The Social Services and Well-being (Wales) currently before the National Assembly for Wales is the most significant piece of legislation the institution has been asked to consider since gaining primary law making powers.

Scope, along with the whole third sector and especially our partners in the Social Services and Well-being Bill Advisory Group, has welcomed the opportunity presented by the new Bill.  The Bill will reform and integrate social services law and make provision for improving the well-being outcomes for people who need care and support, and for carers who need support. It will also increase co-ordination and partnership by public authorities to improve the well-being of people. It is therefore justifiably both broad and far reaching, covering a wide variety of issues and aspects.

However, there is one specific issue within the Bill which Scope and others are seeking more detail on – and that’s the issue of eligibility.

Indeed, the Bill’s success will very much be based on who is actually eligible to receive support through social care. If eligibility isn’t right, then issues of advocacy or regulation or anything else will not have meaning to many people because the simply will not be covered by the Bill.

We broadly welcome the intention to develop a national eligibility framework to ensure consistency across the country. It will set the criteria which local authorities will use to decide whether or not people will receive local authority funded care and support. It will be this framework that will determine the extent to which the Bill meets its objectives. The regulations will define what constitutes an eligible need and are absolutely critical to the working of the Bill.

Deputy Social Services Minister Gwenda Thomas is well aware of the importance of getting the eligibility criteria right. At the start of April she announced to the Health and Social Services Committee of the Assembly that the current eligibility criteria based on definitions of low, moderate, significant and critical levels were “past their sell by date.” She has promised instead to introduce the new national outcomes framework in early June.

In the new framework, Scope Cymru strongly believes that setting the threshold at the equivalent of the current “moderate” criterion is essential to achieving the aspirations of the legislation.

This would ensure disabled people receive not only the basic care and support they need, but also that they are able to take an active role in  their community – as set out by the definition of well-being in the Bill. If the national threshold were to be set at a higher level than moderate or its equivalent, the Bill would fail in its intentions to promote well-being.

Setting the threshold at “moderate” or its new equivalent is essential to ensuring that interventions take place when an individual’s needs are lower rather than their condition deteriorating. This is both beneficial to the individual and is an effective use of resources. Conversely, if the threshold is set too high, a larger proportion of people are likely to need more expensive services for a longer time period. Upcoming research set to be published which we have undertaken with Deloitte’s proves this point.

Beyond this too is the need to ensure that the new criteria are consistently applied.  Our experience suggests that interpretation of the current criteria varies widely between authorities. The Deputy Minister is well aware of this point and said that “the inconsistency that has developed between one authority and the other … is not sustainable.”

All of this is at the heart of the Bill, because unless you get eligibility right then you cannot ensure consistency and reach. Assessing individuals is directly related to this. There is an urgent need for all local authorities to adopt a standard approach and process when assessing and allocating resources to people’s social care needs. This would help to ensure consistency and equity across the country. A standard approach would be helpful for assessors, the individual, their families and carers and providers and would make the portability of assessments across local authority boundaries much easier.

We all want to live in a world of opportunity – to be able to live our own life, play our part and be valued for the person we are.

At Scope Cymru we’re passionate about possibility. It inspires us every day and means we never set limits on people’s potential. Getting the definition of eligibility right in the Social Services Bill is critical to realising this potential.

Ian Thomas is Director of Scope Cymru.

There were a few eyebrows raised last week when the Health Minister, Mark Drakeford AM, talked of problems of older people ‘bed blocking’ at A&E wards.

Setting aside the unhelpful pejorative language about older people, there is a serious point that we need to treat and care for more people (of all ages) at home or in the community rather than in formal and costly NHS or social care environments. This is an area where the Social Services & Wellbeing (Wales) Bill could prove influential, as it paves the way for a much greater emphasis on preventative services.

But what do we mean by the term preventative services?

