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Plans to restrict profit in children’s social care move forward

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PLANS to restrict profit making in the care of looked-after children cleared the first hurdle in the Senedd amid concerns about unintended consequences.

Senedd members voted to agree to the principles of the health and social care bill, which aims to restrict private profit, but warned of “huge risks” in practical terms.

Dawn Bowden, Wales’ social care minister, cautioned that the cost of caring for looked-after children has increased from £60m a decade ago to around £200m today.

“If we carry on that trajectory, we will be looking at a bill for local authorities of around £1bn in the next ten years,” she said, stressing that doing nothing is not an option.

Ms Bowden added: “We don’t want to see children treated as commodities in the care sector; we want to see investment in the care of our looked-after children.”

Russell George, who chairs the Senedd’s health committee, called for investment beyond the £68m the Welsh Government has already committed to the policy.

The Conservative said a majority of members supported the principles but the committee raised “very real concerns” about how the bill will work.

Mr George told the Senedd: “There are huge risks for the sufficiency and sustainability of residential and foster places … as an unknown number of providers leave the market.”

He said the cost of caring for looked-after children has risen dramatically in the past decade, which seems unsustainable with councils already facing enormous pressures.

Plaid Cymru’s Peredur Owen Griffiths raised the finance committee’s concerns about the “disappointing, below par” quality of information provided alongside the bill.

He said the minister wrote to the committee in October to confirm the total cost of the bill at £429m to £455m, a full three months after giving evidence.

“Although we are grateful for the clarification, this approach is simply not good enough,” said the committee chair who raised concerns about “fundamental ambiguities”.

Buffy Williams warned the bill makes it easier for councils to place children out of county.

The Labour chair of the children’s committee explained councils would be required to find accommodation “within or near to” the area rather than the current “must be within”.

She said: “We have significant concerns about this proposal…. Given the critical shortage of quality placements, we fear these provisions will mean that children are inevitably placed further away from their homes.”

Altaf Hussain, the Conservatives’ shadow social care minister, said the bill has admirable intentions but he warned of unintended consequences.

“This bill could lead to a huge decline in the care of looked-after children,” he said.

Dr Hussain told the Senedd seven councils in Wales provide no care at all, “so the private sector is the only game in town”, as he criticised ministers for “demonising” providers.

Mabon ap Gwynfor, Plaid Cymru’s shadow health secretary, backed the aims of the bill which was part of his party’s now-collapsed cooperation deal with the Welsh Government.

He said £3 for every £10 spent on foster care in Wales is going into the pockets of shareholders rather than being reinvested in improving the quality of services.

Mike Hedges, who chairs the legislation committee, was concerned that details of the bill’s impact on key issues such as human rights were not published in time for scrutiny.

“The lack of timely information from the government was a theme of our findings,” he said.

Mr Hedges criticised potentially misleading Welsh Government statements about the “elimination” of private profit from the care of looked-after children.

He clarified that the bill would restrict, rather than eliminate, profit.

Mr Hedges also raised concerns about the lack of an end date for transitional arrangements.

His Labour colleague Joyce Watson called for a national register of foster carers.

Jane Dodds, a former social care worker who is the Liberal Democrats’ leader in Wales, described the current system as dysfunctional.

She said: “If we think about it, we are paying our council tax; that goes straight into the shareholders’ pockets and it doesn’t meet the needs of those really vulnerable children.”

Ms Dodds urged ministers to avoid pitfalls from the experience in Scotland, where a study showed councils spent £218m on for-profit care despite a similar commitment in 2020.

Following the debate on October 22, Senedd members backed the bill, 37-14, with Labour, Plaid Cymru and Ms Dodds in favour while the Conservatives voted against.

The bill now moves on to the second of four stages in the Senedd law-making process, which will see the health committee consider detailed amendments.

 

Health

NHS Wales under renewed pressure as waiting lists and A&E delays grow

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Cancer treatment targets missed again as opposition says Plaid must share responsibility for health service performance

NHS WALES is facing renewed pressure after the latest performance figures showed waiting lists rising, cancer treatment targets being missed again and more patients waiting over 12 hours in emergency departments.

The figures come as the Welsh Government announced an additional £145m for NHS Wales, including £100m to reduce waiting times and £25m for new surgical hubs.

In April, performance against the 62-day target for patients starting cancer treatment fell to 56.7%, well below the 75% target.

In Swansea Bay, just 48.4% of cancer patients began treatment within the target time.

