. Good morning, everybody. Councillor Mark Pritchard, leader of Wrexham County Borough Council.
Bore da. Llinos Medi, arweinydd cyngor Ynys Môn.
Good morning. I'm Llinos Medi, leader of Anglesey county council.
Croeso cynnes ichi i gyd.
Welcome to you all.
A warm welcome to you all. We've got a lot of ground to cover because, obviously, there is a lot of important information we've had from you as evidence, but obviously we need to find out what's going on in local government on the ground as well. We've got some questions we'll ask specifically for some. If you've got something specific to add, if you could add it in in fairly short answers, that would be great as well. So, if the first person gives a substantive answer, if you concur, then be fairly quiet, but if you've got something extra to say then please say it, because it's good to be able to get through the session.
So, no more rambling from me; let's carry on with the first question. The Welsh Government said decisions relating to this budget are,
'the starkest and most painful since devolution.'
It also says it has aimed to protect front-line public services as far as possible. To what extent does this budget protect the services that you offer? I might as well start in the room and then we'll do the order that we did the introductions in, if that's okay, so we'll start with Anthony—if you give us an idea from a WLGA point of view and maybe from a Torfaen point of view as well.
Okay. Yes. Obviously, I recognise both parts of that statement. I recognise the difficult situation the Welsh Government have been put in by the financial position. We also recognise the 3.1 per cent additional funding—that's 3.1 per cent cash additional funding. It's welcome. That's £170 million more, and that will help us bridge some of the gap. However, it only amounts to around a third of the pressure facing local services, so it will inevitably mean difficult choices, job losses and service cuts across local government.
Okay. Thank you very much. Mary Ann. Can we just unmute Mary Ann? There we are. Lovely.
Thank you, Peredur. I concur with Anthony. It is a useful uplift. There's a sense in which this is a growth budget, but it's not enough to allow us to deliver our services when we are dealing with increasing demands as a fallout post COVID in social services and in education, but also inflationary pressures, particularly on waste services et cetera. Despite having more money, it is not enough for us to cover the services that are most needed and to protect the most vulnerable and needy in ways that we would want to, even though that is the focus of our budget.
Shall we go from the south-east to the north-east? Mark, in Wrexham, any thoughts?
Yes, thank you, Chair. Just quickly, we all recognise the increase of 3.1 per cent and, as we say, that's welcomed, but it wasn't welcomed by me, and the reason being for that is that it wasn't enough. I do accept that the Welsh Government has its own financial pressures, but the 3.1 per cent just adds up to £170 million; we need £800 million to be sustainable across the 22. That's what the shortfall is this year. And since austerity started, we've had over £1 billion taken away from the local authority's budget. And I'll repeat that: over £1 billion. With regard to services, it's going to be devastating. We're going to have redundancies, job losses, and the non-statutory services—. I was in a budget workshop on Monday with members, and in three years' time, if we have any non-statutory services in Wrexham, I'll be surprised. Because we have a legal duty, as we all know, to protect the statutory services. That's where we are.
And I'll say this quickly: I've been in local politics, I've been the leader of the council, I've held most portfolios within the council, and I've never known a time like it. It's tragic, and if you add up all the redundancies and job losses across Wales, for all of us, across the 22, it will be in its thousands. My plea today, really, is to you: all we want, as 22 authorities, is to be funded properly, so we can deliver quality services to our residents. Thank you, Chair.
Diolch. A drosodd atat ti, Llinos. Oes gen ti fwy i'w adio?
Thank you. And over to you now, Llinos. Do you have any more to add?
Dwi'n meddwl beth sy'n bwysig ydy'r frawddeg olaf yn y cwestiwn, sef 'Ydy hwn yn medru amddiffyn y gwasanaethau?' A'r ateb ydy 'Nac ydy'. Felly, er bod yna gynnydd wedi bod, mae'n bwysig nodi nad ydy'r cynnydd yn medru amddiffyn y gwasanaethau, ac rydyn ni i gyd yn edrych ar doriadau i'r gwasanaethau yna. So, i ateb y cwestiwn ar ei ben, 'Na'.
I think what's important is the final sentence in the question, namely 'Can this protect services?', and the answer is 'No, it can't.' Even though there has been an increase, it's important to note that the increase can't protect services, and we're all looking at cuts to those services. So, to answer that question in a nutshell, 'No'.
Mike, do you want to come in? Can we unmute Mike, please? Diolch.