The Bill talks of services which “contribute towards preventing or delaying the development of people’s needs for care and support”. The spectrum is wide and subjective, and rightly so – we need to allow people to decide what works for them, and what they feel helps them to retain their independence. For the older people with whom WRVS works, all they want is a little bit of help, which might take many forms – the Older People’s Commissioner has stressed the importance of companionship and support networks, Age Cymru have stressed the benefits of providing help with jobs around the house and garden, and the Institute for Welsh Affairs have praised services tackling loneliness and isolation. All are ‘preventative’ if they help older people to live happily in their own homes without the need for formal and costly residential care.

Research clearly tells us that only a more preventative agenda will be sufficient to respond to current and future pressures caused by changing demographics. We also know that older people themselves see a clear benefit in preventative services, with one recent study showing that older people prefer to receive domiciliary care than to be admitted into residential care. Elsewhere, the British Red Cross have said that their low-level support services alone can delivered savings of between £700 and £10,430 per person.

These supportive noises are not siren voices in the wilderness, or fringe groups with vested interests. Within Wales, the ever-growing consensus on prevention and early intervention includes the BMA Cymru, the SSIA, Public Health Wales and the CSSIW and Healthcare Inspectorate Wales.

So given the clear mandate, what needs to change?

The Social Services & Wellbeing Bill looks set to create a duty for councils to provide some sort of preventative care, and that should be thoroughly welcomed. Yet it is unclear whether these services will be free, and who will be entitled to receive them. These are fundamental questions which have to be answered before the Bill can be properly evaluated.

The charging issue is crucial. For older people to have ‘voice and control’ (in the current lexicon), they need access to information and advice at the earliest stage, prior to any formal assessments. They will obviously be deterred from doing so if they are charged simply for seeking advice. There needs to be a clear commitment in the Bill to ensure there is no charging for information and advice services.

An equally explicit statement is required on eligibility. For some time, local authorities have been gradually raising the threshold at which people become eligible for support – which means those falling below the threshold are less likely to get the help they need. The Bill talks of standardising the eligibility process, but is silent on where local authorities should set the bar. For prevention to become embedded in the system, any changes to eligibility must go hand-in-hand with a commitment that councils must not reduce the number of people receiving preventative support.

The Social Services & Wellbeing Bill is the biggest shakeup of social care in Wales for a generation. But it will only be truly successful if it delivers the shift in favour of preventative care which has repeatedly been shown to be necessary.

Dr. Ed Bridges is Public Affairs Manager for Wales, WRVS

In 1998 the passage of the Scotland Act signified what the then Scottish Secretary Donald Dewar called “the settled will of the Scottish people.” It created a Scottish Parliament on a model which has required no repeal or significant alteration since, though of course the events of a referendum before the end of this Parliament may change that.

The constitutional settlement for Wales in the same period has, in contrast, been anything but settled.

So inimical were the flaws of the Wales Act 1998 that by 2006 a wholescale replacement was required. Most of its provisions, such as the creation of a distinct Welsh (Assembly) Government as a legal entity and the introduction of a pathway to full legislative competence, gained widespread and cross-party approval. Less consensual by far was the provision that candidates would no longer be able to stand for both constituency and regional list seats. This provision, which was never replicated for Scotland, was trumpeted by Labour and attacked by the opposition parties in both the Assembly and Parliament for the way in which it would impact upon every party apart from Labour. Arguably, the demise of key Assembly politicians like Helen Mary Jones, Nick Bourne and Jonathan Morgan is directly attributable to that rule change. Job done for Labour then…

By 2014 we can expect a third Government of Wales Act, exactly eight years after the last one repealed the previous one.

The scope of this new Wales Bill is not intended to repeal its predecessor but rather to amend it. There will be a switch from four to five year terms for the Assembly (in line with Parliament), and a ban on Members of Parliament or Peers being AMs. Most tantalisingly the Bill also offers the potential to legislate on the outcomes of part one of the Silk Commission report relating to the financial powers of the Assembly.

