Welsh Policy Forum Consultation Document December 2004

Health and Social Care Second Stage Consultation

This is a discussion paper only. Its content does not necessarily reflect Government or Welsh Labour policy.

The challenge – a healthier Wales

“The role of the NHS as a great equaliser should be recognised and supported. ” Llanmorlais BLP

“Wales is possibly leading the way in its emphasis on public health issues and the need for individuals to take control of their own health.” Plasnewydd BLP

Our Labour values that built the NHS haven’t changed. They are still as relevant today as they were more than sixty years ago. Fairness, equity and the principle that need and not the ability to pay should determine access to care are the building blocks for the modern Welsh NHS.

Welsh Labour has made a huge investment in the NHS, increasing its budget from £2.6 billion in 1999 to £4.5billion today. By 2007-08 investment will rise to £5.5bn. Of this, £4.273bn will be spent by Local Health Boards and NHS Trusts – an increase of £665m over the next three years. Local authorities are increasing resources for social services too, with budgeted spend on social services expenditure increasing by over 12%.

Extra investment alone though is not enough. In Wales, new money has been put to work to achieve the vision which inspired the Labour founders of the NHS – a health as well as an illness service and a service which provides a fundamental building block in creating a more equal society. In this way the new investment means something tangible to patients and users, improving the quality of the care they receive, preventing ill-health in the future and providing timely treatment when that is needed. It is also because Labour recognised that investment must reach those communities with the greatest need that we brought forward a fairer way of allocating funding through the Townsend formula.

In all of these areas there has been significant and demonstrable progress since 1997.

Waiting times on our target clinical areas have improved. No patients are waiting more than ten months for cardiac surgery. No patients are waiting over six months for an angiography. Just a handful of patients are waiting more than six months for cataract surgery and, in almost all parts of Wales no-one waits more than four months. And thanks to a programme of targeted investment waits over eighteen months for orthopaedic day case / inpatient treatment have been virtually eradicated. Overall two out of three outpatients are now seen within six months.

We are on track to reach our workforce targets that by 2010 there will be 700 more doctors, 6,000 more nurses, and 2,000 more health professionals such as therapists in the NHS in Wales. As part of this progress we are on target to meet too the workforce commitments we made in our 2003 manifesto.

Alongside this we have successfully negotiated a new contract for both consultants and GP’s. The changes to be introduced by the new contracts will deliver an improved service for patients and guarantee that consultants work a minimum of 37 1/2 hours a week for the NHS.

Radical reforms have been made also to the structure of the NHS. Local Health Boards, running co-terminus with local authorities, are now responsible for commissioning local health services. Together with local government they are working with patients and users to determine local priorities and service needs. This new structure is helping to forge close links and better joint working between health and social care, ending the old barriers between the two sectors.

Local Health Boards, as part of a £30m initial investment in response to the Wanless report for Wales commissioned by Labour in the Assembly, are taking forward local action plans to improve the delivery of local services. The Wanless report for Wales has provides an essential blueprint for taking forward health and care services in Wales. The report sets out some key challenges for Labour in the Assembly about the future of services in Wales, but it also endorses our overall approach. The report rightly endorses our approach of avoiding unnecessary hospital admissions, shortening the time patients are in hospital for and delivering secondary care services across Wales that are fit for the 21st century.

Even though they don’t make the headlines there are countless other NHS success stories making a difference to patients across Wales. For example, in just the first year of the new scheme, 46,000 digital hearing aids were provided to the hard of hearing. Calls to NHS Direct increased by 19% in the twelve months to September 2004, with a total of 340,000 calls being made that help to take the pressure of local primary care services. Our Labour Assembly Government received the Award for the Advancement of Optometry from the Association of Optometrists, the first time it has been given to an organisation rather than an individual, for the initiatives brought forward that are revolutionising eye care services in Wales.

Progress is also being made towards delivering on our key manifesto commitments, with the cost of prescription charges already reduced and a start will be made in scrapping home care charges for disabled people from September 2005.

Investment in initiatives to improve the overall health of local communities is also being made. Although it is only a relatively small proportion of overall NHS expenditure its importance far exceeds the actual amount. Welsh Labour is committed to delivering a health service that does more to promote healthy living and better health through targeted investment in the communities with the greatest need, as well as universal measures to improve public health. This agenda has as much to do with the improving access to leisure and sport and to improving education and information about healthy living. More details on our policies in these areas are available in the Culture, Sport and Welsh Language and the Education and Lifelong Learning policy documents.

