Cynulliad Cenedlaethol Cymru

Welcome to today's meeting of the Children, Young People and Education Committee. As of earlier this week, Gareth Davies MS and Tom Giffard MS have left the committee and have been replaced by Natasha Asghar MS and Joel James MS. I would like to thank Gareth and Tom for their time and contributions to the committee's work, and to warmly welcome Natasha and Joel. You're very welcome. The public items of this meeting are being broadcast live on Senedd.tv. A Record of Proceedings will be published as usual. The meeting is bilingual, and simultaneous translation from Welsh to English is available. Are there any declarations of interest from Members? I can see there aren't.

We'll move on now to agenda item 2. I'm very pleased to welcome Jeremy Miles MS, Cabinet Secretary for Health and Social Care, Dawn Bowden MS, Minister for Children and Social Care, Sarah Murphy MS, Minister for Mental Health and Well-being, Sioned Rees, temporary public health protection director, Albert Heaney, chief social care officer for Wales, Alex Slade, director of primary care, mental health and early years, and lastly, Hywel Jones, director of finance. Welcome. I would like to take this opportunity to thank the Cabinet Secretary, Ministers and their officials for their timely and comprehensive response to our request for information about the draft budget. We know that it takes a lot of time to respond. It is really helpful and very much appreciated.

I will now start with the first questions. I'll direct my question to the Cabinet Secretary for Health and Social Care, please. Other than the funding for children's mental health and neurodivergence assessments that are referred to in your written evidence, can you give us other specific examples that show how children and young people will benefit from the increases to the NHS budget, please?

Thank you, Chair, and thank you for the opportunity of giving evidence in relation to the health and social care budget. The budget for health and social care in the next financial year will have seen significant increases, which the committee will have seen from the budget documentation and the evidence, and that's in addition to the additional funding that's been made available this year to tackle, in particular, waiting lists, access to services and women's health. The priority for the budget for next year is to make sure that we can put the service in all its facets on a sustainable footing, recognising the increasing demands on the budget and the inflationary impact on the costs of the national health service more generally. A significant element of the new funding is in relation to pay and pensions for the workforce, and that obviously enables the service itself, in general terms, to be more sustainable, but clearly supports children's health in a wide range of other ways as well. There are specific elements in the budget, as I'm sure we'll come on and talk about in more detail, in relation to the childcare offer, in relation to Flying Start, the points that you have mentioned today. We have commitments to the Designed to Smile programme for children in school for their dentistry, which I know many colleagues would have seen at first-hand. So, there are a number of specifics in the budget where children and young people will benefit by virtue of putting children's health on a more sustainable and stable footing as part of that overall approach.

Thank you. Are there any contingency plans that have been put in place for children's healthcare services so that children's healthcare services are not cut and will address an immediate crisis in other areas of the NHS?

You mean the risk of cuts in children's services at the expense of other services?

Yes. 

Well, we have a requirement that—. The way the budget works, as colleagues will know, is we delegate funding to NHS health boards and other organisations, and they then discharge that budget, spend that budget, allocate it to reflect population needs, including the needs of children and young people. We expect them to do that having taken a full account of the particular needs of their particular local population. Alongside the budget there is a planning and performance regime, part of a planning framework that I've issued this year, just before Christmas. It has some specific things to say about children's health, which I'm sure the committee, if it hasn't yet had a chance to consider, will be keen to look at, and if a health board is planning on making a material change, then we would expect that to be the subject of a risk assessment, as any change of that sort would require to be made across all disciplines of the health service.

Brilliant, thank you. What independent reviews or audits are in place to assess where the funding for children's healthcare is adequate and being used effectively?

Well, I guess the answer to that is in a sense the same answer. We have the planning framework, which sets out our expectations of the system. This year we've tried to strike the balance between saying there are some absolutely key priorities that the NHS needs to focus on for the next planning period, and I've set out in my letter very specific requirements, as I said, many of them, or some of them, specifically in relation to children and young people. There is then a planning process that flows from that that enables us to evaluate the plans that health boards present to us, and we have an opportunity to challenge that to decide whether we are happy to approve those plans or otherwise, and sometimes they're approved, sometimes they're not. So, there is an iterative process that enables us to satisfy ourselves that the judgments being made in general by health boards are ones that are sound and ones that we can support as a national government.

Okay, thank you. My next question is on unhypothecated funding to health boards. This committee is interested in whether children get their fair share of the significant amount of unhypothecated funding to health boards, and when asked about this by us last year, the Minister then, Eluned Morgan, told us that children and young people are ring-fenced within that planning framework. Subsequently this was corrected by the Minister in writing, and we were told the ring fence was not financial. So, as the new Cabinet Secretary, have you reconsidered ring-fencing a specific portion of the health budget exclusively for children's services?

Well, I think that would be a challenging approach, Chair. The premise of the system that we have in Wales is that the Government sets the policy requirement for the health service, and the outcomes that it expects the health service to deliver, and the health service is held accountable for that through a very comprehensive range of accountability mechanisms, but the principle at the heart of it is that local health boards are in a better position to assess the health needs of their local population than the national Government is. That’s the central premise of how the health service operates in Wales, and so it's challenging, then, to be specific about ring-fencing pots of money for particular purposes. It is true to say that at a very, very high level there are some mechanisms in place—so, mental health is one where there is a floor; it's not a ring fence, it's a floor, effectively—and when we have committed additional funding for particular purposes—. So, the planned care programme, there's a very significant sum of money dedicated specifically to that and it is ring-fenced, but that's at a very high level. What we don't do is systematically ring fence funding for particular groups or demographics within the community. We expect health boards to assess the needs of their local population and, frankly, that can vary in different parts of Wales, and they're better placed to do that.

I should say, just for completeness, there are particular examples of much smaller grants where, clearly, they are for a specific purpose. I mentioned Designed to Smile, for example. That is, effectively, ring-fenced, but at a general level we feel that's not the best approach. 

Thank you. Thank you for those comprehensive answers. Do any other Members have questions for the Minister? No. Over to Carolyn Thomas, then, please. 

Sorry, I've—

Sorry, sorry, it's Cefin Campbell. Sorry, I wasn't thinking then, sorry.

You caught me on the hop. But I would like to come in, though, just on that point. 

Sure. 

Okay. Very often, it comes across that Welsh Government is accountable and you get challenged, don't you, in the Senedd regarding funding and why aren't you intervening on this, that and the other.

Yes.

So, that was a really important point that you made that Welsh Government is there setting high-level policies and budgets, but on certain matters the health boards are the delivery body, so it's up to them to make sure that they use that funding in the best way possible. So, that was really, really interesting, the way you described how certain grants and budgets work. So, as a new member to the committee, for the second time, I thought that was really interesting. Thank you.

Could I just supplement my answer there? At the end of the day, what we are absolutely most interested in is the outcomes. So, ring-fencing is about inputs, isn't it, effectively? But what we are all, I'm sure, most interested in is outcomes and we have a very comprehensive range of ways in which we measure whether health boards are meeting their obligations to children, so vaccination programmes, healthy weight initiatives. There's a whole plethora of those and we are able to measure, obviously, outcomes against that and, to some extent, the spend that children and young people can benefit from after the event, if you like. 

I should just say as a general approach, Chair, that there's a new clinical lead for child health that has recently been appointed to the national executive, which I think will help us bring a lens to all of these questions that relate to children and young people, even stronger than we do at the moment. We are developing at the moment a quality statement for children's health as well that will bring a number of these things together, and it may be that the committee has an interest in that in due course. 

That would be good. Thank you.

Thank you. Thank you for that information. Now over to Cefin Campbell. We haven't had two 'Cs' on the committee before, but now we have. Cefin Campbell. 

Thank you, Cabinet Secretary. The Cabinet Secretary is absolutely right, of course, the local authority budget is set by the local government main expenditure group, and that includes, primarily, the funding for social care. And it's the local authority's statutory responsibility to deliver social care services for children. However, they do that within the framework that we set as a Welsh Government. So, much of the children's services, children's social care services, of course are governed by legislation. So, they're regulated, they're covered by legislation, whether it's the Social Services and Well-being (Wales) Act 2014, the Children Act 2004, whatever it might be. So, there is a statutory obligation on the authority. What they then have to do is to work within the budget that's allocated, to make sure that they deliver within the terms of the statutory requirements and within the Welsh Government policy around how those services are best delivered within the legislative requirements.

So, as the Cabinet Secretary has already alluded to, we do have currently a significant programme of transformation for how we deliver children's services, and we work very closely with the local authority to ensure that that transformation programme is delivered by them. How they do that, and within their budgetary constraints, is a matter for them, but we've got very clear objectives, which we speak to the local authorities about on a regular basis, and, I have to say, in a very co-operative and collaborative way. And since I've been in post, I've not had discussions with any local authority that says that they don't agree with the direction of travel that we're trying to take in terms of transforming children's services, which is all about preventing children going into care unless that is absolutely necessary. So, yes, the budget is set by local government, but the policy direction is from us, and we work very closely with local authorities to ensure that that policy programme is carried out.