This last provision is hugely significant but it is of course the clause in the Bill which would repeal the 2006 electoral changes which has exercised the attention of most politicians and commentators. Watching Labour hailing the change as an affront to democracy and the opposition parties in the Assembly describe it as a restoration of democracy this week has all felt a bit like déjà vu. It is the same argument as 2006 all over again. And the obsession with this part of the Bill will, if it continues, obscure serious discussion and examination of the other provisions in the legislation in the same way it did eight years ago.

As the recent three year row over changing Welsh constituencies at Westminster also demonstrated, perhaps the real settled will of Welsh politics is to focus on electoral arrangements from a party political perspective at the expense of everything else.

Daran Hill is MD of Positif Politics. He is also a Trustee of the Bevan Foundation.

The case for everyone to be paid at least a living wage is overwhelming.

One of the first political tricks I learnt was that when you look at a proposition, consider the exact opposite and see if it makes sense. This would produce “people should be paid less than the living wage” which lacks fairness, social justice, economic understanding and is not likely to be popular.

I don’t believe that it makes sense that the government enforces a minimum wage that is not considered enough to live on, which is why I believe the living wage is desperately needed.

The living wage currently stands at £7.45 for workers over 21 in the UK excluding London and £8.55 for London compared to the minimum wage of £6.19 for people over 21 which is being increased to £6.31 from October 2013. Whilst the absolute difference is relatively small the effect it can have on the lives of people is far greater.

One of the biggest problems facing us in Wales to today is in-work poverty which is something the living wage would address, and one of the Westminster Government’s biggest problems is paying in-work benefits which, again, paying a living wage would address. I believe that the government has a moral duty to ensure a decent standard of living for all – a study by the Resolution Foundation shows the Treasury would save over £2 billion a year if all workers were paid at least the living wage. 

The following statement of opinion has been raised in the National Assembly by myself and  Mick Antoniw AM, supported by other Assembly members representing Labour, Plaid Cymru and the Liberal Democrats:

 “Recognizes the principle of a fair day’s pay for a fair day’s work; Notes that current council pay rates force many low-paid council workers into claiming tax credits, free school meals, housing benefit and council tax benefit to support themselves and their families;

 Believes that paying low-paid employees a living wage of £7.45ph would help to combat in-work poverty and promote sustainable standards of living;

 Welcomes the decision taken by some Welsh local authorities to introduce a living wage and encourages all remaining local authorities to consider implementing a living wage for all low-paid employees and subcontracted workers”

Labour’s Westminster Leader Ed Miliband has offered his support for the living wage, claiming that Labour would offer tax rewards to companies who began paying their workers the increased rate.  The Labour leader said in a Guardian interview “that companies could be offered lower business rates or tax relief on training programmes in return for boosting their staff’s pay packets”.  Ed Miliband also supported the idea of living wage zones, which would see certain industries or geographical areas institute the living wage where a significant proportion of companies supported the idea.

The benefit for employers is given by the Living Wage Foundation report that says “A Living Wage Employer ensures that all employees are paid at least the Living Wage. This includes individuals who work on a regular basis at your premises for a subcontractor, such as cleaners or security staff. 

Living Wage employers report improved morale, lower turn over of staff, reduced absenteeism, increased productivity and improved customer service. Between them, the employers committed to paying a Living Wage have lifted more than 45,000 families out of working poverty”

Our ambition for Wales must be to create a high wage and high skilled economy.  Becoming a living wage country would be one further step along that road. We cannot afford it, and it will cost jobs has been the argument used against all progressive change from the abolition of slavery to the minimum wage.  We won the battle over the minimum wage, and the loss of jobs that was predicted to occur did not materialise. It may have reduced sales of top of the range cars but it put money in people’s pockets and helped local economies.

I believe that the economic and moral imperative is to set the challenge to make Wales a living wage country by 2020.  It would make Wales a fairer country and this is a policy that all of us living in Wales could be proud.