Third Term Priorities

Continuing to build a modern NHS fit for the 21st century will be a priority for a third term Labour Assembly Government. Welsh Labour will prioritise investment in the NHS and bring forward reforms to improve the service that patients, carers and users receive.

A key part of our third term health strategy will be to work with our UK Labour Government on the implementation of the relevant aspects of the recently published Public Health White Paper.

Welsh Labour will continue with our twin-track approach of both improving the delivery of services, including further reductions in waiting times, for example in orthopaedics, and introducing measures to improve people’s health and to tackle health inequalities. This approach will require investment across health and social care, but in particular in primary care, the acute sector and social services. A key priority will also be tackling inequalities by building on the introduction of a fairer funding formula and the Health Inequalities Fund.

Cutting the length of time that people have to wait for treatment will be a top priority. This will require building extra capacity in the health service, as well as making better use of the capacity that already exists within both the NHS and the independent sector. Alongside this we will invest in both primary care and social services to help reduce unnecessary hospital admissions, help people live independently at home and to ensure that treatment takes place in the most appropriate setting.

A continued priority will be investment in equipment and buildings. In 2003 we pledged to invest £550 to modernise GP surgeries and hospitals and over the next three years we will exceed this target by allocating a total of £674m to Local Health Boards and Trusts to invest in capital. In 20078 we will be investing £200m more in surgeries and hospital buildings than in 2004-05. Across Wales this investment is transforming local health services. For example new hospitals are being delivered in Rhondda, Blaenau Gwent and Ten by, while additional orthopaedic capacity in South East Wales is being built at Llandough and St Woolos in Newport. In November 2004 a £30m package of investment was announced to reduce waiting times. This included an expansion of orthopaedic services in Carmarthen, a new endoscopy unit at Whitybush hospital and a new day case unit in North Wales.

Another priority will be to improve the overall patient experience of health and social care services in Wales. The new powers given to Community Health Councils will help to drive up standards across the range of health and care services, but more still needs to be done to improve the overall experience of patients, carers and families. A priority for a third term Labour Assembly Government will therefore be to improve the ‘nuts and bolts’ experience for patients and their families by making wards cleaner, hospital food more nutritious and tailoring services more to the needs of individual patients.

In Wales we will achieve this by making a new partnership between the citizen and the service in which the contribution of both users and professionals is recognised and rewarded. We all have a part to play in achieving better health. Patients are not the passive recipients of care but should be kept informed about their condition and allowed to become fully engaged about their treatment and about how they can best look after their own health. An improved focus on the relationship between midwives and mothers has, for example, helped to reduce infant mortality rates in Wales. We will prioritise in our third term patients with chronic conditions that have particular requirements. We will invest in staff training to ensure that their needs are met.

Although it is a priority for all of the Assembly Government, the Health and Social Services Minister has the lead responsibility for tackling child poverty. Welsh Labour will prioritise tackling child poverty throughout its third term and we will work towards achieving the UK target of ending child poverty by 2020.

Are these the right priorities for a third term Labour Assembly Government? What other priorities should we consider?

Reducing inequalities and creating a healthy Wales

The stark differences that Labour inherited between the health of the most prosperous and most deprived communities in Wales was a national scandal. Welsh Labour is determined to narrow this gap by improving the health outcomes of the poorest communities in Wales. We will continue to support community based initiatives to improve access to healthy foods and to information on healthy living.

The improving health agenda is as much an issue for other Assembly Government Ministers as it is for the Health and Social Care Minister. Investment in health promotion and health improvement will increase to over £70m in Wales by 2007-08, demonstrating our commitment to matching our words with investment. While the roots of ill-health and inequality lie in poverty and a lack of opportunities, the solution to tackling it lies in the provision of better and more accessible services, the opportunity to take part in healthy activities and through targeted investment in the areas with the greatest health need.

Labour in a third term will continue to work in partnership through Health Challenge Wales to make Wales a healthier country. A Labour Assembly Government will continue to play its part by providing the advice, support and opportunities to enable people to lead healthier lives. Just as importantly we will continue to work with and to challenge Welsh civil society, voluntary organisations, the media and individuals to play their part also.