What I'm trying to tease out of you is, by giving them some policy direction, and potentially giving them more money, what exactly are you expecting them to do with that extra funding?

We absolutely expect them to be delivering the policies that we're setting out. So, I'll give you a 'for example'. We're currently taking a piece of significant, quite groundbreaking, legislation through the Senedd, as you know—the Health and Social Care (Wales) Bill on the elimination of profit in children's services. Now, to a large extent, Welsh Government is having to support local authorities to deliver that, and that is what we are doing—we have put additional money in to deliver those very specific objectives.

Okay, that's useful. Thank you. My final question is about the role of the Minister for children. In advance of this session, we asked for an explanation of that role, in terms of monitoring the spending on children outside the health and social care portfolio. So, we are deducing from the response that the Minister holds no specific role in relation to the draft budget, for example in holding other Cabinet members to account in terms of making sure that children get their fair share of funding. Is that correct? Are we reading that in the right way?

Well—. Again, I'll defer to Dawn in a moment, but the role of the children's Minister is to be the voice of children around the Cabinet table, effectively, and that is my experience of the conversations we have at Cabinet. I think of my own former role as Welsh language Minister: I wasn't responsible for every single thing the Government does that touches on the Welsh language, but I did have a role in making sure that all other Cabinet colleagues recognised the centrality of that policy area to their work. I would have regular discussions with them, I'd bring papers to Cabinet to make sure that we were all focused on that. I suppose it's a version of the point I was making earlier: it's about the outcomes rather than the inputs. But I won't put words in Dawn's mouth.

No, no, no, no. But that is absolutely right, and I think it's probably important to say the Rights of Children and Young Persons (Wales) Measure 2011 requires all Ministers, regardless of their portfolio, to have due regard to the United Nations Convention on the Rights of the Child when they're exercising their functions. So, it's not for me to scrutinise other Ministers, or hold them to account for their budgets; they have their own responsibility for that, and through the scrutiny process, they will be scrutinised and held to account for what they do with their budgets. But the Cabinet Secretary is absolutely right: in Cabinet, when any Minister or Cabinet Secretary brings forward proposals that would impact on children or children's rights, then I would contribute to that discussion and to the development of that policy and how it's delivered. I think having a Minister with 'children' in the title gives that focus. It gives a focus that makes sure that all other Ministers are more conscious of the need to take account of a specific element. It's a bit like if it's not said, if it's not spoken, it's kind of ignored. But, clearly, all Cabinet Members know that there is a Minister that has a specific interest and responsibility for ensuring that children's rights are considered by everything that they do.

Thank you. Could I ask the Cabinet Secretary, please? You mentioned a children's health statement. Is there a time frame for when this will be published? A quality statement.

I'll ask one of my colleagues to—. We might need to write to you about that.

Yes, that's absolutely fine.

It's in development at the moment, certainly, but we might need to let you know separately, if that's okay.

Yes. Fantastic. Thank you. Now questions from Vaughan Gething, please.

Thank you. Bore da, Cadeirydd; bore da, pawb—good to see you all. My questions are directed at the Cabinet Secretary around children's health early intervention and prevention. You touched on this a little earlier about the additional money the overall department has received and the priorities you've set out on waiting times and access. I'm particularly interested in how you're looking to accelerate progress in reducing paediatric waiting times, but in relation to diagnostic and specialist services. First of all, you've talked earlier about inputs, outputs and outcomes. What outcomes do you expect, not just in terms of reducing the waiting times, but what outcomes do you expect in terms of helping to address long-term development delays for children? So, how you've assessed the money you've got, the money you've allocated to the area, what you expect to see happen, how you expect to hold health boards to account, and what that will do in terms of waiting times, but then your expectation of what that will actually deliver for better outcomes for children.

So, I suppose there are two aspects to that. On the waiting lists aspect to it, if you look at the reduction in two-year waits over the last, I think, two years, the cohort in which that has reduced fastest is in paediatrics—children and young people, essentially. That's the kind of age range in which it has reduced more rapidly, and that's because there's been a particular focus on it. But, to your point about how do we make sure that remains the focus and how we are accountable for that, I met very recently, before Christmas, with the new clinical lead in the NHS Wales Executive with responsibility for children's health, and one of the things that I think we do need to do is bring that lens more consistently across all waiting lists, to make sure we understand the different experience of children and young people on those lists from adults, and that is work that she is going to be leading on for us.

For the additional funding that's been put into the system, there are specific targets that we are monitoring on a weekly basis with the health boards, so we can make sure that they are on target, or if not, that we are able to address that. So, there's a very specific monitoring arrangement in relation to that. I suppose one of the areas that has been most focused on—I'll defer to Sarah in a moment, if I may—is on neurodevelopmental assessments, where there has been a specific allocation of funding to all health boards in relation to that. That funding is being allocated on the basis of presented plans rather than a general allocation, and those plans also have very specific outputs in terms of numbers of additional assessments over the time frame. So, there's a very rigorous framework for us to look at that.

And just on your outcomes point, I absolutely recognise that tackling waiting lists is one aspect to it, and I think it's fair to say, in the ND space, what we really need in that space is a transformation of the service, really, and there is a programme under way to deliver that as well. But perhaps on the detail of that, I can bring Sarah in.

Yes, absolutely. So, to answer about the outcomes, I suppose the outcomes with the waiting lists for neurodivergence is that we want them to come down. But, ultimately, the real outcome is—and you will all know this from the inquiries that you've done—that it's not a diagnosis, it is an assessment, and that assessment means a lot to children, young people and their families. I was talking to the National Autism Society yesterday, and they were saying, 'We've raised so much awareness, but now we have to ride that wave towards understanding and acceptance.' I guess it comes back to the point as well around the money. This is a whole portfolio, and this is a whole Cabinet piece of work, but we do recognise—and that's why that £3 million has been allocated.

Now, this was based, then, on health boards coming back to us with plans on what was actually realistic for them to be able to deliver. So, off that now, it's actually opened up the door for really having those serious conversations, because the assessment that we've got from the NHS executive is that we're going to see, by March 2027, between 41,000 and 61,000 people waiting for these assessments. So, the awareness has led to that need for that assessment. So, the £3 million, then, we will know by the end of March, they're working very hard, and I think there was a lot of enthusiasm, honestly, in the system, to give that real boost, to bring down the longest waiting times. It will benefit the children and young people who have been waiting the longest, and the money then is dependent on the delivery.

So, it'd be useful, given you've mentioned the impact you expect the clinical lead to have, once that work has been done, for the committee to be informed, not just about the work in discursive terms, but what you expect the impact of that work to be. And with the plans to be delivered, it would be useful to know what your expectation actually is. So, not just, 'We expect things to get better', but have you got a measurable impact or expectation? Because, as Sarah Murphy has pointed out, the NHS executive review points out that demand is increasing, so how you expect that the service transformation and the money going into that will actually make a difference, and over what sort of time frame. And if you don't have those figures available now, then when you expect to get them and how you measure that against the budget you're allocating, to understand whether the budget you're allocating meets the need that you understand isn't currently being addressed, and I understand that's why the service transformation work is looking to take place.

Absolutely. So, some of that information is already available and we can certainly provide that, but to your point about the work of the clinical lead, it's a comparatively recent appointment, so we'd be very keen to keep the committee updated on that work and provide whatever information you find is helpful.

And I'm still interested in how you measure wider outcomes in developmental delays and impacts on children, and how you expect changes in waiting times to make a difference to those wider—. And, again, how you measure them and how you understand them. The difficulty always is, because the health service does so much for so many people, there will always be someone who probably has a poor experience or a story to tell, but to understand the overall picture and how you understand and measure that, and then what you look to do to address the issues that aren't the services that we'd want to see provided. And we don't have that in the budget, but I need to understand how the budget looks to get you to that point, and what you as a Cabinet Secretary expect to see happen.

So, there are two stages to that. We can provide the information about the outcomes we're expecting, and then the separate piece of work, which is a slightly longer piece of work, is the quality statement, and we can keep the committee up to date on developments in that.

And the next point is about the workforce. Because, in most of what we say, you need a workforce to deliver it, and we know there are challenges in the workforce. The Royal College of Paediatrics and Child Health have called for a review of the child health workforce, lots of stakeholders talk about a crisis, but no-one can get around the fact that there's a real challenge. So, to deliver what we've got, how you expect to both keep the staff we have got, how you expect to be able to develop those staff and to introduce new ones, both in training new staff, but also recruiting new staff. So, I'd like to understand how you expect the budget to help you to do that and whether you have any measures or milestones in place, in terms of what you expect to see happen with that workforce and the scale of the workforce to address the scale of the challenge.

Sure. Well, I think, in paediatrics generally, over the last decade, probably, there's been a huge increase, certainly at the consultant level, in terms of paediatrics, and the number of training places has increased consistently over the last four or five years—recognising that. But I absolutely accept the point that you're making, Vaughan, around the need to have a holistic understanding of what the workforce needs are, and that is in, as you've just said yourself, a complex organisation, operating in a changing environment, with new levels of demand coming in, both in ND, but also more broadly. But there is also new technology and the opportunities—. It is unlikely to be like-for-like replacement of posts into the future. Health Education and Improvement Wales are doing a review of the paediatric workforce for us at the moment. We will look to see what that review tells us about changes we need to put in place in the future.