My question is to Mark Pritchard. You said you were going to do away with all non-statutory services. Does that mean you're going to close every park? Does that mean you're going to close every community centre? Does that mean you're going to close every leisure centre, and you're only going to have one library in Wrexham?
I didn't say we were going to close every non-statutory service; what I said was I would be surprised if there were any non-statutory services being delivered in Wrexham. The non-statutory services in Wrexham add up to £28 million, and they cover education, early intervention, business advice and support, housing, assets and the economy—the list is there—bus stations, road safety, grass cutting, countryside services, parks, winter maintenance, the environment department, and the list goes on. They're non-statutory services. What I would say to you, as I said to the press, and as I've said to elected members—the 56 in Wrexham—is no stone will be left unturned. That's where we are.
And you're referring to non-statutory services; what about the statutory services? For the very first time—and I never thought I'd be sitting here today having this conversation—we're taking £5 million out of education—£5 million—because we're being forced to, because we've got nowhere else to go. Thank you, Chair.
Thank you for your answers there. If we can move on, in your consultation response, you say the measures that local authorities will have to take to address their budget gap will have to be drastic. Can you provide us with some examples of the measures being considered?
Os gwnawn ni gychwyn y ffordd arall rownd y tro yma, so os awn ni at Llinos gyntaf. Pa fath o bethau wyt ti'n mynd i orfod eu gwneud yn Ynys Môn, os fedri di roi rhyw syniad i ni, i gau'r gap, felly?
If we start the other way around, so if we go to Llinos first. What kind of things are you going to have to do in Anglesey, if you could give us some idea, to fill that gap?
Cyllidebau ysgolion ydy'r lle cyntaf. Rydyn ni wedi medru amddiffyn ysgolion er gwaethaf yr heriau rydyn ni wedi'u hwynebu ers nifer o flynyddoedd. Mae cyllidebau ysgolion yn rhywbeth sydd yn pryderu rhywun yn fawr iawn, ac yn enwedig y bore yma, pan rydyn ni'n derbyn e-bost gan Estyn yn datgan pryder am bresenoldeb plant yn eu harddegau yn yr ysgolion, a rydyn ni'n tynnu mwy o arian allan o wasanaeth sydd angen ei fuddsoddi ynddo fo, oherwydd bod ein pobl ifanc ni yn ei ffeindio hi'n anodd i ddygymod ar ôl sgileffaith COVID a materion iechyd meddwl, ac yn y blaen. Mae hwnna yn wirioneddol bryderus. Ac o gofio mai ein pobl ifanc fydd ein cenhedlaeth nesaf ni, rydyn ni rŵan yn dirywio eu dyfodol wrth wneud penderfyniadau fel yna.
Felly, mae addysg yn un enfawr, ond rydyn ni'n edrych ar wasanaethau cymdeithasol hefyd. Rydyn ni'n edrych ar yr hyn rydyn ni'n gallu ei gyflawni, ac rydyn ni'n edrych ar wneud llai. Un ohonyn nhw yw beth rydyn ei alw'n gymorth dros nos. Cymorth Night Owls rydyn ei alw fo yma ar yr ynys. Beth mae hynny'n ei wneud ydy cefnogi yn ystod oriau allan o'r swyddfa, os oes yna rywun yn disgyn yn y nos, os oes rhywun angen cefnogaeth yn y nos. Beth mae hynny'n ei wneud yn y diwedd ydy arbed arian hefyd i'r gwasanaeth iechyd, achos mi fydd yna rywun o’n gwasanaethau ni, efallai, wedi medru cefnogi rhywun yn ystod oriau’r nos. Rydyn ni'n ailedrych ar beth sy'n bosib yn y gwasanaeth yna rŵan. Felly, mae'r angen yn dal yn mynd i fod yn bodoli, onid yw? Pwy sy'n mynd i fod yn pigo'r angen yna i fyny? Ydyn ni'n trosglwyddo’r gwariant yna wedyn i'r bwrdd iechyd? Ydy'r gwariant yna’n mynd i gostio mwy wedyn i'r bwrdd iechyd?