“It is crucial that the health of patients is monitored, there should be more screening and use made of prescriptions for local health facilities e.g. gyms and swimming baths.”Glyncorrwg Branch Labour Party

“The Inequalities Fund needs to demonstrate evidence of success so that new areas can learn what works best.” Plasnewydd BLP

We will build on the Health Inequalities Fund, having already extended existing projects by two years, to ensure that it targets those communities and patient groups in greatest need. As part of improving its effectiveness we will examine measures to use the HIF to improve staff awareness of complex chronic diseases and conditions. This is essential if we are to ensure that patients with complex health needs get the treatment that they need when in hospital and in the community. Through the Fund we will look to support innovative action by Local Health Boards, such as helping to resource prescribing physical exercise and partnerships with local schools.

In our third term Labour will look at measures to ensure that our programme of immunisation, including take-up rates, is adequately protecting our communities.

Long-term the greatest impact that we can make on improving health and tackling inequalities is to make our communities stronger and more prosperous. Our top priority for addressing these inequalities will be to tackle child poverty. This is a priority and a responsibility for every Assembly Government Minister. Our proposals for tackling child poverty are set out later in this document.

“We should be asking people about their own health outcomes and encouraging them to measure these themselves. The Society would like to see a real drive to improve self management and individual responsibility for managing health, social care and well being.” Chartered Society for Physiotherapy

Earlier intervention is an effective way to prevent longer term illness. In this respect access to primary care services is important. A third term Welsh Labour Assembly Government will continue to promote measures to encourage the recruitment and retention of GP’s and primary care dentists in areas with acute shortages. In partnership with pharmacists and other health professionals we will support the promotion of regular cholesterol and blood pressure check-ups and targeting people in our communities that are at greatest risk.

What else can we do to encourage individuals and communities to lead healthier lifestyles?

How else can we encourage people to stop smoking? How can we prevent young people to from starting smoking? How else can we encourage young people to lead healthier lifestyles?

How can the health service intervene earlier to improve people’s health before conditions become chronic problems? How can screening services be improved?

Pathways to Care

Primary care is the shop front of the modern NHS, the first point of contact in 9 out of 10 cases. It provides a range of important services and is the gateway to nearly all further treatment. Labour in Wales has one of the most demanding waiting time targets for primary care – promising access to a member of the primary care team within 24 hours. Within a year of introducing the new GP contract we are already well on the way to achieving this target, throughout Wales, during the present Assembly term.

In our first term we increased the resources available to primary care, but we recognise that building a modern service will require sustained investment in both premises and people. A third term Labour Assembly Government will prioritise investment in primary care and target resources to ensure greater equity of access in areas with the greatest health need.

We are already investing so that no-one in Wales will have to wait more than 24 hours to see a member of their Primary Care Team. Throughout this term and into a third term we will build on this success and focus on improving access in areas with acute shortages and expanding the range of services offered at local primary care premises.

Already we are widening the “range of health professionals able to prescribe drugs and we are expanding the range of treatments offered in primary care settings. These developments are helping to reduce pressure on the secondary care sector, as well as providing patients with more treatments locally. In a third term Labour in the Assembly will support innovative ways of expanding the amount of routine treatment that takes place in the community. In particular we will look to fund community based treatment and services, including physiotherapists and specialist nurses, for people with chronic diseases and expand the range of treatments that can take place in the community.

We will expand further the number of salaried GPs, together with promoting incentives to get GPs out of old, cramped premises. The new GP contract will make a career in primary care more attractive and we will continue to offer incentives to GPs to locate in areas with particular shortages. Patients also have a duty to ensure that they keep appointments or at least inform local surgeries if they have to cancel. Welsh Labour will support Local Health Boards in raising awareness amongst patients about the problems created by missing appointments.

In Wales Labour is building a modern primary care sector and we will examine initiatives other parts of the UK to assess whether they are applicable to the needs of communities in Wales. Welsh Labour set up NHS Direct to help improve the range of services available to patients. As part of a third term we will introduce measures to improve the range of service offered by NHS Direct, including services that can be provided on-line.