And will that review of the workforce be published and available? I'm sure the committee would be interested, not just to see what they say, but then what the response from you as a Cabinet Secretary is, and how that goes into what you're looking to do, both for training new staff in the future as well as the potential for recruitment.

I'd be very happy to share that with the committee if you'd find that helpful.

Great. And then you mentioned new opportunities and different ways of working. There's a point here about investing in infrastructure and, again, the Royal College of Paediatrics and Child Health have made a specific call for better utilisation of child health data and how child health records can be digitised. It's a long-running challenge for every health Secretary to try and get a better health record, for understandable purposes. I'm trying to understand if you've got a portion of the draft budget that you expect to go into this area, to both improve the infrastructure available, the use of the records we already have and the infrastructure we already have, but in particular whether you're looking at new technology, facilities or research to be used to try to make sure we do get to both high-quality and preventative care in its broader sense for children and young people.

So, the budget contains a number of allocations in relation to digital initiatives. Some of those are broad-based initiatives. The national data resource is a good example of that, and that will support all services, including paediatric services. But there are some projects under way that have a specific relevance to children and young people. So, the Welsh nursing care record has in development a specific module for paediatric in-patient forms in particular. So, there's a mix, really.

I think what has, frankly, been a challenge in the past, as you will know very keenly yourself, is that the lack of availability of capital has been a massive constraint on our ability to make the progress that we want to make in digital. Things are beginning to change in that space, so there will be more capital available next year, but there are still a lot of calls on that, and it is not adequate to meet the level of our ambition in digital, generally.

Sarah leads on digital and I'll ask her to come in in a second, but on the data point, this is exactly one of the points that I raised with the new clinical lead. Clearly, to understand the impact of waiting times on children or the configuration of services on children, we need to have, I would say, a better way of collecting data specific to children and young people, to identify their particular experience. We discussed specifically how we can bring that lens to the data that we capture. It isn't just about what data we capture—we're pretty good at that—it's about having an intelligent analysis of the data that you've got, so that is also one of the workstreams that the NHS executive is taking forward under her direction. But do you want to come in on digital?

Well, again, I think the committee will be interested in what that work delivers.

Sure.

Because you're right, the NHS collects lots and lots of data, but the use of it and how you expect that to improve outcomes, and again how the budget helps you to do that, would be of real interest in the updates from the clinical lead.

Certainly.

Absolutely. Just to come in as well, just to point out that it is not just out of the Welsh Government budget either. I recently met with Cardiff and Vale, and through the work with the Welsh Local Government Association, which invested money, and the regional partnership board, which invested money, they've now got a really good child-centred link-up between all of the data from community, from education, and that they collect from social services. So, that's giving them a really good picture of that child and their needs. So, I think the committee would be really interested to find out more about that, but also how they funded that—they took responsibility for that. And that gives you a picture then. And as we know, and as you'll know, the link between being in school, between mental health, between attainment—. It's all really linked.

So, I think that that’s been excellent, and that’s the kind of best practice that we’re looking for, but also looking at other ways of funding and it being the responsibility of everybody. And, then, also, just to add on that we have the electronic health record as well, which is moving ahead. And we have an EHR club that is very much leading on this. So, that will also be of huge benefit, because we’ll be joining up all of the data, and having that across the nation.

And I’m interested in how the data then leads to better services, and how the money flows to deliver those, or indeed, a better organisation. I won’t get into how you save money, or whether you just spend money more efficiently—I’m sure Hywel could talk to us about it for a long time. [Laughter.]

But, on additional money, the vaccination programmes have got another £2 million.  

Yes. 

The draft budget obviously doesn’t tell us what you expect that to deliver, or why the £2 million figure has been chosen. So, could you tell us how those funds have been allocated, why the £2 million figure has been chosen, what particular vaccination programmes, and how children and young people will benefit from those, because, obviously, vaccinations aren’t just for children and young people?   

No, indeed. So, the funding is there to do a number of things. It’s obviously to meet the requirements of the national immunisation framework in general terms, and to meet the costs of inflationary pressures in terms of vaccination as well. There are some new changes in the system—either recent changes that require funding next year, or the new changes next year, which have a budgetary implication. So, for example, we’ve just introduced the new RSV vaccination a few weeks ago, which obviously benefits newborn children specifically. That requires funding into next year as well now. And there will be some changes to the vaccination schedule next year as a consequence of Joint Committee on Vaccination and Immunisation advice. We’ll share information about that in due course, but that does have a budgetary implication, which this is intended to address.

What I would say on that particular point is that Public Health Wales, as you will know, do an annual report on vaccination, and I’m very concerned. Uptake, as ever, is good across Wales, but we will all be concerned about the inequities or inequalities that underlie some of that. And, as you would probably expect, unfortunately, the uptake in more disadvantaged communities is not as high as it is in other communities. What I want to see is whether we can use that rescheduling next year to find ways to try and close that gap to some extent, so I’ll be asking PHW to help us with that as well.

One of the things I’m interested in is vaccine take-up, because, overall, you’re right, the level across Wales is good, and, in lots of areas, better than in England, for a number of different reasons. But the inequality that exists—. And every time there is a measles outbreak, which sometimes happens—England have had more, so they’ve lost their measles-free status, which has affected the UK with the World Health Organization—it is largely about people not taking it up in less advantaged communities. So, I’m interested in the money you’ve allocated and how much of that goes to address that, or whether, actually, you’re looking at different ways, that aren’t necessarily about money, to try to improve uptake, because we all understand that vaccines are a hugely effective public health intervention.

So, specifically then, part of that will be to fund the new scheduling, because that has a budgetary cost. And what I’m hoping we’ll be able to achieve is, through that new scheduling, to find ways of using that to increase uptake, really. And I’ve tasked PHW specifically, on the back of the report that they’ve provided, which is annual—I’m sure the committee will see it if it hasn’t already—to help us think about how we can think of new ways to try and close that gap, and to understand what the practical interventions are. They’re not—. There’s a bit of a temptation sometimes to think this is a sort of behavioural challenge. It’s not just behavioural; there are systemic challenges as well. So, I want us to have a fresh look at what we can do, and, again, I’d be very happy to share that with the committee as well.

I think that would be very interesting for the committee, to understand the work that Public Health Wales have done, your response, and your assessment of what’s behavioural and what’s systemic, and, again, how money can and can’t help that, and what else you then expect to see happen, because that will make a difference in outcomes.

Sure. 

But the final question from me is about obesity—a really significant challenge for the whole country. I can’t understand from the draft budget whether you’ve allocated money specifically to address childhood obesity, and, again, how much of this is about money, how much of this is about systemic challenges, behavioural challenges, the wider food environment, attitudes to exercise—all these things matter—but to understand how you’ve allocated the money to try to address what is a really significant public health challenge for today, which will make a big difference to the how the health service is able to run and function for a long time to come.

So, I’m interested in what that looks like, and then I may have a follow-up.

Sure. The budget for the healthy weight programme is generally sustained at the same level as it was last year. However, in the many discussions I've had with the team since I've come into this role, the one statistic, the one piece of information and data, that I found most terrifying is that about 27 per cent of five-year-olds in Wales have issues with overweight or obesity. Now, that's a terrifying figure, both for those individuals, but also for our ability as a system to deal with that in the long term and the consequences of that. That's one reality. The other reality is that internationally there is no country in the world that has been able to reverse the growth in obesity. There are two or three countries who have been able to make a material difference in slowing down the growth, and they're countries with particularly healthy food cultures, I would argue.

So, the position is very stark, but the conclusion that I've drawn from that with the team is that where that leads you is that the most urgent work actually needs to be in childhood obesity, because actually that's where you do see international success, and we also see that can change the behaviour of parents as well, indirectly. I also happen to think—this is a personal view—that when we talk about the importance of making sure children are healthy and not obese and not overweight, those messages are better received by the public than the messages Government is able to give in relation to overweight and obesity generally, and I think that provides an opportunity for us to reframe the discussion to some extent. So, whilst the budget overall remains the same, what I think you will see when the plan is published in the spring is more of a focus on childhood obesity and overweight. And, you know, that isn't principally in the behavioural space, is it? As you were saying yourself, that's around, I think, the new opportunity we have in schools with the universal primary free school meals policy, to reconnect healthy food with the life of children, but also the high in fat, salt or sugar advertising work that's already under way.

I would be interested in how you're looking to implement measures in the framework you've got, but also the evaluation of it to understand the impact of those. And the final question from me is just to pick up on what you said about being frightened about the figure on childhood overweight or obesity at the age of five, and to understand how that leads to the budget choice to essentially keep the budget at the same level. So, is it that you don't think the budget is the challenge, and you think there are other interventions, and, if so, I think it would be useful for us to understand what those interventions are, and how you expect them to be effective, and equally over what time frame? Because parents of young children are likely to be much more motivated to do something; I think your broad point is a fair one. But how does that then lead into both the budget allocation and then how you're then setting priorities where the budget isn't necessarily the only thing that can deliver change?

