National Assembly for Wales

Consultation:  Proposed Domiciliary LCO Committee - The National Assembly for Wales (Legislative Competence) (No 4) Order 2008 relating to charging for Non-Residential Social Care (Domiciliary Care)

The WLGA and the ADSS Cymru submit this joint response as evidence to the National Assembly for Wales. It represents the political and the professional view of local government in Wales.   We welcome the opportunity to expand upon this evidence with supplementary oral evidence on the 31st of January 2008 to the Domiciliary LCO Committee.

1 Response to three questions posed by the committee

We note that the primary purpose of this consultation is to consider whether legislative competence for domiciliary charging would be beneficial for Wales and not to speculate or determine how that competence should operate when it comes into force.

Statutory powers are held by local authorities to assess and determine an adequate and fair level of charges.  They do this in order to meet their responsibilities and the charges reflect the priorities and pressures of the individual council.  An inevitable but not wholly undesirable outcome will be variances some greater than others, to reflect the overall circumstances of the individual council.

We welcome reassurances that the Deputy Minister for Social Services has given that the Welsh Assembly Government does not wish to remove this discretion from local authorities and move to centrally set fee levels for services provided but to deliver a fair and consistent approach1.  We support this aim, however achieving it could have serious implications for local government and require additional resources.  There will need to be considerable further investigation and research undertaken to arrive at a satisfactory process for implementation and a greater understanding of the impact of any use of the power.  Both the WLGA and the ADSS would be willing to work closely with the Welsh Assembly Government (WAG) to resolve such issues as they become clearer should this power be considered beneficial.

In this context we support the overriding principle which we believe this LCO seeks to address, namely to minimise the variances and impact on service users and individual agencies.

We understand that this represents the very first step in the process and welcome the Assembly Government’s commitment to involve local government fully and in partnership through this process should the government proceed to obtain this power. We note that the legislative process is complex and that even should it be desirable, the Measure would not become effective until 2011 at the earliest.

The exceptions as cited in the supporting papers of the LCO would not hinder the effectiveness of this LCO however we have a number of important issues that we wish to share with the committee regarding the scope of the LCO.

2 Specific Messages

2.1 We need to improve the existing unfair and unsustainable social care funding system in Wales.

Social Services is neither a right nor free at the point of delivery to the people of Wales, unlike the National Health Service (NHS).  The funding of the social care system has not been reviewed for decades and is generally now considered outdated, unfair, complex to understand and administer and un-sustainable.  The WLGA and the ADSS strongly supports this view.

A complex mix of council, private, voluntary sector and independent organisations provide care and support to the most vulnerable people in our society.  This complexity is exacerbated by geographical differences, local costs and historic different charging positions of councils, making the system unwieldy and creating inevitable variances across Wales.  We do not believe that a quick fix can be found to smooth out the variances whilst the fundamental problem of insufficient resources remains unaddressed.

We have for several years experienced the inevitable situation of rationing services set within finite resources.  The increasing shortfall has been met by individuals and families and/or services being withdrawn or reduced.  Thresholds for access have been raised and charges increased.  Most councils now only provide services where people’s needs are considered substantial or critical which goes against the spirit of all our intentions of early intervention, prevention and minimising the call upon over stretched NHS resources.

This situation is the result of a chronic lack of resources.  It will not improve in the short term, particularly in view of the current settlement for local government, year on year increases in costs and rising demand.

Councils have been implementing changes, redirecting resources from within and outside of social service areas for several years, whilst meeting year on year service efficiency targets.  Whilst these efforts are important and are recognised to have kept the situation from deteriorating even further, these efforts will never meet the shortfall that faces us over the next 10- 15 years.

A detailed account 2 of this shortfall and the drivers is appended to this evidence produced by the ADSS resources group for the last round of the budgetary process. In this report Social Service budgets for 2006/07 increased by £74m which included an additional £45m from WAG. Despite this the current shortfall remains £54.2 m.

In July 2007, the WLGA produced its priorities for the Assembly 'Let Government Commence, the political and service challenges for the Assembly Third Term’ 3.  In this the WLGA called upon the Assembly Government to fulfil its commitment to conduct a review of funding for social care and to keep pace with a similar review in England which will result in a Green Paper being issued with potential serious implications for Wales. This commitment was given within the cross party strategy 'Fulfilled Lives - Supportive Communities’ 4.  However we can find little reference to this in the Assembly Government document - 'One Wales’ 5.   