“One of the community pharmacy’s greatest contributions to increased health and well-being lies in its ability to support people in maintaining their own health, and in dealing with relatively minor conditions which might otherwise consume the scarce resources of general medical practice.” Royal Pharmaceutical Society of Great Britain – Welsh Executive

Of particular importance to the future of primary care in Wales will be the new pharmacy contract that if agreed will enable local community pharmacists to play a more proactive role in the health of local communities. The changes envisaged in the contract will make best use of the skills of community pharmacists and their staff in delivering modern NHS services for patients. The changes will also help to deliver our wider agenda of improving health and well-being by enabling people to live healthy and independent lives. Welsh Labour is increasing the number of nurses and pharmacists able to prescribe medicines and to help treat patients with chronic conditions such as asthma, diabetes, mental health problems and cardiovascular disease. In January 2005 a total of 85 extra nurses and pharmacists will be trained to become supplementary prescribers, taking the total in Wales to 250. We will seek to build on this scheme in our third term.

We are already providing an additional £5.3m over three years to improve access to modern dentistry services across Wales and to start the process of reforming dental services in Wales. We will use the regulatory provisions now available to the Assembly to help retain and recruit dentists in Wales and we support LHBs in addressing inequity in access. Expanding dental education further will be a continued priority for Labour, building on the 17% increase in dental hospital intake already delivered as a result of Labour Assembly Government investment. Labour recognises that people are more likely to work where they train and we will ensure that opportunities to train in Wales are a key part of our third term approach.

Already patients are able to access a range of primary care services and we will look at measures to expand the choices that patients have locally, with the aim of delivering convenient, high quality and accessible care through the NHS.

Improving access and choice is important in its own right, but it is also an essential part of reducing the pressure on the acute sector and to reducing waiting times. Increasing the alternatives to admitting people to hospital is an important element in treating people more quickly and conveniently and to freeing up the secondary care sector to perform their core tasks better. Investment in primary care must therefore be seen as an investment too in secondary care and in helping to reduce waiting and improve health.

Secondary and acute care is constantly changing. Developments in technology mean that a greater proportion of surgery is being performed on a day case and twenty-four hour basis or out-patient basis, together with more treatment being undertaken at home or in the community. As part of new investment planned announced in November 2004 four new daycase units (in Swansea, Ceredigion, North East Wales and in Conwy and Denbighshire NHS Trust) have been allocated funding.

Most people, in most parts of Wales, do not wait for very long for treatment. Nor is speed of treatment always the top priority for patients, as experience of the second offer scheme in Wales demonstrates. For a small proportion of patients, however, health service waits have been, and can still be, too long and our priority is to reduce the length of time that such patients have to wait for treatment. We understand the distress that long waits can cause for both patients and their families and we are investing in new capacity to ensure that patients wait for as little time as possible for treatment and for appointments.

The majority of patients do not wait more than six months, but we recognise that too many people are waiting too long for treatment and for appointments. A third term Labour Assembly Government will continue to prioritise reducing waits, building on the success we have had in reducing waiting times for our targeted clinical areas.

We have introduced the second offer scheme that provides people waiting for more than our maximum targets for inpatient treatment an alternative option of treatment. We will continue with this scheme as part of our overall strategy of reducing the length of time patients have to wait for treatment. By the end of March 2005 this offer will be available to patients waiting more than 12 months for inpatient or day case treatment and twenty-four hour procedures.

“Age Concern Cymru agrees with the reference for the need to make a clearer line between elective and emergency surgery to reduce the elective treatment disruption. Many older people are waiting a long-time for surgery, which will often adversely affect the quality of their lives.” Age Concern Cymru

Increasing capacity within the Welsh NHS is an essential part of reducing waiting times, as well as making better use of capacity that already exists. We will increase the amount of day-case procedures undertaken and fully utilise other available capacity to ensure patients get treatment quickly and conveniently. Labour will look to continue to build a clearer divide between elective and emergency care services with District General Hospitals and we will continue to roll out the booked admissions system to reduce the number of missed appointments and to improve services for patients.

Labour has secured a new contract for consultants that will deliver a better deal for the NHS. The terms of the contract will ensure that they have to dedicate a core week of 37 1/2 hours to the NHS. The contract also introduces a shared commitment to improve the quality of service for patients. Labour in the Assembly will continue to move forward in partnership with health professionals, while ensuring at all times that patients get the best deal possible

“It was generally felt that care in hospitals was very good. However, the Labour Government needs to integrate primary and secondary care at a planning level to bring services together.” Pontypridd CLP

Finally, we will do more to tackle the demands being placed on hospitals by expanding the range of treatments and procedures undertaken in primary care and by investing in social care to avoid unnecessary hospital admissions. As far as possible we will support people to stay independent in their own homes, as well as tackling delayed transfers of care. The £4m provided to Local Health Boards to commission social and community care places from local authorities has helped to significantly reduce delayed transfers of care. Given this success we will continue to provide direct funding for Local Health Boards to ensure patients in hospital are able to be discharged quickly into the most appropriate care setting.