Absolutely. Well, there are two points to that. Firstly, the overall budget is set at the same level, but what you will expect to see is a larger proportion of that being spent on tackling childhood obesity, but I don't think it is just about budget, and it definitely isn't just about the health budget, certainly. Actually, it's about a broader range of interventions across the Government, in truth, so partly in education. You could make the case in planning. I think Wales is the part of the UK with the fastest growing hot fast food presence on the high street. So, there are not behavioural, just structural, choices that can be made. Those are often really difficult to do, but I think that's where some of the solutions are. The active travel budget, for example, will be important in this, won't it? So, I think it's a cross-Government approach. When we publish the new strategy in the spring, we'll obviously have more to say then about metrics and evaluation, and obviously we'll be happy to come and talk to the committee if it finds it helpful.

You're going to want to keep people with you, because part of the challenge is that, for a lot of those interventions, there will be a group of people who will say, 'This is the Government telling me what to do with my life—why on earth should you make these choices about my life, as opposed to supporting me and helping me?'

Absolutely.

And there's a danger, isn't there, that it sounds like lecturing, not helping?

There is a real danger of that, and that's really why I started in the way that I did, talking about the opportunity that I think—. And I hope I'm not being naive or overly optimistic about it, but I do think there is something in the quality of the messaging that authoritative voices, or whoever they are, give in relation to supporting the health of children, which is heard differently from Government messages in particular about, 'Do more exercise', or 'Eat less fatty food.' I think people do hear that very often as preaching. It's really complex. But I think that people hear it differently in the context of children. So, I think that there's an opportunity for us to look at it from that fresh perspective, I hope.

I'll stop there and I'll resist the temptation to give anecdotes about my own life as a parent. [Laughter.]

Can I bring Carolyn Thomas in?

I was just going to say that the Petitions Committee are looking at a petition calling for a ban on smartphones in schools, and we heard that, rather than using the word 'ban', schools have smartphone-free areas or they're a phone-free school, rather than saying that they're banning phones. And we're hearing that children are attending school non-verbal, having too much screen time and are taking information from their mobile phone devices, maybe on health issues as well. I was talking earlier to that lady over there. So, I think that's part of it as well, myself. Sorry, it's not a question, it was just a—[Inaudible.]

If I can come in as well, I also have responsibility for the Food Standards Agency and energy drinks, and so we have recently been able to publish the consultation that we did on energy drinks for under-16s. There's a lot of research there to show that that is having a huge impact on young people, from a physical perspective and obesity, but also hugely for mental health as well. So, that's something that I would like to keep the committee updated on—

Yes, please.

—as we progress that, because I think that that could be very significant. But it comes back to all of the comments that have been made and the comments that you've made, Carolyn Thomas: how do you present that in a way that doesn't feel as if you're lecturing people? It's true.

Can I just make one point, finally? I think the other point, Vaughan, to say, is that I think that, by looking at it from a children's perspective, that helps rebalance the contribution that behaviour change and structural systemic change can make to the challenge. I think that that takes us down a route that says, 'Well, actually, we have to make it easier for people to make the right judgments', rather than be trying to change individual behaviour quite so much.

Thank you. We now have some questions from Joel James, please.

Thank you, Chair, and thanks, everyone, for coming in this morning. If it's okay, I just want to pick up a few questions with the Minister for Mental Health and Well-being, just regarding your responses to some of Vaughan's questions. Did I hear correctly you mention that the waiting lists for neurodivergence could be up to 41,000, 46,000? 

Yes. So, currently, as of September 2024, there were 20,770 children on the waiting list. We don't have the more recent data at the moment, as we're going through this period of trying to bring those waiting lists down. But, yes, modelling then, using demand and activity data up to March 2024, it suggests that the number of children and young people waiting for assessment could increase to between 41,000 and 61,000 by March 2027 without further intervention.

You mentioned there then 'without further intervention'. So, what are you looking to do, then, to intervene, if that makes sense, to sustainably manage that figure?

Absolutely. So, obviously, I've already touched on the £3 million—up to £3 million—for the health boards to bring down those longest waiting times, and that was very much in line with the exercise that the First Minister did over the summer, and knowing that this is an absolute priority. But, at the same time, we have done a national accelerated design event, which was really good. It was over a couple of days. It brought together stakeholders, health boards, everybody who has a part to play in this, because we all recognise that this cannot continue and we have to change. So, part of that—. I've had the initial response back, but I will be able to share, then, what's come out from that design event.

You mentioned there, then, that one of the responses that the health boards have done with that extra £3 million is to bring forward plans, really, as to how they're going to look to tackle this. Can you give us an idea of what has been included in those plans, and have there been any other outcomes from that funding? And also, is that funding just a one-off funding, then? Could these health boards expect more in future?

No. To be very clear, the £3 million is one-off funding, and that was because, again, it was part of the overall objective of the Welsh Government to find the areas where we feel that the waiting lists are having the biggest impact and to bring those down across every health board. So, the letters then went out to all of the health boards in early November, and they've had to bring back plans on the likelihood of them meeting the targets that we have set. A lot of this has been bringing in capacity, and it has been bringing in capacity from the private sector as well. But obviously, that is just not sustainable. I think what’s been really helpful throughout this process has been looking at the health boards and the ones that have the longest waiting lists and really getting into those discussions with them, with my officials, meeting on a weekly basis, about, 'Why is this the case, and what extra do you need to be able to address this going forward?' And some of this will be around the changing of the model—using the work sector that we have currently more effectively. It will also be planning more for the future and it will also be about collaboration across health boards and across Wales.

With that in mind, I know that the Welsh Government have said that they want to do 2,000 additional assessments by March this year. Is that a target that's being met?

At the moment, we are getting the data through; we need to validate it, though. They are meeting with officials on a weekly basis. If it’s okay, Chair, I will bring Albert Heaney in at this point, as he will be the person who will be leading on this.

Thank you very much, Minister. Thank you for the question. You're absolutely right: the health boards have put plans together, working with officials and the NHS executive, as requested by the Minister, and there is confidence that they will deliver an additional 2,000 assessments on the longest waits by the end of March. Importantly, the money is on condition that those are delivered. So, it’s coming the other way around, shall I say, on this occasion. So, it’s not money that’s given out and then they ask—the money is on delivery, which is really important. There’s a lot of confidence around that. That is really helpful for those with the longest waits.

But really importantly, as the Minister says, the energy—. And I’m really pleased that there is a lot of co-production, there’s lived experience, there’s a real energy around this, because I think there’s recognition from all parts of this that it can’t just be about focusing on assessment—there has to be a focus on the models, the earlier interventions, the different pathways. So, I think we’re really pleased that there was an accelerated design event held towards the end of November; there’s a comprehensive report that’s just landed on that, Minister, which we will be going through, and we have a day set aside in January to analyse and then offer further advice to the Minister on next steps. Thank you; diolch yn fawr.

Thank you. Chair, if that's okay, I was just hoping I could ask a few questions on child and adolescent mental health.

Absolutely, yes.

I know from the budget that £820 million is being ring-fenced now for mental health services. What sort of metrics will you be using to track that progress, and in terms of reducing the waiting times and improving the service and expanding the access?

As you said, the money is set aside for mental health. It has parity with our health budget, which I think is really important. I think it’s really good in this space to go back to when the committee heard evidence last year from my predecessor’s predecessor, who is now the Cabinet Secretary for Education. Lynne Neagle set out that she wanted the waiting times, including child and adolescent mental health services waiting times, to come down—that’s been achieved; a delivery unit review of CAMHS, which we have done; the rolling out of the '111 press 2’ for mental health across Wales, for 24-hour needs—I’ve had the most recent figures saying that 5 per cent of calls that come through are from people who are under 18, so this is something that we would like to improve.

We also have things like the Meic helpline. We also then have the eating disorder services, including the joint commissioning committee scoping of an in-patient unit for eating disorders in Wales, which we now have. And we also have worked to improve the transitions between child and adult mental health services, which we’ve done extensive work on. This came under the recommendations that the committee made—4 and 5—which we have completed. That’s what the funding was that we told you we were going to use last year, and that is what we’ve delivered.

In terms of what we’re going to be doing, going forward, we have, as you know now, the two mental health strategies that will be coming out this year. We are doing them as ‘all ages’ and it will be based on need. But on your specific question about the money—the £820 million, which does sound like a huge amount of money, but it’s spent very well—it comes back to what the Cabinet Secretary said at the beginning, which is that the majority of this is allocated to the health boards, and then they're the ones who decide the services.

You mentioned eating disorders; what impact do you think the £2.2 million will have that's been allocated to the NHS executive's strategic programme for mental health? What sort of impact will that specifically have on tackling issues such as eating disorders?

Joel, my hearing's going a little bit. I can't hear you very well when you're speaking, I'm sorry. Can you speak a little bit louder?

Sorry. Cefin, you were struggling there as well, I think, weren't you?

And I'm sitting next to you. [Laughter.]

I speak quite quietly. And this is on a loop, so when I speak I hear my voice, and I don't really like the way I sound. I'll try and speak a bit louder, then. That question I asked there about the £2.2 million, you heard that okay, though?