I ni, fel arweinyddion, mae'n rhaid i ni gydbwyso’n cyllideb ni. Dyna ydy ein cyfrifoldebau ni, ac mae'n rhaid i ni wneud iddo fo adio i fyny. Felly, mae pob dim yn cael sylw. A beth sy'n bwysig i'w nodi yw bod pob un gwasanaeth yn bwysig i'r defnyddwyr gwasanaeth. Pan rydych chi eisiau rhywbeth gan yr awdurdod, mae hwnnw’n bwysig i chi. Rydyn ni hefyd yn nodi y cynnydd rydyn ni'n ei weld mewn digartrefedd. Mae hwnnw’n flanced ar draws Cymru. Mae chwyddiant yn araf deg yn mynd i lawr, ond mae sgileffaith y chwyddiant dros y flwyddyn ddiwethaf ar deuluoedd yn ei gwneud hi’n anoddach i deuluoedd fedru cadw to dros eu pennau. Rydyn ni'n gweld mwy o deuluoedd yn dod ar ein gofyn ni, ac mae o wedi cynyddu yn y fan yma ers y Nadolig.
School budgets is the first place. We have been able to protect schools despite the challenges we've faced for several years. School budgets is something that causes great concern, and especially this morning, when we received an e-mail from Estyn stating that they're concerned about young people's attendance in schools, and we are taking more money out of a service that needs more investment, because those young people find it difficult to come to terms with the effect of COVID and mental health problems. So, that's really concerning. It's especially concerning because they're the future generation, and we're now destroying their futures by making these decisions.
So, education is a huge one, but we're also looking at social services. We're looking at what we can achieve, and we're looking at doing less. One of them is what we call overnight support. Night Owls is what we call it here on the island. It provides support out of hours if someone falls during the night or if they need some kind of support during the night. And what that does at the end of the day is it saves money for the health service, because someone who could have gone to those services, we could have supported there. So, we're looking again at what's possible in that service now. So, the need is still going to exist, isn't it? Who's going to be picking up that need? Are we going to be transferring that expenditure to the health board? Is that going to cost more, then, for the health board?
For us, as leaders, we need to balance our budgets. That's our responsibility, and we need to make up the deficit. So, everything needs to be given attention. And what's important to note is that, for the service users, every single service is important. When you need something from the local authority, that's very important to you. We also need to note the increase that we've seeing in homelessness. That's seen in a blanket way across Wales. Inflation is slowly reducing, but the side effects of inflation over the past few years on families are still making it more difficult for families to keep a roof over their heads. We're seeing more and more families come to us, and that's increased since Christmas.
Diolch, Llinos. Coming over to Mark, you've highlighted quite a few things already. Is there anything in particular that you'd want to add, briefly?
I will, Chair, thank you, and I'll go through it quickly. I'm conscious of the time. Obviously, I mentioned schools—£5.3 million. I just want to say what I feel about education and schools. Education is the only way we can level up the social injustice in this country. If you have poor parenting and you live in an area of deprivation, the only opportunity you have is education and a fantastic school within that community to set the foundations for you to break that cycle of deprivation. I said earlier on we are taking—that's how difficult this is—£5 million from education.
On a similar theme to what Llinos said, there are disability facility grants, which do adaptions in people's homes, when they're waiting in the hospital to come out. Slips and falls, handrails and everything, adaptions within the property, walk-in showers—we're looking to take money out of there. I never thought I'd be saying this, but I am.
The other areas I touched on quickly are non-statutory. Yes, we'll be looking at them. We'll look at everything—social care, everything we will look at to save money, because that's what we have to do. We had a discussion yesterday on business support—£2 million is the consideration. We're going to cut that in half. Fleet management—we're doing that. Obviously, there's restructuring. When I started here, I think it was 16 we had, senior directors. We had a chief exec, directors, chief officers, 14 we had. They've all gone. All we've got is a chief exec now and the seven chief officers. The problem is, where we are, Chair, and I'm sure you all know, as I said earlier on, we've had £1 billion taken out. This has been consistent. It's been cuts, cuts, cuts, cuts. It's non-stop. There's nothing left. That's where we are. Thank you, Chair.
Diolch yn fawr. Mary Ann, obviously Monmouthshire is a more rural county as well. Do you have any reflections on some of the challenges around that?
Like all others, we've not been able to cover the full inflationary pressures facing our schools, and we know what the knock-on effect may be in terms of losing teaching assistants and teachers themselves, depending on the school, and the impact that will have on our learners, particularly at a time when return-to-school rates are still not as they were pre pandemic, and while mental health and well-being is reduced and where we need more support in the schools.
In terms of being a rural county, there are a number of knock-on effects, I think. One is that, while we're not anticipating redundancies, we are having an across-the-board job freeze, and that will have an impact on our existing staff, so reaching into rural areas on a reduced and severely stretched staff, who have their own well-being issues, which I think we'll come on to later. There's our ability to maintain waste management at the levels we want to, with increasing fuel costs, for example, when we have to cover so much more mileage than more urban authorities. We haven't, at this point, reduced our collection rates.