 Mike Hedges is Assembly Member for Swansea East.

The support offered to disabled people is undergoing a revolution. As our report for Disability Wales, published yesterday, outlined, thousands of disabled people will be affected by major changes to Disability Living Allowance, Employment and Support Allowance and Housing Benefit, as well as by a myriad of less well-known changes such as loss of Severe Disability Premium and Disabled Tax Credit, and uncertainty over the future of the Independent Living Fund. And many of the benefits received by disabled people are also affected by the cap on the uprating of benefits – effectively a real terms cut – although some benefits are protected. 

The financial impact on many disabled people will severe. 

Some disabled people will be affected by not one change to benefits but several, potentially losing almost all their income as well as associated benefits such as eligibility for a Blue Badge.  A disabled person whose impairments are moderate could easily not only lose their Disability Living Allowance but also their contribution-based Employment and Support Allowance after a year. He or she would have no income, relying totally on family and friends for food, clothing and heating, even though he or she may still not be fit for work.

Disability is being redefined

Underlying the changes to benefits is the most worrying change of all – the redefinition, by stealth, of disability itself. Disabled people have fought hard over many years for a focus on disability equality, rights and empowerment, with an emphasis on a social rather than medical understanding of disability. 

But the new benefits regime is based on rigid and arbitrary tests of what a disabled person can or cannot do. 

The Work Capability Assessment is the embodiment of this.  In it, the magic number is 15 – with this number of points or more, a person is entitled to claim Employment and Support Allowance. Less than 15 points, he or she is fit for work.

So, if someone cannot ‘mobilise’ for 50 metres without stopping, he or she gets 15 points and can usually claim ESA.  If they can mobilise for, say, 60 metres they only get 9 points.  Now, 60 metres isn’t very far – at normal speeds it’s less than a minute’s walk.  Despite this, someone who can mobilise for 60 minutes will be found fit for work. It is people with moderate impairments who, despite quite significant difficulty doing everyday tasks, are no longer able to claim disability benefits. 

Only severe impairments are classed as disability

The idea that only severe impairments count as ‘disabled’ is reinforced by the daily news reports of scroungers, cheats and frauds, the vast majority of which involve disability benefits.  Claimants who do not have something visibly wrong with them are vilified – even though they may have a heart condition or mental health condition that severely limits what they can do.  Even worse, what can be quite severe health conditions are equated with every day aches and pains just because they involve the same part of the body. ‘Bad backs’ are the epitome of this as if conditions such as spinal stenosis (look it up – it’s no joke) are the same as a twinge after a spot of gardening.  

It seems that a disabled person has to conform to the stereotype of being a wheelchair user who cannot talk or feed themselves if they are to warrant society’s support.  It’s back to the ‘poor cripple’ idea.  

Clearly there are different types of impairment with some people able to do much less than others and who need more support. But the rigid division of disabled people into “properly” disabled people – who get the magic 15 points – and the “scroungers” – who don’t – rolls back our understanding of disability to the Victorian era. 

Meanwhile, the questions of improving access to employment for disabled people, to eliminating discrimination and ensuring that everyone can fulfil their potential no matter what their condition is swept to one side. 

Victoria Winckler is Director of the Bevan Foundation. This article draws on a report prepared for Disability Wales. For further information visit www.disabilitywales.org

Photo: Walesonline

The big-wigs of political and civic society converged for a momentous event on Wednesday.  No not the one at St Paul’s, but at the Pierhead, for a conference to discuss the ins and outs of the second part of the Silk Commission.

As has been done many times before and will continue to be done in the future, the Welsh devolution settlement was to be dissected and scrutinised. However, as Professor Richard Wyn Jones indicated in his keynote speech, continuously talking about the “rules of the game”, or in this case, continuously discussing the structure of the devolution settlement in Wales, is not very healthy.  But when will we actually be able to get on and play the “game” itself?

