How much should we pay for care?


It's been described as an oil tanker of a piece of legislation.

There are around 800 amendments alone for the Social Services and Well-being Bill.

It's the biggest piece of legislation to have gone through the assembly so far.

Unlike the Human Transplantation Bill, which introduced a system of presumed consent for organ donations, there's no one overriding principle here.

Instead, this could be seen as one giant tidying up exercise of a multitude of regulations and rules governing the care of the elderly, vulnerable children and the well being of carers themselves.

Up until this point, much of this has been done on an ad-hoc basis or covered by legislation for Wales and England.

Much of this provides a framework for Wales-only legislation for the first time.

The one big area it touches on is the eligibility of people to have the costs of their social care covered by local authorities and health boards.

Currently that can depend on where you live.

The big ticket item here is social care for the elderly, particularly in areas like dementia.

Care Forum Wales, the main body which represents care homes in Wales, says it will help remove the post-code lottery that governs the eligibility of social care.

But there's no answer to the question of what the exact criteria will be.

Crucial details like that will be worked out at a later date, much to the concern of the leader of the Welsh Liberal Democrats Kirsty Williams who says there should already be some kind of indication of what the outcome of this policy will be.

The bill, being debated tonight, will continue its progress through the assembly next week.

One of the really big questions - separate to this bill - that remains unanswered is how the Welsh government will help families in future deal with some of the huge costs associated with social care.

In England there are plans to cap the amount the elderly will have to pay for social care at £75,000 in 2017.

There will also be a rise from £23,250 to £123,000 in the amount of assets people have before having to contribute to the costs of basic nursing care.

A decision by the Welsh government is expected later in the year.

Nick Servini Article written by Nick Servini Nick Servini Political editor, Wales

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  • rate this

    Comment number 14.

    #12 sorry not shouting - my son in law an Anaesthetist tells me its only teaching hospitals that have this constraint, there is no reason local hospitals cannot operate as normal as satellites to the big teaching hospitals - but here in Wales the politicians would rather condemn patients (and relatives) to long distant travel even if it cost lives

  • rate this

    Comment number 13.

    Cont. "Whatever did we do before? " We had dentists operating and giving anaesthetics. We had the Dr Finlays of this world operating on kitchen tables. We had 'general surgeons' who would fix a hernia in the morning and do your varicose veins after lunch. We had the Australian Flying Doctor, doing operations to radio instructions.

    We didn't have audit, so mortality post-op ???

  • rate this

    Comment number 12.

    #11 Don't shout at me. I didn't dream it up. I am just pointing out that this is the current reality. Imposed by the various Royal Colleges. I didn't say an anaesthetist with 5years experience as a Registrar can't give an anaesthetic without a consultant in earshot. The College did.
    So, you are right: Maternity cannot be provided locally any more.

  • rate this

    Comment number 11.

    Boxer - stop and think about what you've written.

    Because the NHS career/training structure dictates every patient has to be treated at a teaching hospital no matter what their needs. Because no Dr, not Consultant status cannot work unsupervised away from a teaching hospital.

    So Paediatric, Maternity, Heart, etc. facilities cannot be provided locally any more.

    Whatever did we do before?

  • rate this

    Comment number 10.

    #9 You haven't understood my #8.
    It isn't enough to have registrars under the nominal control of a consultant 25 miles away, or even available at home at the end of a telephone. To get approval as a training establishment, there must be 24-hour consultant cover. No approval , no junior doctors. No juniors, no consultants.

  • rate this

    Comment number 9.

    Boxer #2
    Better to have a Consultant commute than the very sick (especially very young children) stuck in ambulances for up to 3 hrs. on rural roads.
    We live in an age of instant communication, there are better ways.

    The problem is, the Senedd is shutting down services that work, and do not have the vision to find a better answer.
    Worth remembering when faced with this argument, John Redwood did.

  • rate this

    Comment number 8.

    Closing local NHS facilities in this rural dispersed county, is idiotic.
    Basically, WAG has no choice. You won't employ consultants unless you give them a team of junior doctors. Modern training requirements mean junior doctors must work under supervison. Hence at least four consultants in each speciality. To make these big teams econonomic, you need a big hospital, or at least a big unit.

  • rate this

    Comment number 7.

    An important bit of legislation that will impact more than the NHS and Education.
    But how many would trust the Senedd with a paddle boat let alone a Tanker.

    Closing local NHS facilities in this rural dispersed county, is idiotic, Condemning many, an example of the Senedd's failure to manage major services affecting peoples lives

    Perhaps Social Services another area that should not be devolved

  • rate this

    Comment number 6.

    #4 " how much failure even the sheeple can stand "

    'Sheeple' Is that Welsh dialect or a typo? I am not being sarcastic, just basically ignorant.

  • rate this

    Comment number 5.

    ... my concern relates to the quality of advice used to formulate the legislation, can Carwyn be certain, did his advisors tell him what he would prefer to hear rather than the pragmatic truth ?

    I agree with dispozest, this legislation will have little room for forgiveness, get it wrong and any response will be savage.

  • rate this

    Comment number 4.

    The clowns in the Bay Bubble have the capacity to get this SO wrong it may yet be their undoing! I hope!

    There's a limit to how much failure even the sheeple can stand and when you start screwing up the lives of the old and the sick it has a nasty habit of coming back to haunt you!

    This really could bring people out on the streets...

  • rate this

    Comment number 3.

    #2 The idea is attractive: reduced gas bills on the Costa Brava. However, given the property scares lately, some form of protection scheme would be needed. Also, an ex-pat community is fine for the fit retirees, but Spanish speaking staff for the bedridden would increase social isolation, with relatives 700 miles away.

  • rate this

    Comment number 2.

    An answer ?

    Spain has almost 3 MILLION unsold homes, mainly hotel type blocks, situated quite near the coast

    How about buying up some of these potential 'homes' for use as low cost old people's homes for the Welsh?.

    Lot of Spanish/Welsh care workers available, and as its a buyer's market, these 'homes' are ridiculously cheap

    With that weather our old folks would be queuing up !

  • rate this

    Comment number 1.

    a UK wide issue in reality despite it being devolved. with an ageing population and smaller pot to share around, there are no easy answers.



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