Expanding capacity requires an expanded workforce. Significant progress has already been made since 1997 and we are on target to meet both our 2003 manifesto commitments and our longer term workforce targets. The most recent annual figures demonstrate the progress that we have made, with an additional 70 consultants and an additional 748 more nurses, mid-wives and health visitors.

We recognise that access to childcare is a major obstacle for many people who want to train as health care professionals and we are taking measures to address this. From 2004 between 700- 800 health care students a year will be eligible to receive an NHS funded child care allowance to help them meet up to 85% of childcare costs. This will help to widen access to health professional training and to retain more students wanting to go into the health professions. We will continue to work to expand the availability of childcare for people who want to train as health care professionals and to break down practical obstacles to them undertaking the opportunity to train.

Improving the service that patients receive requires too a change in the management of the NHS. Good management is an essential part of a successful health service, but likewise poor management leads to patients getting a poor service. A third term Labour Assembly Government will support innovative management and reward it with giving local managers additional autonomy in how to run local services. But we will also not hesitate to withdraw autonomy where managers are failing patients. The creation of the Assembly offers an opportunity to impose greater accountability on managers for the actions that they take. We will improve also local community engagement in how NHS Trusts are run, ensuring that managers are accountable to both the Assembly Government and to local people.

Welsh Labour recognises the public concern over cleanliness in hospitals. Our ten year plan for the NHS – ‘Improving Health in Wales’ – committed us to delivering modern, clean and well maintained environments for both patients and staff. National standards of cleanliness were introduced in 2003 and we will continue to monitor progress and ensure that they are delivered. These standards provide the platform for tackling all health care infections, including M RSA. We have published a national strategy for dealing with all hospital acquired infections across the health and social care sectors, with a particular focus on when patients can be most at risk in the move between the community and the hospital.

Are we effectively linking up health services in your area? How could services be improved?

How else can we encourage primary care specialists to provide a wider range of services in the community?

How can we strengthen Local Health Boards so as to ensure that they reflect the views of the local community? How can we strengthen local accountability?

How else can we reduce waiting times further? Are there particular specialities in which we need to reduce waiting times?

What other measures should we consider to control infections and to improve hygiene in our hospitals?

How can we improve the experiences of patients and their families during hospital stays?

Joined up health and social care

“Early intervention by service providers can be critical in empowering disabled people and preventing dependence.” Leonard Cheshire Society

Improving the care and the treatment that patients receive requires an effective partnership with local government. The pattern of services provided must reflect that complex long term conditions, such as Parkinson’s disease, do not fit neatly into rigid categories of care. To provide appropriate treatment the old barriers between social and health care must be broken down. Effective, joined up services can improve people’s health, improve the quality of life for carers and users and help to relieve pressure on secondary care. Likewise, a failure to join up services and to invest in social care leads to a poorer quality of life for users, longer stays in hospital and longer waiting times for hospital treatment.

“Social Services must be more responsive and equitable”. Welshpool BLP

As well as avoiding unnecessary hospital admissions our social care services must be made strong enough to provide more appropriate care for people as soon as they are fit to leave hospital. Labour is investing additional resources to reduce delays in the transfer of care and to ensure that the resources are there to find alternatives for patients who do not need to be in acute hospitals. We will continue to fund Local Health Boards to commission care places from local authorities to further reduce delayed transfers of care.

Investment in social care has significantly increased since 1999, reflecting the level of priority which Welsh Labour has attached to it. Because we recognise that improving social care require long term and sustained investment in our third term our Labour Assembly Government will continue to provide increased resources for the service.

Local authorities must attach a high priority to social services also and Welsh Labour will ensure that they deliver increased and sustained investment. We will use policy agreements with individual local authorities to ensure that needed improvements in social care are delivered. We recognise the concerns expressed in the Wan less report for Wales regarding the effectiveness of Policy Agreements to deliver improvements in social care. We will continue to monitor their effectiveness in respect of social services. More detail on policy agreements is provided in the Local Government and Public Services document.