We're in a slightly different position than some councils in that we started making substantive cuts last year. We started transformation of services last year also, so our preventative measures are helping us in some way. The real impact is around social services and education, which will come up time and time again. The transport issues cut across the whole region. We face it with school transport—that is statutory. We cannot change that; we have to look at new models, which is what we're doing.
Thank you. If I come to you Anthony, from your own experience in Torfaen, but also as the finance lead for the WLGA, for your thoughts about your pressures locally. But also, we've heard about quite a few of the councils in England looking at section 114 notices; have you got a sense of any of our councils in Wales looking precarious?
I don't think we're in as bad a position as that in Wales, but I think being in a less bad position than local government in England is not something to spend too much time boasting about, really, as the situation across England is dire. There are lots of councils from the north to the south, from affluent areas to less affluent areas, of all political persuasions, all saying that they're very close to being not viable going concerns, and that's a very unenvious position. To ask why that is, because I think members of the public do, this isn't because of cash cuts this time around; it's because of inflation causing pressure on local services, just as it is on households, and the pay pressure that causes. Because, of course, our staff need to live as well—we'll come back to that later—but they've had year upon year of real-terms decreases, and increasing demand on services. And, to agree with what Mark Pritchard said before, this is the fourteenth year that we've been doing this. Many of the things we've already done.
In Torfaen, we've already got rid of the mayor, the chauffeur, the budget for biscuits and things that people often tease us about that councils get—we don't get any of those now. I ride my bike to meetings instead. So, lots of those things that people think are the obvious things to cut first have gone. Therefore, I know it's a cliché, but we are cutting the bone. This year in Torfaen, to give an example of the one I know best, we've done an admin and business services review—that's saving £1 million. But that's 20 members of staff put at risk of redundancy and having to look for either redeployment or leave the organisation, so that's not an easy thing to do. We've reviewed our estates and our energy again to see what more money we can take out of them. We've reviewed our senior management costs, as other colleagues have said. We've done everything we can within social care to review the structure and become more efficient, to protect the outcomes for those who need us most.
To agree with Llinos, we're straining every sinew at the moment to try and protect schools, because we know, in the post-pandemic environment, school budgets are pressed. They've made lots of non-staff savings, so my impression is that any more savings schools have to make will come from staff, and we don't want them to lose some of the teaching assistants and other support staff who've provided invaluable support for kids struggling to get by after the pandemic. So, those are the things we're trying to protect, and that's the way we're trying to do it.
Llinos, wyt ti eisiau dod i mewn ar hwnna?
Llinos, would you like to come in on that?
Yes. In addition to what Anthony just said now about the section 114 notices, I think we have to be honest as well, that, even though we're in a better position, I think a number of authorities know that they're quite close and they only want a few things to go wrong during the year. That's why we're carefully managing our reserves as well. I know most authorities are using reserves to balance the budgets this year. We're keeping an option that—. Flooding—we're having extreme weather, now, gritting and everything. If these aren't budgeted, you turn to your reserves to budget these things that are totally out of your control—storm damage and those things. So, I just think that it's extremely important that we mention the vulnerability that we face now because we are using our safety net to balance the budget, and, with your reserves, you can only spend them once. So, we will be looking for that next year. So, I think it is important that we note that anything can go wrong, and I think, as 22 leaders, we've all faced different emergencies over the last years of being in our leader roles. And you know how quickly that money can be spent as well, and totally out of your control.
Andrew Morgan from RCT council has been quoted as saying that local authorities will only be able to do the statutory things, and we've touched on that with Mark. What does that actually mean? So, what does it mean in 'just doing the statutory things'? I'll come to you with this, Mark, because you've talked about the non-statutory and the statutory, and delivering statutory services is a wide area of how you deliver it and what does that mean. So, could you talk us through, maybe, what getting rid of the non-statutory but just doing the statutory would mean to our constituents, and what would that mean to the wider implications of that? So, Mark, if I come to you with that.
Thank you, Chair. Well, I think first of all I would say that if there's a choice between statutory and non-statutory, all of us in this room are going to go for the statutory service because we have a legal—. The law states that we have to protect them, and rightly so. And the statutory services are for the most vulnerable people in our society, and that's the way it is, and we all understand that. On the non-statutory services, Mike asked me the question and I think I gave him a very comprehensive reply, and I'll state it again: it will be a breakdown of society, because—
Because of time, there's no need to go over this now, but just maybe what the impact would be, then, on communities.