Yes, I always put my headphones on.

Good point. I'll put mine on. [Laughter.]

It does really help. I have a wonderful lead on this area on the NHS executive, who I meet with regularly. As you probably understand, I have a particular interest and focus on eating disorder provision. I think that a lot of the work that's being done in that space is on prevention and on the tiers, and where health boards allocate that money. As I've said, we can't instruct necessarily health boards to do that, but we can do quite extensive modelling of where we think the benefit of that money will go. So, that's a huge part of it.

But also, of course, we do give money to Beat, which run the national telephone helpline, so that people can be directed to the services, and I think that going forward, it's more about now doing the scoping to ensure—. As you know, I'm very passionate about people being able to receive care at the earliest opportunity as close to home as possible, and so that is a huge focus of that work, but also the peer-to-peer support, which I think is very prevalent now across all of the health boards.

And I would say as well, in my experience, the money that is now genuinely put into eating disorders and the outcomes that we see as a result have really increased. I think that many people in the mental health space will tell you that they always felt that eating disorder service provision and funding was the poor relation in that space, and that's just not the case any more. I hear that from across the system. That early intervention and that prevention is a huge part of that, and you'll see that as well in the strategies as they come through.

Thank you. Chair, if there's time, I've only got two final questions. You mentioned in answer to one of my previous questions the £820 million ring-fenced for mental health; what percentage of that is for CAMHS? Can you give an idea on that?

And my final question: in the evidence that we've taken, concern has been expressed, especially by the Royal College of Psychiatrists, about a postcode lottery in terms of school mental health services, and I was just wondering what's being done to try and bring consistency to that, to address those concerns.

Absolutely. A postcode lottery is something that I see across my whole portfolio, because obviously, I have neurodiversity, I also have learning disability and I have mental health and dementia. So, these are things that, again, with the NHS executive, I've found very helpful in having those leads on each, so that we can learn the best practice and we can ensure that the needs of the communities and what they want and what's effective is being met. So, that's something that we're doing through the modelling of that. If it's okay, I'm going to bring Alex Slade in here to talk a little bit more about that £820 million, if that's okay.

Thank you, Minister. In terms of the segment we see in the outturn data and the allocations for specific areas, obviously, in terms of the budget, as the Cabinet Secretary described at the outset, we're not specifying how much of the ring fence for mental health is going to CAMHS, but we'll see that as that gets spent through the health board returns.

The Minister mentioned performance in CAMHS in terms of improvements there. In terms of the referral to assessment, we're at 93 per cent, all-Wales position, against the 80 per cent target. It's a really good position in terms of the CAMHS performance, and showing that that money is reaching those individuals and supporting them.

If I can come in and add there as well a little bit on the inreach programme that we have in schools. I work quite closely with the Cabinet Secretary for Education on this; of course, we have quite a lot of crossover. There has been a decision made that that will be brought under the NHS executive as well. So, CAMHS is hugely improving, and that will be something now that in schools will also come under the CAMHS umbrella, as opposed to it being under Public Health Wales and being separate. The funding for that was always within our budget. It was off and came back, so now it will remain with us.

Thank you.

Thank you, Joel. Could I ask the Minister, please—? The mental health strategies were due to be published last year. Is there a timescale of when we can expect to see them?

They will be with us by the end of the financial year. There was a decision made on that, I think, because, as many people will say to me, strategies and plans need to have the funding to go with them. And so, that's something that I've talked a lot about with my officials. I think that what we'll do now, though—. There was an expectation that the suicide and self-harm prevention and the mental health and well-being strategies would come out at the same time, but we are going to separate them out so that they're given their own moment to bring those into the system and to get that feedback.

But, again, to assure you, many of the reports that this committee have done will be absolutely feeding into that. I think it's been quite transformational in Wales, we really do co-produce, and even though that takes time, it's worth it, because this will be a 10-year plan, and it's really important that it feels as though it belongs to the people of Wales. 

Thank you. Carolyn. 

Earlier, when we talked about neurodiversity and a lot of young people coming forward needing assessments, what support then do we have in place to help families and young people, because of the anxiety, as well, once they have that diagnosis? Albert, you mentioned earlier—did you say that you're working on a programme? I know that in north Wales, there's an organisation called Your Space that helps hundreds of families and young people, but they've got a funding crisis. They're told the rent's trebling and they've got to move, so I'm really worried about them. I think they do get a little bit of funding from the health board, I'm not sure. The council don't. So, I'm just wondering, going forward, about what the plan is to help sustain this, to help with support going forward.

The RPBs do get funding that they use for the waiting well, for the assessments, which I think is really crucial. And also, then, as I said, I work quite closely with the Cabinet Secretary for Education on the additional learning needs and how that all works together. I do think, though, that the assessments are really important, because they really do set out, 'This is where the child and young person excels, these are their skills and this is where they will just need that additional support.' So, a lot of that, then, is brought in through education and through those settings.

And then, also, we do have a wonderful stakeholder, charity and third sector around this as well that offers that support. But I would argue too that we have raised an awful lot of awareness, but this is a whole-society transformation that we also need of that understanding and acceptance. When I met with the National Autistic Society this week, one of the key things we actually touched on was the upcoming Mental Health Bill that will be coming through from the UK Government, because what they would like to do, and which I agree with them on, is that it's another opportunity to set out that when people who are neurodivergent get overwhelmed, that is not an excuse to section them under the Mental Health Act. That is something that I think is going to give us an opportunity, honestly, to talk more about that as we bring that through. I will bring in Albert, though, in case I have missed anything in terms of the additional support that's given after the assessment.

Thank you, Minister. I think you've covered it really well. Probably just a couple of comments from me on the back of the really helpful question. I talked about an accelerated design event—a bit of jargon, that, so apologies. I can understand why there was a supplementary question. Basically, that's an event where professionals, those affected in terms of services, are really looking at how we become assessment focused. So, you're right, until you get the diagnostic, until you get the assessment, all the anxieties are held. What this is about is really looking at what are the models, what are the type of services that we need across all of Wales, earlier, that give confidence to parents and families in relation to their children. That's where we're hoping, then, to analyse that report from the information this January and then to take plans forward. So, it is a range of different types of support services that the Minister, quite rightly, has in place, but, at the moment, we want to make sure we move from—. As you've mentioned today on a number of occasions, we don't want to see a postcode lottery here, we want to see a consistent approach in the way we do business in Wales. Thank you.

Thank you.

Natasha, please.

Thank you so much, Chair. My question is actually for the Minister for Children and Social Care. I'll begin by asking about funding for the full roll-out of the Flying Start childcare, if that's okay with you.

I'd like to know why there isn't a commitment in the draft budget to fund the Wales-wide roll-out of Flying Start childcare to all two-year-olds, given that this was actually a co-operation agreement with Plaid Cymru, and that the draft budget narrative actually states that those obligations would be honoured.

Yes. Well, I think we do have the obligation to roll out the Flying Start programme and before I answer that question in detail, it's probably important to explain what we have done with that, with the additional funding that has been in over the last two years. So, over the last two years, the expansion into phase 2 of Flying Start has seen more than 9,500 additional two-year-olds being taken into Flying Start settings. So, we've moved beyond the original targeted interventions in particular postcode areas to a wider intervention and outreach interventions as well, that deliver those places.

I think it's probably important to say that, although £20 million of additional funding was identified for childcare as part of the budget, the childcare offer, this was about, basically, uplifting the hourly rate from £5 to £6, because we hadn't reviewed that for three years, and what we knew was that the sector was in considerable danger of falling—a number of settings were saying that without an increase in that rate, they wouldn't be able to continue. And, of course, we had to bear in mind that a number of those childcare settings also provide Flying Start. So, it was important that, within that £20 million budget that we allocated for childcare, we gave that uplift in the childcare sector for the childcare offer, but at the same time, that was also supporting Flying Start.

So, the commitment is absolutely there, it remains there. It is part of our programme for government. We have seen the expansion into phase 2. We have now commissioned all local authorities to present us with their plans for phase 3. We've had all those commissioned plans back from them, and some of them have identified considerable challenges that are not necessarily related to funding; they are about capacity in the sector. And we're seeing this across the whole of the childcare sector, and this is not just unusual in Wales; we've seen, with the childcare offer in England, that the challenges of rolling out that new childcare offer in England are primarily about how you find the childcare workers to deliver the expansion. So, the £20 million absolutely does include support for Flying Start, as well as nursery education.

Okay. Thank you for that. I'll stay on the same theme. So, for the full Flying Start programme as well as child poverty now, we're all aware on this committee, and I think beyond, that children are more likely to be living in poverty than any other age group. We are aware that 28 per cent of children in Wales are living in poverty and are being hit the hardest by the cost-of-living crisis that people have experienced. Why have you decided to fund the expansion of the childcare offer, which is targeted at working parents, rather than the full Flying Start programme targeted at children in the most deprived areas, because there are many of them across Wales?