As with health services, we need to make social services more responsive and equitable to the people they serve. Free nursing care for all nursing home residents, together with six weeks free home care for vulnerable people leaving hospital were good initial steps. We will look to build on them throughout our second term and into a third term.

Supporting older people to remain independent is another important element that requires action across the whole of the public sector. We will improve the early adaptation of homes on discharge from care and encourage older people to take up the Pension Credit. As promised at the last Assembly Election we will scrap Home Care Charges for disabled people in Wales. Through Supporting People we will continue to provide assistance for people in supported and sheltered accommodation. In its first year alone £139m was spent delivering services to a wide range of vulnerable people. We will continue using funding from Supporting People to improve support and services for people in sheltered and supported accommodation.

Improving services for carers remains an important part of reforming health and social care. We will continue to fund and extend respite care, fully assess carers’ needs and to reform NHS practices to make life easier for carers. The provision of services for carers will become part of mainstream social services and funding for this purpose will be transferred to local authority Revenue Support Grant in April 2006. There is still much more to do to support carers and we will allocate additional funding to extend respite care and to improve support services for carers. In particular we will continue to look at all ways of improving support for young carers by working with schools and the Youth Service to ensure they get the support and advice that they need.

“Training for social care staff for patients with Parkinson’s disease in Wales needs to be funded…a significant amount could be achieved in a short space of time with targeted training. ” Parkinson’s Disease Society

A third term Labour Assembly Government will introduce further measures to expand and improve the quality of the social care workforce. We recognise that without a well paid and well trained workforce we will not be able to deliver the quality of service that people need and that we want to deliver. Progress has already been made in increasing the numbers of staff with qualifications. We will build on the introduction of the new qualification introduced in 2004 by focusing on areas of the sector that still face shortages of appropriately trained staff.

Labour will continue to improve mental health services. Working with the Mental Health Network we will develop innovative solutions in primary care, share good practice and ensure that staff members are appropriately trained and aware of the needs of mental health patients. Welsh Labour will continue to promote measures to tackle stigma surrounding mental health issues. We will increase the involvement from patients and carers and improve hospital advocacy services. Welsh Labour remains committed to completing the programme of social care resettlements for people in long-stay learning disability hospitals in 2006.

A third term Labour administration will build on the success of the Better Advice, Better Health scheme that is being delivered in partnership with Citizens Advice Cymru. The scheme allows GPs to refer patients who need benefits advice and social care services to experts from the Citizens Advice Bureau. It aims to improve the uptake of unclaimed benefits, to improve the income levels for poorer people and to reduce the amount of time GPs spend resolving non-medical queries. In just the first year the scheme helped more than 6,400 clients, including some of those most in need of benefit advice such as older people, the disabled and people with mental health problems. It is an invaluable service in some of our most deprived communities and a third term Labour Assembly Government will continue to support and to build on the success of the scheme.

Labour in the Assembly places a high priority on the needs of older people, introducing the groundbreaking strategy for older people, taking forward the implementation of the Commissioner for Older People and appointing a Deputy Minister with specific responsibility for older people. A third term Labour Assembly Government will use the implementation of the Older People Strategy to improve services for older people, including the opportunities for learning and leisure. We will continue to focus in a third term on tackling pensioner poverty and inequalities between the poorest and the most affluent pensioners.

How can we encourage local authorities to continue to prioritise social services? How can we encourage joint working to improve delayed transfers of care?

How else can we encourage more people to enter the social care workforce? How can we expand training opportunities for social care workers?

How else can we improve services for older people?

Ending Child Poverty and Protecting Children

“The commitment to tackling child poverty must be reflected in the Assembly’s budget allocations. ” Coalition of child care organisations

Ending child poverty by 2020 is the defining mission of Labour in Government. It is an ambition that defines our politics as democratic socialists. A Labour Assembly Government will play our full part in helping to meet the ambition laid down by the Prime Minister. Although the Health and Social Services Minister has the lead on matters relating to children, tackling child poverty is a responsibility for every part of the Assembly Government.

As well as tackling child poverty Labour recognises the need to ensure that the needs of children are at the heart of all that we do. This is why Labour in the Assembly has signed up to the UN Convention of Children’s Rights and why, working in partnership with Labour at Westminster, we introduced the Children’s Commissioner for Wales.

