A National Health and Care Service

One of the greatest achievements of the 20th Century was the creation of the National Health Service so that illness, accidents or disease should not produce the threat of financial debt.

Plaid Cymru believes that we need the same approach for all personal care. Whether because of age, disability, temporary illness or chronic conditions many of us will require help with daily living. Some of us might need a safe space to live in and be cared for on a permanent basis. Our ambition is that personal care should be free at the point of need.

Although our services need more investment Wales can be very proud of the care services currently offered to people living at home and in residential care. For those of us currently cared for by these services or with loved ones in this position, the dedication of the staff is no surprise but Covid-19 has opened the eyes of many to the hard work, innovation and challenges of providing home care support, nursing care in the community and quality of life for residents in care homes. Our ambition is make sure that those working in caring are rewarded and recognised as they deserve and that they have the autonomy and funding to provide the high quality care services they can be proud of.

It is distressing for people to have to stay in hospital or suffer while services argue about whether care needs are ‘social’ or ‘health’ and who will pay for the care package. Why should a person with dementia who requires 24 hours personal care support in toileting, movement to prevent pressure ulcers, support with feeding and drinking be told their needs are not healthcare needs and NHS funding is not available? The current system is unacceptable and cannot be defended.

To achieve our vision, a Plaid Cymru Government would:

  • Establish a Commission to explore ways we can source extra money to fund the creation of a seamless Health and Social Care Service, free at the point of need. The Commission will report within a year and consider Plaid Cymru’s preferred option of using general taxation. It will also consider a levy-based Social Care Fund on the lines suggested by economist Gerald Holtham.
  • Task our new National Health and Care Service to establish national frameworks for the delivery of all aspects of health and care, and for seamless integration of delivery on a local level, bringing together local government and health boards in new Regional Care Partnerships.
  • Reform the care assessment process so it focuses on identifying personal care need, and is no longer based on arbitrary definitions of ‘health’ or ‘social’ care.
  • Set out national expectations for the individual living contribution (or ‘hotel’ costs) required – and more importantly set national milestones for reducing and eliminating this aspect.
  • Invest in the range and quality of care in the community by extending Section 25B of the Nurse Staffing Levels (Wales) Act 2016 to cover community nursing and increasing the number of district nurses and nurses with a community master’s degree.
  • Work with providers to ensure care workers pay, terms and conditions are brought progressively into line with those of NHS staff, starting with making a £10 minimum wage mandatory for any care provider in receipt of public funds and addressing sick pay.
  • Raise the profile and status of nurses and nursing care in care homes by increasing nursing student placements in care homes alongside the development of career pathways to specialist and consultant posts in Older People’s care, Infection Prevention and Control and dementia care.

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