Yes. Well, to a degree, I think I've just answered that in the previous question, so maybe I was anticipating where you were going with this. But to be clear, we haven't expanded the childcare offer; what we have done is we've uprated the hourly rate and we've had to put that into the system to protect the system—that was the point I was making previously. The hourly rate in Wales for childcare settings was £5 an hour; we've uprated that by 20 per cent to £6 an hour, so that it's now on par with a vast majority and actually better than a vast majority of childcare settings in England, in fact. So, it was not about expanding the childcare offer, it was about sustaining it, and as I said, the importance of that is not only the importance of having affordable childcare for working families and parents who are in training and education, which, of course, is not available in England, but it is also to sustain those childcare settings that provide Flying Start places as well.

Okay. My final question is about access to childcare for disabled children. I'd like to know in what way, if any, have you used allocations in this draft budget to address the wide-ranging concerns about childcare, as set out in the report previously.

So, within the budget—. I’ll start by saying that we do, actually, acknowledge that childcare places for children with disabilities is a challenge, and we noticed that from the report that you did and we responded to that. So, what we have to do, in terms of the delivery of childcare places, is that we work very closely with local authorities, who have got the responsibility for doing their children’s assessments, their assessments for childcare places. Within those, they need to take account of the delivery of, or the provision of, support in childcare settings for children with disabilities. So, we would expect local authorities to take that into account when they are producing that assessment. In response to the childcare assessments and the work on the previous report that this committee has undertaken, we would be looking primarily for local authorities to identify the sufficiency that they have in the system, what they need within the system, how many particular places they would need for children with disabilities, and we fund that within part of the childcare programme and, of course, the local government funding through the rates support grant. 

It's really about ensuring that the childcare offer is sustainable in the sector generally, and that the local authorities can provide in the systems that they have in place, that they can provide adequate places for children with disabilities. But it is very much, as I say, a question for local authorities to deliver that sufficiency assessment and make the provision within their settings.

Thank you, Chair.

Thank you. I have supplementary questions, please, from Joel, to begin with.

Yes, sure.

Thank you, Chair. I don’t know who might be best to answer this, and I know Natasha raised some good questions there about Flying Start, and it got me thinking. So, with the initiatives like Flying Start, Families First and Nest, what is being done to make sure that there is no overlapping of the services provided and that there’s sort of consistent and comprehensive support for families?

I think that’s a very good question, actually. The Families First programme and the new online family support programme, Teulu Cymru, is aimed at doing just that. So, Teulu Cymru is a new online service for all families to access to find out where is the most appropriate place to go for the most appropriate support that they need. So, if any particular family is saying, ‘What is available for me in terms of childcare, Flying Start or any kind of assistance with education or provision of school uniform?'—anything that may be available through Welsh Government funding to support families—people can be directed absolutely to the right place through Teulu Cymru. So, that’s the kind of all-encompassing family support online network, and they will feed into Families First and all the other support mechanisms that we have. But it’s about ensuring that those families go to the most appropriate place and are pointed in that direction.

Thank you.

Thank you. Can I bring Cefin in here then, please?

If I can go back to Flying Start as well, you mentioned that the uprating to £6 an hour was necessary, and I agree and that is to be welcomed. So, in the overall picture, given the commitment to rolling out childcare to all two-year-olds through the Flying Start programme, are you saying that by uprating that we will not be able to achieve that aim?

No, not at all. The aim is still there, the objective is still there, it is still a programme for government commitment. It was part of the co-operation agreement, as you know, and we’re still committed to that. We’ve made very clear that we’re committed to continue delivering all of those areas that were part of the co-operation agreement. What I’m saying is that the—. And that will be delivered through our normal funding process, because this is—. We’re talking about additional money; the £20 million was additional. That doesn’t mean to say that there isn’t money still in the system to be delivering Flying Start. The £20 million was additional, over and above what we would be having in the budget in any event.

Okay. Right, okay.   

Thank you.

[Inaudible.]—Flying Start under the childcare inquiry we did on another committee, and they asked, because of the inflationary pressures, the difficulty of delivering it then and getting enough staff, et cetera, they asked if you could just concentrate on ensuring that the Flying Start areas were sustainable before extending the roll-out. The increase in the hourly rate is really welcome. Did you say in the budget that you’re going to look at increasing it on an annual basis, or review it on an annual basis?

Yes.

Because that’s really important for all these settings and for local government and everybody to know that, going forward with their planning.

Yes. I did a written statement on this a few weeks ago, when I announced the uplift in the hourly rate. Within that statement, I committed to an annual review of rates. Previously, it had been every three years, which is why things had fallen behind to the extent that they had, and the sector was saying—. I mean, it was a difficult three-year period, wasn’t it? Because in the middle of that three-year period we had horrendous inflation, which we hadn’t seen in previous years. In previous years, three-year reviews were probably okay, but in light of that experience, the 20 per cent uplift, we feel, did cover the losses that the sector felt through that high inflation rate. And committing to an annual review means that we can now judge what the appropriate rate is based on and what the cost-of-living increases might be in any given year, rather than having to wait three years.

Great, thank you.

Thank you. Just finally from me, the Bevan Foundation has estimated that, without the final roll-out, 40 per cent of two-year-olds won’t access childcare. Do you agree with that assessment?

Absolutely. We know that we've got an awful lot of children that are still not covered by Flying Start. Flying Start is very different from a standard childcare offer. I think it's important to note that. We have two aspects of our childcare offer, don't we? We have Flying Start and we have the universal childcare offer for three and four-year-olds, and they are different. One kind of follows the other. Our objective absolutely is that every two-year-old in Wales will be able to access a Flying Start setting in phase 3 of the roll-out. And as I've said, we have already commissioned local authorities to plan for that phase 3 roll-out, and we have had their plans back. As I explained in the answer to Natasha Asghar earlier, there will be financial challenges within all of that, and we can only ensure that we deliver when we know that we’ve actually got a budget to deliver it. But we are planning for it, and the local authorities are in the process of preparing for that eventuality. The biggest challenge that we have, probably a bigger challenge than finance, as I’ve said to Natasha, is actually getting people in the system. The shortage of childcare workers and Flying Start workers is something that is the biggest challenge in delivering the roll-out.

Okay, thank you. Before we move on, I’d like to welcome the young people that have just joined us in the viewing gallery. You’re very welcome. Lastly, we have some questions from Cefin Campbell, please. Sorry, I’ve done it again—it’s Carolyn. We’re going to have to put big name badges on you. [Laughter.]

I'm changing my name to Kaz with a 'K'. [Laughter.]

You'll have to change your names. [Laughter.]

Could I ask about assurance for long-term grant funding? The National Adoption Service and Foster Wales were given grant funding for three years, and that comes to an end. The WLGA have also expressed concerns. When they employ people to do these projects, then they’re very concerned, aren’t they? If it’s the end of the three-year period, or if it’s a rolling one-year programme, it’s really difficult for them. So, if you could give me some information on that.

On the National Adoption Service and Foster Wales, there’s a very specific pot of money that’s available to them. We’re absolutely committed to supporting foster services in local authorities. They’re an integral part of our transformation of children’s services programme. When we look at what we’re trying to do with the elimination of profit from children’s services, moving children away from residential care, having fewer children taken into care, the role of foster services is absolutely critical to that. So, there is no doubt from our point of view, from the Welsh Government’s point of view, that we will be continuing to support Foster Wales and our adoption services.

What we did in 2019 is we provided a core level of funding, which was £2.3 per annum. That was to help develop that tailored care that is needed around adoption services and the needs of adopted families, which is quite different. And the funding that ADSS and the WLGA are talking about was not this core funding. They were talking about additional funding that was provided over and above that for specific periods to deliver particular activities, and, in respect of Foster Wales, what that was was an additional £4.3 million over four years to provide further support, to focus on the key priority areas. And then from April 2022 to 2025, there was an additional investment of £1.6 million to the National Adoption Service to deliver its time-bound three-year plan. So, that was what they were talking about, and that was the 'Adopt Cymru 2025 and Beyond', which focused on the modernisation of the adoption agenda in Wales, and that was a time-bound programme. But, as I said, I completely recognise the key role that the adoption service and Foster Wales play in delivering our vision for children's services, and I'm absolutely committed to sustaining that funding going forward.

Okay. Thank you. Regarding placement costs and NI contributions, I know it's not Welsh Government's decision, but it's having an impact in relation to third sector foster and residential care providers. They're projecting a £38 million overspend. So, really, your view on that, going forward.

Yes, and you're absolutely right, Carolyn, that, of course, national insurance is not devolved. It was not a decision taken by the Welsh Government, but the UK Government has confirmed that it's going to provide funding to public sector employers to cover the cost of national insurance. I met yesterday, actually, with the Cabinet Secretary, with Mario Kreft, who's the chief executive of Care Forum Wales, and he, as you would expect, raised this issue with us. This isn't an issue that is specific to the social care sector; this is a wider issue that we're having to look at across all providers that the Welsh Government is responsible for supporting. Perhaps I'll ask Hywel Jones from finance to talk about how we're responding to that as a Government, across the whole Government, really.