A “jagged edged” settlement was the sound-bite of the day.  The mishmash that is the conferred powers model of devolution means that the competency to legislate has repeatedly been called into question and will most probably be questioned in the future, with other Welsh Government bills likely to follow the path of the Local Government Byelaws Bill in its referral to the Supreme Court by the Secretary of State.

The consequence of this “failed model of devolution” is that there is great pressure for the next change in the settlement to be the right one and, according to most of the rhetoric on this topic, the right model is the Scottish model. Where there is confusion and complexity in the Welsh model the reserved powers model in Scotland is clear, something demonstrated in the complete absence of referrals of Scottish legislation to the Supreme Court by the UK Government.

However, we are quick to blame the devolution model when perhaps the problem lies in elsewhere. The lack of capacity, communication and general “tools to do the job” was a common thread of concern in all policy areas under discussion and indicated that before any decisions on policy devolution are made, assurances are needed about the equipment needed to play the game.

As the perpetually used Ron Davies reference asserts, devolution is a “process not an event”, but unless achievable changes are proposed and implemented in Wales and a conscious move away from “failed devolution” is made, that process may never end.

Naomi Williams is a consultant at Positif Politics. The conference was organised by Positif Politics, WCVA, Public Affairs Cymru, the UK Changing Union project and the Bevan Foundation.  

Image: Welsh Government

In my view, the Social Services and Wellbeing (Wales) Bill is a very welcome and progressive piece of legislation, particularly as it represents a major step forward in the process of changing the way people in Wales receive social care and support.

It’s no secret that over the years, social services in Wales has been faced with a number of fundamental challenges, especially as we have an aging population leading to an increase in service demand.

I’m pleased that the Welsh Government recognises this in the form of this ambitious Bill, which aims to transform the current system to better meet the needs of service users as well as deliver a sustainable, high quality social care system for the future.    

At the last Cross Party Group in February, I had the opportunity to discuss the draft legislation in further detail with fellow AMs and colleagues from the public, private and third sectors.

I’ve also had the chance to reflect further on the Bill and come up with some potential suggestions and ideas that I believe would  strengthen this legislation to further benefit both those that receive and those that deliver social care services in Wales.   

One of the major themes of this Bill relates to prevention and early intervention. The Bill introduces a duty on local authorities, facilitated by Local Health Boards, to provide information, advice and assistance to help people understand what is available locally,  how they access help and, where necessary, to be assisted to access care and support.

Firstly, I believe that there needs to be more clarity on what is meant in terms of prevention; this will be essential in getting the Bill right in terms of achieving individual outcomes and objectives. In particular, more clarification is needed around preventative services, along with how they will interact with assessment, eligibility and charging for services.

Although I strongly welcome the inclusion of preventative services in the Bill, I do believe there is concern among some organisations and bodies that it is not currently clear enough as to who would have access to preventative services. For instance, at what point a person will be deemed to have ‘care and support’ needs, and how this will promote real prevention and early intervention.

I feel that the legislation needs to identify more clearly the steps that are envisaged to provide proportionate support to people, and the relationship between preventative services, assessment and the eligibility framework. Once this is clear, I believe that it will be possible to identify when eligibility and charging can be applied, as well as ensuring there are no unfortunate unintended consequences. After all, the proposals for preventative services will not bring benefits to service users if the threshold for accessing them is set too high.

It’s my view that an indicative definition of preventative services on the face of the Bill would help to ensure provision of both general universal prevention and more targeted individual-level prevention.

Despite positive intentions, I do think that the wording of the Bill could be strengthened on the need for a person centred approach; this could, for example, be done through provisions that require the active involvement of people throughout their experience of care and support services, co-production of care plans and outcomes, and promotion of options that are available to exercise voice and control.

