HSC(6)-09-22 PTN 8

Y Pwyllgor Iechyd a Gofal Cymdeithasol

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Health and Social Care Committee

Senedd Cymru

Bae Caerdydd, Caerdydd, CF99 1SN

SeneddIechyd@senedd.cymru senedd.cymru/SeneddIechyd

0300 200 6565

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Welsh Parliament

Cardiff Bay, Cardiff, CF99 1SN

SeneddHealth@senedd.wales senedd.wales/SeneddHealth

0300 200 6565

Eluned Morgan MS

Minister for Health and Social Services Julie Morgan MS

Deputy Minister for Social Services Lynne Neagle MS

Deputy Minister for Mental Health and Wellbeing

28 October 2022

Dear Ministers

Welsh Government Draft Budget 2023-24

In line with our usual practice, I am writing in advance of the Welsh Government’s Draft Budget 2023-

24 to request written information to inform our scrutiny.

We note the Welsh Government’s intention to publish the Draft Budget on Tuesday 13 December 2022, and will be inviting you to attend an oral evidence session early in the new year. The clerk will

liaise with your offices about dates.

To assist in our scrutiny, I would be grateful to receive your response to the issues outlined in the annex to this letter, and any other written information you would like to provide, by 14 December

2022.

Yours sincerely

Russell George MS

Chair, Health and Social Care Committee

Croesewir gohebiaeth yn Gymraeg neu Saesneg. We welcome correspondence in Welsh or English.

Annex: request for information from the Welsh Government to inform scrutiny of the Draft Budget 2023-24

Commentary on actions and detail of Budget Expenditure Line (BEL) allocations

A breakdown of the 2023-24 Health and Social Services MEG allocations by Spending

Programme Area, Action and Budget Expenditure Line (BEL).

Indicative Health and Social Services MEG allocations for 2024-25 and 2025-26.

Commentary on each of the Actions within the Health and Social Services MEG, including an analysis and explanation of changes. The baseline for this purpose should be consistent

with the baseline set out in the budget narrative and expenditure tables.

Other information

In addition to the four usual themes of value for money, prioritisation, preventative spending and affordability, and an indication of how the Well-being of Future Generations Act 2015 and its five ways of working have influenced the budget allocations for health and social care, the Committee would like to receive information on the following (where not already covered in the commentary on each

Action).

Putting people at the heart of health and social care

Please provide details of how the draft budget allocations for primary care services, including investment in the primary care estate and primary care networks, will contribute to the Welsh Government’s policy aim of shifting care from hospitals to primary care or community settings. How will you assess whether the allocations are achieving the

intended outcomes.

Please provide details of the allocations in the draft budget for prevention and early intervention, and how you will assess whether the allocations are achieving the intended outcomes. Will the allocations enable a ‘whole system’ joined up approach to improving people’s health and wellbeing, in addition to targeting resources (and achieving

measurable outcomes) in areas of key concern.

Please outline how your priorities for mental health and wellbeing are reflected in the draft budget across Welsh Government portfolios and MEGs, and how the impact of the allocations will be assessed to ensure they are achieving the intended outcomes. Please

also provide details of:

Any reductions or increases relating to specific mental health allocations compared to

previous years (e.g. grants being reduced or increased, or being introduced or removed).

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§ Allocations in the draft budget relating to mental health services; children and young

people’s mental health and wellbeing; dementia; autism and neurodiversity; and

implementing ‘Healthy Weight, Healthy Wales’.

How will the draft budget allocations mitigate the public health impact of the rising costs

of living, including the impact on the physical and mental health and wellbeing of people in Wales, unpaid carers and the health and social care workforce.

Innovating for improvement

Please outline how the Draft Budget will support the development of a ‘whole system approach’, with greater integration of health and social care, as described in A Healthier Wales. In particular, please explain how the Draft Budget balances the need to meet existing service pressures with the need to transform services and develop new models of

care.

How will service transformation and integration be supported in the longer term to achieve sustained progress on the transformation agenda, ensure a focus on rolling out and mainstreaming the learning from successful pilots, and avoid reliance on continued additional funding. How will the Regional Innovation Fund be deployed and what

measurable outcomes is Welsh Government expecting?

Please provide an assessment of the revenue and capital costs of delivering the Welsh

Government’s vision for digital and data, as described in A Healthier Wales, and including increased support for digital and virtual care. This should also include details of spending on digital which has been funded through the Regional Innovation Fund, and details of

the proportion of spending through the RIF that has been spent on digital and data.

Health and social care workforce

Please explain how the Draft Budget will contribute to the delivery of a sustainable health

and social care workforce, and will reduce and control spend on agency staff.

What provision has been made in the draft budget to build and maintain the morale and physical and mental health and wellbeing of the health and social care workforce, including volunteers and unpaid carers, and how will you assess the impact of these

measures.

Health inequalities and inequities

Please outline how the Draft Budget will contribute to the reduction of health inequalities, This should detail how the Draft Budget will ensure that the most disadvantaged are prioritised, and that there is fair access to health and care services in rural areas. The Committee would also welcome information about how the Draft Budget will target inequalities which have been exacerbated by the pandemic, or those resulting from a disproportionate impact of the pandemic on the health or wellbeing of particular groups (such as older adults, people from black and ethnic minority communities, or people on

low incomes or who are otherwise financially insecure).

Delivering a post-pandemic reset

Please explain how the pandemic has influenced allocations to budget lines within the Health and Social Services MEG, and provide examples of any changes made to

allocations as a result of COVID-19. In answering this question, please address:

The assumptions underpinning allocations made as a result of the pandemic, including

how you will ensure there are sufficient contingency funds in place should the situation escalate from Covid Stable to Covid Urgent.

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Allocations that have been made to support additional service capacity or additional staff

resource as the response to the pandemic continues, including primary, community and hospital services, social care, public health, and the vaccine programme.

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Allocations for mental health support services for the health and social care workforce.

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Allocations that have been made to ensure the maintenance of an adequate and

appropriate supply of PPE.

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What allocations are included in the draft budget for tackling the waiting times backlog. In your answer, please explain what assessment has been made of the impact and outcomes of resources allocated during 2022-23, and how allocations in the 2023-24 draft budget

will be targeted.

Social care

Please outline the planned allocation for social care, including:

Any additional funding identified for 2023-24, and how such funding will be targeted.

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How the allocations will ensure the ongoing viability and stability of social care services,

including residential and domiciliary care.

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§ What support the draft budget will provide for unpaid carers, including evidence of

specific spend on respite care and financial support for carers.

§ Measures in the draft budget that will improve the sustainability of the social care

workforce.

§ How the draft budget will help the social care sector to respond to rising costs of living, including rising energy costs. In your answer, please provide evidence of specific spend to support domiciliary care workers, and unpaid carers and disabled people, and their

families.

Local health boards’ financial performance

Please provide an update on the overall financial performance of health boards. This

should include:

§ The projected end of year financial position for health boards, including identification of

those that have continued to fail to meet their financial duties

§ Those that have been in receipt of additional end of year and in-year financial support, the

extent of that support and the planned duration.

§ Details of how the Welsh Government will support and work with health boards to bring

NHS Wales back into financial balance.

§ Information about what provision is being made in response to rising energy costs.

Impact of the draft budget on particular groups and communities

How have you taken gender budgeting into account in this budget when preparing your

expenditure plans.

Please outline what assessment has been made of the impact of the draft budget allocations on particular groups or communities, including women and girls, black and

ethnic minority communities, children and young people, and older people.