Yes. Thanks, Minister. I'll just supplement that point to expand. So, obviously, UK Government have confirmed that Welsh Government will receive additional funding for those that meet the definition of a public sector employer. I'm aware the Cabinet Secretary for finance has written with an initial assessment to the Finance Committee of what those additional costs would be to devolved public sector employers, which is around £253 million. We absolutely recognise, as the Minister has said, the challenge this presents to partner organisations.

Our assessment for other areas outside of public sector employers across multiple partners, as the Minister described, given it impacts third sector grant funded bodies, packages of care, is much more complex. So, we do not have a total assessment of that potential impact across that range of providers at this stage of the planning process, but I know, through mechanisms, the Cabinet Secretary for finance and Treasury colleagues continue to be in active dialogue with the Treasury on the approach here.

I think the WLGA have been able to present some figures, haven't they, from third party organisations that they use as well, and purchasing, from the care provision, so, hopefully, that will help with your call for ask to UK Government as well going forward. You're just looking at me; I just think, if we've got this benchmark figure to go to UK Government to say, 'This is the impact', it might help with those conversations.

We do have an initial estimate of the insurance costs for the devolved public sector employees in Wales. We think it's about £253 million. That was what Hywel just said. But, beyond that, how all of that is going to be dealt with is going to be very much down to what we get from UK Government when that decision is made.

And that's predicted to be June time, isn't it?

Is it in June? I don't know.

It was originally.

Before that—. Before the spring statement, I think, yes.

Okay.

Did you also raise—? You were raising the question about three-year funding, was that specifically in relation to the ADSS and WLGA?

It was, which you responded to earlier, thank you very much, yes.

So, voluntary sector funding, I mentioned earlier an example with Your Space, and we have a lot of volunteers as well. So, the sustainable social services grant scheme allocates £3 million in 2025-26 for grants relevant to children and young people, and £9.7 million in care-experienced children change funds. Again, one-year commitments there for those, so, again, any assurances to the voluntary sector?

I mean, there are a number of grants—. You're quite right, Carolyn; there are a number of grants that are that are allocated on an annual basis, but we do we do also allocate a significant number of grants on a three-year basis, particularly through the sustainable social services grant. Actually, the last phase, the second phase of the sustainable social services grant, has run from April 2020 to April 2025. So there are a number of organisations that have been in continuous receipt of those grants for five years, and what we've what I've just done is extend the allocation of that funding, so all of those organisations that are in receipt of the sustainable social services grant under the second phase have had that extended to April 2026 while we look at a more simplified, streamlined grant process that will come into play from 2026 onwards. I was particularly concerned and keen that we should do that for a number of reasons; not least of all is that what I saw in terms of the allocation of the sustainable social services grants was that we were we were issuing those grants to organisations doing absolutely amazing work in lots of areas across Wales, and delivering in large part programme for government commitments on behalf of Welsh Government, but they were quite often in pockets. They were quite often incredible schemes that we saw in a particular part of Wales, and that was because there was a particular organisation in that area that had the capacity or the vision or the wherewithal to be able to do it.

As a Minister trying to deliver these programme for government commitments across the whole of Wales, I found that a huge frustration, that we just saw these real good pockets of practice that weren't rolled out across the country. So, what I'd like to see is, going forward, that we have our sustainable social services grants being funded to deliver that kind of high-quality provision right the way across Wales, and we'll be looking at organisations that are best placed, then, to be able to deliver things not just in pockets, but across the country. Now, it may not be the same organisation, it could be lots of different organisations, but if we're going to say that we want something delivered—this is important; this is a programme for government commitment—we can't just be having them delivered in parts of Wales and not across the whole country. So that's why I'm looking to change the way in which the social services grant will be delivered going forward. 

I know social services departments in local authorities in north Wales would welcome that, in a way—that partnership working, learning best practice—if Welsh Government could help facilitate that a little bit more.

No, that's absolutely right, and we've had conversations with the third sector around all of this, and it is something I think they would welcome. I had a meeting with them relatively recently where we talked about just what I'm saying now, the pockets of excellence, and it can't be what we talked about earlier on—postcode lotteries. We can't have postcode lotteries for pockets of excellence. If we've got excellent projects that are delivering what we want to be delivered, we've got to see that rolled out across the whole of the country.

And local authorities, 10 years of cuts—a lot of the services they may have provided in the past, each year they've had to look at maybe not providing. So, volunteers and charities, third sector, have had to step in.

They've filled the gap, yes.

And that's what's happened, so that's the model we have now, very often. So that's why we need to sustain them going forward, to help them and to grow, like you say, share that best practice.

Yes, and I think it is a real challenge, isn't it, at a Government level, and it’s the kind of conversations that are taking place with the UK Government. Our budgets are set on an annual basis, so it's very, very difficult. As a Welsh Government we know what our budget is going to be this year; we don't necessarily know what it's going to be next year. So, it's very difficult to plan three or four years ahead when you only know what you're getting from year to year. So, we understand how that feels, and we absolutely understand how that is from the third sector perspective. It's something that we're very much in tune with, and hope that we can develop a new kind of system that will that will help in that area. 

After 12 years of being a county councillor, moving here, it felt like this was a big council, in a way, because you rely on funding from UK Government as well. Does Welsh Government itself have sufficient staffing capacity to support its own policy ambitions in terms of children's social care, going back to that you rely on the UK Government for funding as well, and me saying it feels like it's a big council? There would be different budgets, but it's difficult. 

It's one of these quirks of Welsh Government, Carolyn, that Ministers actually have no say in the staffing issues around departments; that is within the purview of the Permanent Secretary. What I can say is I have an amazing team that work with me in children and social care, and they do fantastic work. They go above and beyond the call of duty quite often. So, from a ministerial point of view, of course I would love to see more officials in my team, but that is absolutely a matter for the Permanent Secretary.

And I echo that as well—[Inaudible.] 

And Jeremy does. 

Certainly, Chair. [Laughter.] 

Thank you. Those were my questions. 

I'd like to thank the Cabinet Secretary and Ministers for joining us this morning. We really appreciate your time and that of your officials as well. Thank you very much. 

Diolch yn fawr. 

Thank you very much. 

Moving on to item 3, I propose in accordance with Standing Order 17.42(ix) that the committee resolves to meet in private for items 4, 7 and 8. Are Members content? Yes. We will now proceed in private.  

Welcome back. We'll move on now to agenda item 5. I'm very pleased to welcome Gillian Baranski, the chief inspector of Care Inspectorate Wales, and Margaret Rooney, the deputy chief inspector of Care Inspectorate Wales. Members have a series of questions, and I'd like to begin. As chief inspector, what would you say has been the main achievement by Care Inspectorate Wales in terms of its role in providing assurance on the quality and safety of services for children, and what has been your main challenge?

Thank you for that. I think it's been quite an interesting year for Care Inspectorate Wales. In the foreword to my annual report, I talk about reflections for the year. But I think, as we think back over it, one of the things that stands out, despite the nature of the year it's been, where we've still lived with the long after-effects of COVID, an increased demand for services, cost-of-living crisis and recruitment issues, and I think the most heartening thing, is that what we've found is most care for children in Wales is good care. And that's a huge testament to the dedication of the workforce that exists right across Wales. As the regulatory inspector, that clearly doesn't make us complacent, because we would prefer most care to say that all care is good care. But we do think that, in the year ahead, the publication of ratings for regulated services will provide both an evidence base and a spur to further improvement in the sectors that we work with.

I think the other key thing for us is that we have a very strong partnership with Social Care Wales, which is the workforce regulator. And the relationships that we have with our fellow inspectorates, in particular Healthcare Inspectorate Wales, Estyn and His Majesty's Inspectorate of Constabulary and Fire and Rescue Services—I'm sorry, it's such a long title—I think what that's given us is an invaluable opportunity to consider whole-system impact and change, in addition to being able to look at individual constituent parts. If I was looking forward to the future—and I'm always very nervous to say this—it does feel that with a combination of our legislation, the commitment of the sector, and the fact that the financial settlement is not as extremely challenging as we were all expecting, this could be quite a positive year for care. And the reason I'm nervous to say it is because the last time I made that statement was in February 2020, and we all know what happened after that. From our perspective, what we're pleased about is that, despite the challenges that we have faced as an organisation, our staff have continued to be very dedicated, very focused on ensuring and seeking to ensure that every child in Wales gets the best possible care that is able to be delivered to them.

Thank you. Is there a reason for the rise in your staff costs by £1 million in 12 months covered by the report, from £14.2 million in 2022-23 to £15.2 million in 2023-24? What difference will this make?

Well, some of it's about additional work that we take on. So, for example, with the risk of reregistration, we were given additional funding, so the position for Care Inspectorate Wales is we can only deliver what we can with our core budget. For ratings, for example, which has been a significant amount of work for the inspectorate, we were given additional resource to employ further inspectors to develop frameworks. And if you look back in the annals of history, Care Inspectorate Wales, before my arrival, had a budget that was very similar to where we're at now. So, there was a period of reduction, then stabilisation, and then, over the last year, with the increased costs we've had for specific projects, we've been given more funding.

Thank you. You are responsible for inspecting and driving improvement of local authority social services. How would you describe the quality of children's social care across Wales at this point in time? Are you confident that the scale of change identified in our report, 'Radical reform for care experienced children and young people' will in any way be delivered in the foreseeable future?