We are concerned that this commitment in Wales does not fade whilst in Westminster, we are seeing a greater, more high profile response from all the key agencies and government. We note the release of the report 'The future of care funding’ 6 issued by Caring Choices on behalf of 15 organisations including the LGA, across the long term care system and the important report  'Putting People First - a shared vision and commitment to the transformation of adult social care’ 7.  Key messages from both reports are to ensure that the Green Paper soon to be produced by the Government will fundamentally reform an outdated, unfair and unsustainable system including the Benefits System which is not a devolved issue.

Within this context we are concerned that this initiative to give the Assembly Government powers to set charges for just one element of the social care system, appears to be merely 'tinkering at the margins’  whilst greater effort and focus needs to be on the wider agenda. We recognise that this will require strong political leadership and consensus from the National Assembly for Wales.

2.2 The impacts of the proposals are unknown and may not improve the situation.

The main reason cited for obtaining the LCO is to smooth out the unfortunate impact the current situation creates for service users.  Removing the 'post code lottery’ of different charges in different local authorities is laudable. We are aware that differences in the system exist.  Any attempt to smooth this will inevitably lead to a redistribution of resources which is notoriously difficult to manage.  However it be undesirable for any local authority to be worse off as a result of these proposals.

Parts of Wales are subject to variances and pressures due to their proximity with England. The North Wales Coast in particular suffers from a huge ingress of people wishing to retire there. It cannot be overlooked that if there were to be a less costly regime to the individual in Wales this would be a further deciding factor on individuals choosing to move to Wales for their retirement.

The WLGA also notes the recent report from the LGA which set out in detail the dilemma - 'Submission to Comprehensive Spending Review: Who pays for what’ 8. It cites a number of useful and transferable messages:

  • Overall local government has been successful in ensuring that income from fees and charges keeps pace with inflation but only 11% of total expenditure of the cost of delivering home care to the elderly was secured through this method.
  • Whilst inconsistencies in the policy (different charging regimes) exist the main impact of any attempt to standardise the policy will be on those who pay the full cost. Therefore standardising the amount charged will not have an equal impact on authorities and in some will generate very little additional income.

We want to work with the Assembly to help overcome these differences but local government can only do so if the full impact of any change to the charging regime is fully worked through in collaboration with local government. Any shortfall in resources will need to be found by central government.  

The Assembly Government has an agreed policy with local government that all future initiatives and new responsibilities must be fully funded before they are passed on to local government and this agreement has been central to the partnership approach developed in Wales. A detailed research and impact analysis exercise would be necessary. The WLGA would be willing to assist with this exercise to determine the extent of additional funds required and the methodology for implementing the different charging regime. A task and finish group would be welcomed however, our primary desire would be to work with the Assembly on a complete overhaul of the funding system and we would see this aspect on charging only forming one part of that process.

3. Conclusion

Whilst there persist long term funding shortfalls in the social care system, variances and inequity will continue to exist across Wales. It is difficult to see how service users and their families will not continue to bear an increasing part of this burden as resources become ever more stretched and demand shows no sign of abating.  

The LCO if the government proceeds to have the power will not solve this fundamental problem and even with the power the situation will not improve in the short term. We approve in principle to the LCO but have serious concerns about the potential impact.

Money will inevitably be needed to implement the changes and in isolation from the overall problem can be nothing more than a short term fix. Changes in isolation to the big picture may well cause damage to the delivery of social care services and increase demand way beyond that which is affordable to the Country as a whole.

The WLGA and the ADSS Cymru wish to continue in partnership with the Assembly, to tackle the significant challenges facing social care in Wales.

Beverlea Frowen Bruce McLernon
Director of Social Services and Chair of ADSS Cymru Resources Sub Group
Health Improvement
Welsh Local Government Association

Enc: Appendix A - extract from WLGA ESG Report 2008/09 - 2010/11 (pages 24-33)

References

  1. Welsh Assembly Government, Cabinet Statement,  26th November 2007
  2. Welsh Local Government Association / Association of Directors of Social Services Cymru, Expenditure Sub Group  Report 2008/09 - 2010/11
  3. Welsh Local Government Association, Let Government Commence: The political and service challenges for the Assembly Third Term, July 2007
  4. Welsh Assembly Government, Fulfilled Lives - Supportive Communities; a strategy for social services in Wales over the next decade
  5. Welsh Assembly Government, One Wales: A progressive agenda for the government of Wales - an agreement between the Labour and the Plaid Cymru Groups in the National Assembly, 27th June 2007
  6. Caring Choices, The Future of Care Funding; time for a change, January 2008
  7. HM Government, Putting People First - a shared vision and commitment to the transformation of adult social care, January 2008
  8. Local Government Association, Service Working Group - Adult and Older People Services; Submission to Comprehensive Spending Review, 2007