Okay. Well, listen, if you look at the non-statutory areas—and I'll give you some examples—of community centres, libraries, parks and gardens, highways maintenance, street lighting, that gives you an example. We will be looking at those areas and, unfortunately, we will have to stop some of them. I think what we've done in the past, and we've done it really well—I must compliment all the other 21 authorities—is we've tried to retain as many staff as we can. A lot of people are saying salami slicing. Well, if you take 20 per cent off your non-statutory services every year, you're going to end up with nothing. So, the impact it will have within the communities that we represent will be devastating, because of the areas that we service within the non-statutory services. And that's it, and, look, it's brutal, it's unpleasant, but that's what we've got to do. And not only that, we've put millions of pounds extra into social care, and it just keeps on rising. The demand is there for everybody to see. It's not just in Wales; it's across the country. And those increases just continue to increase, and the funding process and the amounts of money we're given each year are just not enough, and that's it. But, coming to non-statutory services, a lot of those services are what affect our residents and within our communities. And yes, we will have to look at libraries, yes, we will have to look at community centres, yes, we will have to look at resource centres. Everything that is there, we have to look at now. Thank you, Chair.
Anthony, did you want to come in?
Yes. This is a difficult one, because, as a community leader, I'm less interested in what's statutory and what's not statutory than I am in what makes an impact on people's lives. And many of those non-statutory services do make a big impact on people's lives, and we've seen, from the taking away from them in other areas, the impact that's had on statutory services further down the line. You cut money from youth services and, five, six, seven years down the line, you find out you've got more anti-social behaviour and disorder. You cut money from community centres, you find you have more community issues, anti-social behaviour within those communities.
School transport is a great one. Of course, it's a statutory service to a point, but if you remove councils' ability to have any discretion about what they offer and how they offer it, you find a system that's frayed around the edges. Libraries, of course, are another one. It's statutorily necessary for us to provide a library service, but what that means, of course, is another question. We've tried co-locating our libraries with other services to try and keep those going, but—. I'm very wary that if councils are pushed in the direction that they can only offer statutory services or the bare minimum, we won't be able to offer some of those early intervention prevention services that, in the long term, have a positive impact on our budget.
In Torfaen, we took some decisions five or six years ago that I believe are now paying dividends in our budget now and that we can see in the demand on areas like social care. I don't want to withdraw the funding from those services in order to protect the—. It's the old adage of when a building's on fire, you have to concentrate on putting the fire out, but you also want to go into schools and communities and talk about fire prevention, don't you? How can we balance those two things right when we're being squeezed in such a way as to almost push us towards short-term decisions.
Thank you.
Llinos, ti eisiau dod i mewn ar hwn? Na. Fe wnaf i ddod atat ti am yr un nesaf. Rydym ni'n dod i ddiwedd tair blynedd y spending review. Dydy'r Llywodraeth heb roi gwybodaeth bellach tu hwnt i 2024-25. I ba raddau mae gan hynny impact ar lywodraeth leol, a sut ydych chi'n mynd i allu planio tu hwnt i eleni?
Llinos, would you like to come in on this? No. I'll come to you for the next one then. We're coming to the end of the three-year spending review period, and the Government hasn't provided further information on funding beyond 2024-25. To what extent does that have an impact on local authorities, and how are you going to be able to plan beyond this year?
Mae impact blwyddyn nesaf yn cael effaith fawr ar sut rydym ni'n gosod y gyllideb eleni, ond hefyd mae'n rhaid i ni osod y gyllideb i wneud y siŵr ein bod ni'n diogelu pawb eleni. Felly, mae'r sefyllfa yn gwbl—. A mae'r rhagolygon rydym ni wedi eu cael o 1 y cant o gynnydd y flwyddyn nesaf yn rhoi pob awdurdod mewn sefyllfa lle os nad oes adran 114 wedi bod eleni, yn bendant mi fydd yna un y flwyddyn wedyn. Yr her fwyaf i ni ydy ein bod ni fel awdurdod yn gorfod cael medium-term financial plan, felly er nad oes gennym ni'r wybodaeth yma, mae'n rhaid i ni a'n swyddogion cyllid ni roi cynllun tymor canol i fewn. Ond eto, dydy'r un llywodraeth yn rhoi unrhyw arweiniad fel yna i ni. Mae o bron iawn yn gwneud ein swyddogaeth ni yn amhosibl, ond rwy'n clodfori'r swyddogion 151 bob awdurdod yng Nghymru sydd yn mynd rhagddo ac yn rhoi o leiaf ryw fath o arweiniad.
