Health
‘Nobody taking responsibility’ for paying care workers the real living wage
CARE HOME providers urged the Welsh Government to follow through on a key commitment to ensure care workers are paid the real living wage.
Giving evidence in the Senedd, Care Forum Wales, which represents more than 450 care homes, warned funding did not reach all parts of the sector in 2024/25.
The non-profit organisation said funding for the real living wage (RLW) was not ringfenced, so some councils chose to spend the money on libraries and teachers’ salaries instead.
Care Forum Wales raised concerns about “nobody taking responsibility”, with the Welsh Government claiming to have provided the money and councils saying it was insufficient.
Labour’s manifesto for the 2021 election contained a pledge to “ensure care workers are paid the real living wage during the next Senedd term”.
But Sanjiv Joshi, Care Forum Wales’ treasurer, warned the Welsh Government’s push for care workers to receive the real living wage has become an aspiration rather than a reality.
He told the local government committee: “The first year when it was announced … providers had to give an undertaking to commissioners that we were paying the real living wage.
“Since then, that’s now become aspirational as commissioners have not had the funds – or so we are told – to follow through and maintain those real living wages.”
Giving evidence on April 3, Melanie Minty, policy adviser at Care Forum Wales, said: “The real living wage, as Sanjiv said, isn’t reaching the sector necessarily.”
But, describing the RLW as a drop in the ocean, she warned care homes cannot compete with councils and the NHS which pay a higher rate than used in costing commissioned care.
Under the Welsh Government’s 2025/26 budget, funding for the real living wage is allocated to councils within the revenue support grant, meaning it can be spent on other areas.
Ms Minty also voiced concerns about an increasing number of councils receiving grants to build care homes that “will never recover their costs”.
She pointed to the example of Carmarthenshire Council building a £19.5m residential home despite free capacity in the county’s independent sector.
Cautioning that commissioning too often focuses on cost over outcomes, she said: “I’ve heard of commissioners going into homes and saying ‘you’re spending too much on food’.
“Things like holidays have been drastically cut back for younger people.”
Mr Joshi, who runs the Caron group of care homes in mid and south Wales – which includes Valley View Care Home in Hengoed – warned of a £9,000-a-year difference in nursing fees between neighbouring councils.
He said: “We’re talking about Cardiff and RCT … imagine the pressure that puts on and it’s not driven by the needs, the needs would not be that different.”
Pressed about the minimum level of profits required to make services feasible, Mr Joshi replied that he targets an 11% return which is unachievable in parts of Wales.
Warning of an “irrational” policy direction, he said: “We have the private sector delivering incredible value for money [yet] being eroded by underfunding. Then we have the public sector spending four or five times that amount, it doesn’t make sense.”
Mr Joshi told the committee families are increasingly having to make up a difference in costs that should be provided by councils and health boards.
Warning charity providers are exiting the market, Ms Minty said: “Most of our third-sector members have sold their care homes because they are not viable.”
Ms Minty called for a fee methodology that can be applied consistently across Wales, with some councils far more transparent and understanding of the costs than others.
“Cardiff, while giving a really good increase this year, has been very honest in admitting they know it’s not going to meet all the changes,” she said. “Whereas other local authorities … have been known to make an offer and say this will cover all sorts of things.”
She said the sector has stabilised since the pandemic and Brexit but increasing employer national insurance contributions have added to the pressure.
She told the committee: “I think we’ll see an unintended consequence will be that employers are forced to suppress pay increases … and some will be forced to make redundancies.”
Health
Fresh alarm over life expectancy in Wales as CMO warns of ‘prevention revolution’
WALES is living sicker for longer, the Chief Medical Officer has warned, as new figures show a worrying drop in the number of years people can expect to live in good health – with women hit hardest.
The findings, published today in Dr Joanne Absolom’s first annual report since taking over from Sir Frank Atherton, have prompted immediate calls for the next Welsh Government to overhaul its approach to public health after the 2026 Senedd election.
Dr Absolom says Wales must now move decisively away from a system that largely treats illness towards one that prevents people becoming ill in the first place. Her report warns that healthy life expectancy is falling across the country and highlights widening inequalities between communities.
Responding to the findings, Darren Hughes, Director of the Welsh NHS Confederation, said the message could not be clearer.
“NHS leaders in Wales welcome the report’s call for a prevention-first approach,” he said. “We have to move from simply treating illness to actively promoting wellbeing, and that means a proper cross-government strategy that tackles inequality and gives people the support to take control of their own health.”
He added that every pound spent on proven public health programmes delivers an average return of £14 – evidence, he said, that prevention “makes moral and financial sense” at a time when NHS budgets are under extreme pressure.
“It is deeply concerning to see healthy life expectancy falling, particularly for women,” he said. “Investment in prevention is vital if we are to make our health and care services sustainable.”
While health boards, councils and community groups are already working on preventative programmes, the Welsh NHS Confederation says Wales needs far greater ambition – and the NHS must be given the tools and flexibility to scale up what works.
The Chief Medical Officer’s report also raises serious concerns about NHS workforce shortages and urges significant investment in digital technology to improve productivity and patient outcomes.
Mr Hughes said all political parties should “take heed” as they prepare their manifestos for next year’s Senedd election.