Labour in the Assembly will bring forward our response to the report on child poverty in Wales. Labour understands the need to prioritise our resources to support children and families in greatest need. Resources are not infinite and we will target them at those children with the greatest need. We understand that the socio-economic status of children and their families remain the most significant determinant of life-chances. A third term Labour Assembly Government will continue to prioritise tacking income-related poverty.

However, poverty is not just about income, a fact recognised by the both the UK Labour Government strategy and the Child Poverty Taskforce report to the Labour Assembly Government. A third term Labour Assembly Government is committed also to tackling the lack of opportunities children living in poverty have to participate in their wider community and to take up leisure opportunities and organised youth and school activities (participation poverty). Furthermore, we will also look to tackle the inequality of access to important services that children living in poverty face (‘service poverty’). Widening opportunity to participate in their wider community and enabling them to have access to basic and important services will be a key focus of our work in a third term Labour Assembly Government.

Welsh Labour understands the importance of giving children the best start in life. This is why we are introducing Early Years Learning Centres in every local authority in Wales and why we have, since 1999, created 11,000 extra childcare places. Alongside this we have introduced an innovative Play Policy for Wales that has the needs of children at the very heart.

Furthermore, Labour in the Assembly will work with the UK Labour Government to build on the introduction of the Child Trust Fund. This is an important measure that seeks to address asset poverty and to give young people (from low-income families in particular) an important helping hand early in their adult life. We will look at ways in which Labour in the Assembly can help young people in Wales maximise the benefits of this important scheme.

Our focus will be to work with the UK Labour Government to tackle both the causes of poverty and the income poverty experienced by too many families in Wales. We will work to increase employment opportunities for the poorest families, giving them the skills, the training and the confidence to enter the workplace. In our third term we will expand Sure Start, childcare places and early years learning. We will focus on expanding educational opportunities for children from the poorest families by giving them the opportunity to undertake either vocational or academic study after formal schooling. In particular we will expand educational opportunities for looked after children. We have launched a major review of the support available for vulnerable children. Labour’s Neath Assembly Member Gwenda Thomas is examining in detail the measures in place to protect and support such children and the outcome of this work will be taken forward as part of our third term agenda.

Improving the quality of life for children in the poorest parts of Wales must be a priority for Communities First. More must be done to involve them in local regeneration initiatives, but ultimately the success of Communities First should be measured against whether services and opportunities for children are improved in the poorest communities. However, Communities First must be seen as just one part of our drive to eradicate child poverty by 2020. It should be a priority for all levels and agencies of government and they all have a duty to work together as part of a national, co-ordinated programme.

Inequality of income and access to finance lies at the heart of child poverty. We will support Credit Unions to help them support families to meet the costs of school uniforms, school trips and other school related financial commitments. Labour in the Assembly will also support the Department of Work and Pensions in running benefit take-up campaigns as part of the overall strategy to tackle both pensioner and child poverty.

How else can we tackle child poverty in Wales? What should other Assembly Government Ministers do to tackle child poverty?

How can we build on the success of Sure Start? What other support can be given to young parents and families with the greatest need?

How can we build on UK Labour Government initiatives to tackle child poverty here in Wales?

What else can be done to improve the life-chances of looked after children?

Health and Social Care

Responses received to the first stage consultation


Pontypridd CLP

Branch labour Parties

  • Canton BLP
  • Ewenny and Vale BLP
  • Glyncorrwg BLP
  • Llanmorlais BLP
  • Plasnewydd BLP
  • Welshpool BLP

External Organisations

  • Age Concern Cymru
  • Coalition of national child care organisations (including Barnardo’s Cymru, NCH Cymru, Children in Wales, Save the Children Fund, NSPCC Cymru / Wales, Tros Gynal) Chartered Society for Physiotherapists
  • Leonard Cheshire Society
  • Parkinson’s Disease Society Wales
  • Royal Pharmaceutical Society of Great Britain – Wales Executive
  • Wales Council for Voluntary Action

Promoted by Jessica Morden on behalf of Wales Labour Party, both at 1 Cathedral Road, Cardiff, CF11 9HA. Printed by Wales Labour Party at 115 Cathedral Road, Cardiff CF11 9HA.