A further comment I have relates to the provisions in the Bill that allows local authorities to charge for information, advice, assistance and preventative services. There is some concern about these powers, particularly as there is a strong belief that information and advice should be free, independent and accessible. This is a basic principle that I would wholeheartedly agree with. I therefore hope that the Welsh Government will be providing local authorities in Wales with guidance and advice over charging for such services. 

On a final note, there is some concern that the role of service partners (such as Local Health Boards) remains unclear, and there is uncertainty over whether the Bill extends the role of partners beyond that already in place.

It’s my belief that without a meaningful relationship between local authorities and the health service, there could be potential conflicts about charging. Although the Bill provides for local authorities to be able to charge, LHBs will be unable to charge. This could possibly cause conflict in terms of joint working between health and social care rather than encouraging cooperation. It’s therefore advisable for the Welsh Government to consider implementing guidelines, or developing a strategy, towards resolving any potential issues that may arise as a result.

Despite my suggestions, I’ve no doubt that this Bill will make a significant and positive difference to the lives and well-being of people who need care and support, as well as carers who equally need support. It’s likely that all of us, at some stage in our lives, will come into contact with social care services, whether it be for our own needs or for the needs of loved ones and friends; that’s why it’s reasonable to want this ground-breaking Bill to be the best it can possibly be in order to meet our needs and desires as a civilised society. 

Mike Hedges, AM, Chair of the Cross Party Group on Older People & Ageing and former WLGA spokesperson for Health and Social Services.

Image: Cardiff Met University

There are just 5 days left for organisations and individuals in Wales to tell the UK Government that “equality’ isn’t red-tape but a fundamental requirement of a fair society.  

Nearly a year ago, Home Secretary Theresa May announced a review of the part of the Equality Act 2010 that requires public bodies to have “due regard” to equality in the provision of services.  The idea was that, when deciding how to allocate council housing, say, or which social care services to cut, public bodies would have to demonstrate that they had taken account of the needs of people with protected characteristics.  That the review came out the UK Government’s “Red Tape Challenge” should indicate that the review is not looking to strengthen the provisions of the 2010 Act.  

The closing date for submitting evidence is 19th April 2013.  

The review not only includes the GB-wide general equality duty, but also looks at the specific duties that are devolved to the Welsh Government.  However, the review’s steering group does not appear to include any member with a remit for Wales, nor, despite the claim that the review will seek evidence from stakeholds in devolved nations, does there seem to have been much active engagement.  (Happy to be put right on this however).

The risk is that if the general equality duty is removed then the Wales-specific duty will fall as well.  

As well as the general, GB-wide equality duty on public bodies, there is an additional, Wales-specific duty on devolved public bodies. Welsh Ministers can (and indeed do) set out additional requirements on local authorities, health boards and so on, so that, for example, Welsh public bodies have to address the gender pay gap and publish a strategic equality plan inlike their English counterparts.  But if that part of the Equality Act that specifies the general duty is removed, then the Welsh duties will go as well. Like it or not, Welsh Ministers would lose power over equality in Wales.   

The public sector equality duties are far from perfect, with many feeling that they encourage a tick-box approach and don’t mainstream equality issues. But they’re all that there is at the moment, and having been in place for just two years it is, frankly, simply too early to say if they really are a burden or have no impact.

It is vital that organisations from Wales submit their views.

The review needs evidence on the equality duties including evidence from organisations in Wales. Don’t wait – the deadline is 19th April!  The Assembly Committee on Communities, Equality and Local Government is conducting a short review of the future of equality and human rights.  

More information about the Public Sector Duty review is here.

The Equality and Diversity Forum has a useful briefing and template for responses here.

 Victoria Winckler is Director of the Bevan Foundation.

Image: Wales Online

On 10th April Elaine Morgan was awarded the Freedom of the County Borough of Rhondda Cynon Taf. What this world leading feminist, radical and atheist thought of some of the procedural pomposities, pastors and lieutenants abounding, she was too polite to say.