“Those seeking to form the next Welsh Government have a clear blueprint here. We cannot keep doing the same things and expect different results. Prevention, workforce and digital transformation have to be top priorities.”
The Welsh NHS Confederation — which represents all seven health boards, the three NHS trusts, HEIW and Digital Health and Care Wales — has already outlined its detailed priorities in its own election document, Building the health and wellbeing of the nation.
With the Senedd election just over a year away, today’s report adds fresh, authoritative evidence that Wales needs a radical shift in how it approaches health if it is to secure a healthier future for all.
Health
Government orders clinical review amid sharp rise in mental health diagnoses
4.4 million working-age people now claiming sickness or incapacity benefit, up by 1.2 million since 2019, many because of a mental health condition
A CLINICAL review into how mental health conditions are diagnosed across the UK is expected to begin this week, following concerns within government over rapidly rising sickness-benefit claims linked to conditions such as autism, ADHD and anxiety.
Health Secretary Wes Streeting has commissioned leading clinical experts to examine whether ordinary emotional distress is being “over-pathologised” and to assess why the number of people receiving sickness and incapacity benefits has grown to 4.4 million – an increase of 1.2 million since 2019.
According to reports in The Times, ministers are particularly alarmed by the surge in the number of 16- to 34-year-olds now out of work because of long-term mental health conditions.
Streeting said he recognised “from personal experience how devastating it can be for people who face poor mental health, have ADHD or autism and can’t get a diagnosis or the right support,” but added that he had also heard from clinicians who say diagnoses are “sharply rising”.
“We must look at this through a strictly clinical lens to get an evidence-based understanding of what we know, what we don’t know, and what these patterns tell us about our mental health system, autism and ADHD services,” he told the newspaper. “That’s the only way we can ensure everyone gets timely access to accurate diagnosis and effective support.”
The review is expected to be chaired by Prof Peter Fonagy, a clinical psychologist at University College London specialising in child mental health, with Sir Simon Wessely, former president of the Royal College of Psychiatrists, acting as vice-chair.
Prof Fonagy said the panel would “examine the evidence with care – from research, from people with lived experience and from clinicians working at the frontline of mental health, autism and ADHD services – to understand, in a grounded way, what is driving rising demand.”
The move comes as the UK Government faces mounting pressure over the rising welfare bill. Ministers earlier this year pulled back from proposed changes to disability benefits, including those affecting people with mental health conditions, after opposition from Labour backbenchers.
Speaking on Monday, the Prime Minister said a fresh round of welfare reform was needed.
Keir Starmer said: “We’ve got to transform it; we also have to confront the reality that our welfare state is trapping people, not just in poverty, but out of work.”
Health
NHS Trust CEO ‘forced out’ after raising concerns — Welsh Govt denies wrongdoing
A CONSERVATIVE MS has pressed the Welsh Government for answers after the sudden departure of the Velindre University NHS Trust’s chief executive, amid media reports that he raised concerns about alleged governance failures within NHS Wales Shared Services.
During Health Questions in the Senedd today, James Evans MS asked Health Secretary Jeremy Miles to explain why former CEO David Donegan left his post after just a year. Reports circulating in recent weeks suggest Mr Donegan had raised issues relating to governance, and in some accounts, possible criminality. These claims have not been substantiated publicly.
Velindre’s own 2024/25 annual report notes that the Trust “escalated concerns to Audit Wales and Welsh Government about the current governance of Shared Services, which hadn’t been reviewed since 2012.” No details of the concerns have been published.
Welsh Government response
Jeremy Miles MS confirmed in the chamber that correspondence relating to the issues does exist, but said it would not be appropriate to release sensitive material while internal processes are ongoing. He did not comment on the circumstances of Mr Donegan’s departure, citing employment confidentiality rules which are standard across the NHS and public sector.
A Welsh Government spokesperson has previously said that they expect all NHS bodies to follow “proper governance and HR procedures,” and that they “do not comment on individual employment matters.”
Velindre NHS Trust position
Velindre has not publicly stated that Mr Donegan was removed because of whistleblowing activity. The Trust has described his departure simply as a “change in leadership” and says it continues to engage with Audit Wales and the Welsh Government on governance matters.
Opposition criticism
After the exchange, James Evans MS — the Welsh Conservative Shadow Cabinet Secretary for Health — criticised the Health Secretary’s “lack of transparency”.
He said:
“I am extremely disappointed with the Health Secretary’s refusal to provide clarity on the circumstances surrounding Mr Donegan’s departure, or to release the correspondence relating to governance concerns within Shared Services. The public must be able to trust that millions of pounds of NHS funds are being managed properly.”
Mr Evans said he will write to the First Minister and Cabinet Secretary formally requesting the publication of correspondence “in the interests of full accountability.”
Context: What is NHS Shared Services?
The NHS Wales Shared Services Partnership (NWSSP) manages national procurement, payroll, recruitment, estates services and other core functions for health boards and trusts. It sits within Velindre University NHS Trust but operates independently of its operational healthcare work. Governance arrangements for NWSSP were originally set a decade ago and are subject to periodic review by Audit Wales.
There is no evidence at present of wrongdoing by the Welsh Government or NWSSP, beyond the concerns referenced in Velindre’s annual report.
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