Treatment waiting lists also increased, with 680,003 patient pathways recorded in April. The estimated number of individual patients waiting for treatment stood at 536,500.

Two-year waits rose to 3,694. In England, the comparable figure was 191.

Emergency care also came under further strain in May. The proportion of patients spending less than four hours in Welsh emergency departments fell to 64.4%, against a target of 95%.

A total of 11,066 patients waited 12 hours or more before being admitted, transferred or discharged, up from 10,287 in April. The target is zero.

Ambulance performance remained under pressure. For red calls, the median response time improved to nine minutes and 12 seconds, but the 90th percentile increased to 22 minutes and 39 seconds, meaning response time targets were still not met.

Welsh Conservative criticism

The Welsh Conservatives said the figures showed a “worrying backslide” in NHS performance and accused Plaid Cymru of sharing responsibility for the state of the health service.

Natasha Asghar MS, Welsh Conservative Shadow Cabinet Secretary for Health and Social Care, said: “These figures show a worrying backslide in NHS performance in Wales. Cancer treatment times have fallen, waiting lists have risen, two-year waits are up and more patients are being left waiting over 12 hours in emergency departments.

“Plaid Cymru cannot escape responsibility for this. They propped up the previous Welsh Labour Government by backing their budgets and are now in Government themselves. Patients across Wales need action, not more talk of improvement.

“Whilst any extra funding for the NHS is welcome, £145m will not be enough unless it is accompanied by urgent reform, a comprehensive workforce strategy and real delivery for patients.

“The Welsh Conservatives have been clear that the Welsh Government needs to declare a health emergency in our NHS. We need more beds in our hospitals, a robust NHS workforce and a serious plan to cut waiting lists and to support our emergency departments.”

Funding announced

The Welsh Government says the extra £145m will support work to reduce waiting times and improve access to treatment.

Of that, £100m has been allocated to reducing waiting lists, while £25m will be invested in new surgical hubs.

Health leaders have welcomed the additional funding, but warned that money alone will not solve the pressures facing hospitals, GP services, social care and emergency departments.

The latest figures are likely to increase pressure on ministers to show clear progress before the winter, when demand on the NHS is expected to rise further.

Welsh Government response

The Welsh Government said the figures related to April, before the new administration took office, and showed that both treatment waiting lists and the longest waits had increased.

Health and Care Minister Mabon ap Gwynfor said too many people were waiting too long for treatment, and said emergency care performance was not yet at the level patients and staff should expect.

He said: “Our focus is clear — cut waiting times, prioritise those who have been waiting the longest, improve access to services and build an NHS that can keep up with demand in the long term.

“To bring waiting times down and keep them down, we need to change the way the NHS works — making sure patients move through the system more smoothly, from their first referral all the way to treatment.

“We’ve got a plan to do this, working with the fantastic NHS staff right across Wales. The £145 million we’re announcing today will be important in tackling the waiting list and waiting times and helping people be seen quicker.”

The Welsh Government said £100m would be used to help reduce waiting lists and waiting times, £25m would be invested in new surgical and diagnostic hubs, and £20m would go towards essential maintenance across the NHS estate.

 

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Health

Welsh Government announces £145m NHS funding boost

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NEW funding of £145 million has been announced for NHS Wales as ministers seek to cut waiting times, improve hospital facilities and increase capacity across the health service.

The package, announced as part of the Welsh Government’s Supplementary Budget for 2026 to 2027, includes money to reduce waiting lists, develop surgical and diagnostic hubs, and carry out essential maintenance across the NHS estate.

Health leaders and nursing representatives have welcomed the investment, but warned that money for buildings, equipment and waiting list initiatives must be backed by a wider plan for staffing, primary care, community services and social care.

The Welsh NHS Confederation said the additional funding was welcome, but called for a “whole-system” approach to health and care.

Its director, Darren Hughes, said: “NHS leaders in Wales welcome this additional funding for the NHS to reduce waiting times and make essential maintenance across the NHS estate.

“We also welcome the Health and Care Minister’s focus on developing a long-term strategy to address waiting times. We agree that a long-term solution is required to build sustainable capacity and drive whole-system improvements.”

Mr Hughes said strengthening primary and community care would be essential, including programmes designed to move more services closer to people’s homes.

He added: “Alongside improvements in primary care, we must also prioritise the social care sector.

“We would also welcome a broader and more balanced approach to how NHS and social care performance is measured and published. Focusing solely on waiting times does not provide a complete picture, and there needs to be more comprehensive data published across the breadth of the NHS and social care services.”