Mae'n bwysig bod y cyhoedd a phawb yn deall nad eleni ydy'r flwyddyn waethaf. Os ydy'r rhagolygon yn gywir, mae'r flwyddyn nesaf yn mynd i fod lot, lot gwaeth. Dyna pam mae'n rhaid i ni fod yn ofalus ynglŷn â defnydd arian wrth gefn, a'r defnydd fyddwn ni'n gwneud o ran gwasanaethau a treth cyngor. Mae'r gymysgedd yna'n hanfodol bwysig o achos y flwyddyn nesaf. Dwi'n gwybod ein bod ni fel awdurdod rŵan yn meddwl mwy am beth fyddwn ni'n stopio Ebrill nesaf—er ein bod ni'n teimlo ein bod ni wedi cael cyllideb eleni sydd ddim yn ddelfrydol o bell ffordd, ond mae'n gyllideb fedrwn ni ei chynnal am y flwyddyn nesaf. Ond bydd rhaid dod â phethau i ben erbyn Ebrill y flwyddyn nesaf.
The impact of next year is having a big effect in terms of how we're budget setting this year, but also we have to set the budget to ensure that we do protect people this year. So, the situation is totally—. And the forecasts that we've had of a 1 per cent increase next year is putting all authorities in a situation where if there hasn't been a section 114 this year, there will be one next year. The biggest challenge for us as a local authority is that we have to have a medium-term financial plan. So, even though we don't have this information, we and our finance officials have to put a plan in place. However, no government is giving us any direction in that regard, and it makes our role almost impossible. But I do praise our 151 officers in local authorities in Wales who are giving us at least some kind of guidance.
It's important that the public and everybody else understands that this year isn't the worst year. If the forecasts are right, next year is going to be a lot worse, and that's why we have to be very careful in terms of the use of reserves and what we are doing in terms of services and council tax. That combination is very important because of next year. I know that we as an authority are now thinking more about what we will stop next April—even though we feel that we haven't had an ideal budget this year by a long way, it is a budget that we can maintain for the next year. But we will have to bring things to an end by next April.
So, I take it that it's similar in other areas. Anything substantive to add to that, Anthony?
It just comes back to the point I made, and the question before, about wanting to be able to make long-term decisions and not short-term decisions. One of the advantages we've had in this budget this year is we've been working on it since February, and the longer the time period you have to make decisions and put those decisions into effect over, it means that you can do more imaginative things than when you have to do it tomorrow. So, my appeal to you would be to put as much pressure as you can both on the Welsh Government and the UK Government to give us as much forward indications as they can, because then we can look to the future and say, 'Look, even if the future's not going to be rosy, we can try and get there over a number of years', as opposed to this year-on-year situation where we are left having to basically dig out the bottom line. The more notice central governments can give us, the more creative we can be and the more we can help protect those services.
We're just talking about future planning, with the three-year spending reviews coming to an end now—just for Mary Ann, who's had a couple of technical issues, but you're back with us now, so it's good to see you back. I don't know if there's anything further you wanted to add to that, Mark, or I'll move on to Peter. Basically, the message was clear—
There are a couple of things I'd like to add, Chair, if I may.
Okay. I'll bring you in after, Mark. There we are.
Thank you. For us, the distinction between statutory and non-statutory is not helpful. It’s not helpful because many of the things that we need to do that are preventative allow us to make effective savings and become more efficient, effective and supportive to our residents in those statutory services. To give an example, the work that we’ve done on supporting families and carers when there is an alert from schools, for example, means that we have lowered the number of children that need statutory services, and that reduces the financing and the resourcing that we need. But we need to invest in those preventative services.
I’d also like to say that all the work that we do in our community hubs, our libraries, our leisure services is absolutely crucial for community and individual well-being. So, we want to protect that. We may have to reduce hours, but closing them is going to have not only an impact on the well-being of our residents, but also on the NHS further down the line. Anthony gave the example of youth services, for example. By truncating our youth services we are seeing and will see knock-on impacts not only on our young people, but on the community safety of our communities and how they feel secure. That’s why I think it’s so important that we are allowed to have multi-year funding, so that that piece of preventative work is really thought through creatively, where together we can develop innovative practice and we can think forward as to how we can be better at our statutory service provision.