The Royal College of Nursing Wales also welcomed the investment, but warned that new facilities alone would not reduce waiting lists unless there were enough appropriately trained staff to run them.

Nicola Williams, Executive Director of RCN Wales, said investment in surgical and diagnostic hubs and essential maintenance had the potential to reduce delays, improve patient experience and increase NHS capacity.

But she said: “Buildings and equipment alone will not reduce waiting lists.

“Delivering sustainable improvements depends on having the right, appropriately trained and skilled workforce in place, and nurses will play a pivotal role in the provision of safe, effective and efficient care.”

RCN Wales said nursing staff across Wales were reporting rising patient complexity and demand, missed breaks, and difficulty providing the level of care patients need.

The union also raised concerns that newly qualified nurses had faced uncertainty about securing permanent employment, despite continued pressure on services.

Ms Williams said Wales could not afford to lose the talent and commitment of a generation of nursing graduates.

She added that any move towards strengthening primary and community care must be matched by investment in the nursing workforce needed to deliver those services.

The announcement will now raise questions about how much of the funding will reach west Wales, and whether Hywel Dda University Health Board patients will directly benefit from any new surgical or diagnostic hub.

No specific locations for the proposed hubs have yet been confirmed.

 

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Health

£145m NHS Wales boost welcomed — but nurses warn staffing is key

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NEW NHS funding must be matched by proper workforce planning if it is to cut waiting lists and improve patient care, nursing leaders have warned.

The Royal College of Nursing Wales has responded to a Welsh Government announcement of an additional £145 million investment in NHS Wales.

The package includes £100 million in revenue funding to reduce waiting times, £25 million capital funding for new surgical and diagnostic hubs, and £20 million for essential maintenance across the NHS estate.

The Welsh Government says the investment is intended to increase capacity, speed up diagnosis and help more patients receive planned treatment more quickly.

Up to ten surgical and diagnostic hubs are expected to be developed across Wales over the next four years. These facilities are designed to carry out high-volume planned treatment and tests away from the day-to-day pressure of emergency hospital care.

But RCN Wales said the success of the plan would depend not only on buildings and equipment, but on having enough trained staff to run the services safely.

Nicola Williams, Executive Director of RCN Wales, said: “RCN Wales welcomes this additional investment in NHS Wales and the Welsh Government’s commitment to reducing waiting times and improving patient care and outcomes.

“Investment in surgical and diagnostic hubs, alongside funding for essential maintenance, has the potential to significantly improve our population’s health, reduce delays, improve experiences and increase NHS capacity.

“However, buildings and equipment alone will not reduce waiting lists. Delivering sustainable improvements depends on having the right, appropriately trained and skilled workforce in place, and nurses will play a pivotal role in the provision of safe, effective and efficient care.”

She said robust workforce modelling and planning would be “critically important” if the hubs were to achieve their ambitions.

The announcement comes as RCN Wales joins healthcare leaders, employers and government representatives at a Graduate Summit to discuss employment opportunities for this year’s nursing graduates.

RCN Wales said it welcomed the Welsh Government’s focus on the issue, but warned that newly qualified nurses had faced uncertainty about securing permanent employment despite continuing pressure across NHS services.

Ms Williams said: “Nursing staff are telling us consistently and across Wales that, despite there being no vacancies, there is insufficient staff to meet increasing patient complexity and demand.

“Nurses are going without breaks and feel most shifts that they are unable to give the care that patients need.

“It is therefore deeply concerning that newly qualified nurses have faced uncertainty about securing substantive employment.

“Wales cannot afford to lose the talent, skills and commitment of a generation of nursing graduates that our health and care services desperately need.”

RCN Wales said retaining newly qualified nurses was essential for the future sustainability of NHS and social care services.

The union also welcomed the Welsh Government’s commitment to strengthening primary and community care, but said any shift towards treating people closer to home must be matched by investment in the nursing workforce.

Ms Williams added: “Nurses are central to delivering care closer to home and helping people stay healthier for longer.

“Any shift in resources towards primary care must be matched by investment in the nursing workforce needed to deliver these ambitions.”

The key question for west Wales is whether any of the proposed surgical or diagnostic hubs will be located in the Hywel Dda area, and whether Pembrokeshire patients will see a direct benefit from the new funding.

No specific locations have yet been confirmed.

RCN Wales said it looked forward to working with the Welsh Government and health service partners to ensure the investment delivered lasting improvements for patients and supported the nursing workforce on which those improvements depend.

 

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