Okay. I mean, that's a really helpful question, and I think our perspective of local authorities across Wales is that they are all facing rising demand for help, and they're all facing workload pressures. We're satisfied that they've all got processes and strategies in place to facilitate the partnership and collaboration work that's essential to help them face the challenges. Not all of them necessarily managed to make the best possible use of those partnerships in the interests of the children they serve. The distinctive demographic nature of Wales, of the 22, makes it quite difficult to determine cause and effect. But that said, the evidence shows us that the best-performing authorities invest both time and effort in establishing partnerships, both with other statutory bodies, the third sector and internally within their own workforce. Because the leaders of social care across Wales encounter daily the challenge of keeping people safe, and children in particular, nurturing and developing their workforce and managing very tight budgets.

Those that manage and are able to focus on early prevention, intervention as well are more likely to serve their children well. There are three issues that have struck us about local authorities' social services this year, and the first is the workforce issue. Now, efforts to improve workforce—recruitment and retention—have actually had considerable success for local authorities this year. Our findings suggest significant Wales-wide improvement in the last 12 months. Initiatives such as 'row your own', the development work that's gone on to retain the workforce that they've got has been very positive, but the context remains very challenging, and the pace of improvement across Wales varies. So, recruitment of specialist teams, for example safeguarding teams, can be a real challenge, and recruitment in some of the more rural areas can be very difficult. If you think as well, whilst recruiting newly qualified staff seems to be an improvement, there is a relatively small pool of those very experienced social care workers that all local authorities are competing for, and if you look at the north, in north Wales, we are competing with some major cities for staff as well.

The other issue is this partnership and collaboration, which we come back to again and again. It includes partnerships with health, third sector. There's a lot of focus on integrated services, and the stronger authorities are those that are developing those trust and partnership relationships. But for all authorities, the partnership can come under strain when issues of who pays becomes an issue. For a child and their family, they don't care whether it's the local authority who pays or the local health board, they just want someone to pay, and our issue with this is that the part that we play is we're very invested in working with fellow inspectorates to try and ensure that we model what we tell the local authorities they should be doing, which is partnership working.

The final aspect on your question is about prevention and innovation. There is a significant emphasis across Wales by local authorities on prevention and early intervention, development of early help hubs, therapeutic services, and our work shows that local authorities are working hard to listen to children and provide child-friendly assessments. The challenge for all of the local authorities, however, is where they find the investment to save in early prevention and intervention when there is so much demand on services for now, and authorities clearly need to improve their data to help plan effectively for future as well as immediate needs of children and young people in communities. So, overall, for local authorities at the moment, I think there's been some very interesting progress this last year, in very challenging circumstances.

Okay, thank you. Thank you for your answers. We now have some questions from Carolyn Thomas, please.

My question was about recruitment and the use of agency workers, because we hear that for our young people in care the best thing to help them is to have a consistent social worker, isn't it, for them and their families, really, to build up that bond of trust and help—that consistency is so important. So, I was interested to hear that progress has actually been made this year in some ways, and I'd like to hear more about that, really, and what we can do. I was also interested to hear about—. I was a councillor for a long time—there is always that battle between who pays, between the health board and the local authority, and I've been speaking to people in the social care sector in local authorities about whether Welsh Government could actually help with that a little better to make it frictionless, or work out who is in control of funding or maybe better collaboration going forward. So, what are your thoughts on that, really, of what can be done regarding recruitment, or to hear a little bit more about that, and on retention, that consistency, and then that smooth working between the two?

So, on the recruitment side of things, we're not the workforce regulator, but we're aware from the data that we see that, for children's services, there's about 10 per cent of a vacancy rate, which is filled by about 367 agency social workers. Now, it's fair to say that some agency social workers are incredibly experienced, they're long established. But the risk that we run is always that they are here today and can be gone, and for a child, one of the key things we know is that a child needs stability, and a child needs certainty, and in our work, when we talk to children and we meet children and they can't even remember the name of their social worker or they’re on their third social worker, that's not providing the type of service that a child, particularly a looked-after child, deserves from its corporate parents. But local authorities have done a lot of work to try and retain and recruit. Their 'grow your own' work is particularly interesting. There's been some recruitment—

Could I just come in on that? Surely it's more cost effective in the long run, because would they not pay agencies more money than to have direct employment?

I'm sure local authorities would absolutely prefer to have their own team rather than bring in agency workers, but when you have, at the moment, slightly different terms and conditions—and we know there's a great deal of work that's going on with our partners in Social Care Wales to try and harmonise terms and conditions in Wales—whilst we have what we have, who could blame a social worker for moving to another authority area if they're going to receive better terms and conditions? So, I think the stability of a framework across Wales would be hugely valuable, but that would come at cost, because there are some local authorities that pay significantly more than others, and therefore how do you meet that cost impact?

There's also a lot of work in social care about the development of positive cultures, which we're very committed to, because it isn't simply about, 'Great, we've got a new social worker, they've arrived, fantastic.' It's 'How are we going to keep that social worker?' What we find across all of our work is, where the leadership and management of a service is good, where staff are listened to, staff are valued, staff are consulted, it tends to create a very different atmosphere and environment. And in the surveys that we've seen, a lot of social workers do feel very valued by their employers. Social workers are a very interesting category. Clearly, people have got to pay their bills, it is about money, but they also want to feel valued and in an environment where they can grow and develop.

On frictionless funding, I wish I had the golden answer to give you. I would be writing textbooks now if had that answer. We have a national advisory board that's made up of service users. It's very powerful, because we put all our strategies, we share them with our national advisory board, and it's where the rubber hits the road, because then you feel the reality of what goes on. And when you hear someone talking about their daughter, who's got mental health needs, who's now an adult, and she says, 'I have been battling for years to get my child's entitlement', you think there's something not right in a system where a parent, for something that's a right for the child, has to fight for it. But frictionless funding, I'm not sure. I wish we had an answer, Margaret. I'm not sure we've got one.

I think if we had the answer to that, we'd probably be in higher paid jobs, I would suggest. [Laughter.] Going back to your point about the workforce, I absolutely agree with everything that Gillian has said. I think, also, social work is such a hard job. And not just social workers, but also social care workers working in children's homes, and fostering and adoption et cetera. And there's something about us as a society valuing social workers and those who work in social care, to attract more and retain them. I think, last year, at the committee, we were talking about this again, and we were talking about, at careers days, how many careers officers try to encourage people to go into social care. There's something about us as a society and how we value social care workers and social workers.

A point we make every year in our annal report is that we need to celebrate more the work that social care and care does. Our colleagues in the NHS do a brilliant job, and everyone recognises that, but when we start talking about care and social care, you hear terms like 'unskilled'. Well, anyone who's visited a care home or a children's home will know that the work that our social care workers do is anything by unskilled. And until there's a sense of real parity that this is a career worth pursuing—. Yes, certainly, my careers talk was, 'Do you want to be a nurse or a teacher?' No-one ever actually mentioned social care to me. I admit that was a very long time ago now.

Very often we talk about growing the economy through business, and where are the jobs. But they’re out there in social work. And growing the economy through people as well. 

You made 20 recommendations in the rapid review of child protection in September 2023, and, earlier this year, the committee discussed the lack of clarity over who’s responsible for overseeing the changes needed in that report. So, 12 months on from the review, to what extent are you confident that recommendations have been implemented, and is progress being made?

We did a series of thematic reviews around child protection. There was the rapid review of child protection, which was quite a niche review. The question was are children being placed appropriately on the child protection register and are they being taken off the child protection register appropriately. Our response to that was, yes, in most cases, they were. But alongside that, we’ve done a series of joint inspections of child protection arrangements, which started back in 2019. The aim was, then, that we would do one of these in each of the regional safeguarding board areas, in partnership with Estyn, in partnership with Healthcare Inspectorate Wales, and the police inspectorate, and that was looking at abuse and neglect across Wales. The first two looked at exploitation of children, and with the remaining ones, we moved on to protection of children aged under 11. So, we’ve done Newport, Neath Port Talbot, Denbighshire, Bridgend, Cardiff and Powys. And the themes of that echoed the themes of the rapid review.

We’ve just done an overview report, which we published in November of last year, and, for each of these, we’ve asked the local authority, on behalf of the partnership, to give us a written statement on proposed action, responding to the findings. It should be multi-agency, involving health boards, education, police forces. The response sets out what the partnership is going to do. What we do with that is it forms lines of inquiry for any future single inspection by us or joint inspection of the agencies. Similarly, with regional safeguarding boards working in conjunction with the national independent safeguarding board, they’ve already got in place actions that came from the rapid review, and JICPA provides another opportunity to look at this. What we do in our follow-up work is, ‘Well, where are we with that?’ Similarly, it’s happening with the mental health support, but your question was about the first two.

Our view is what is the point in a major thematic review that reveals issues if we then go back—. It’s always our worry that we go back in another five years and we’re writing the same report again. We have made a decision about where we put our resources, and follow-up for these big national thematics is now a considerable priority for us in terms of our approach to ‘What have you done with this?' Those will be published as well, so that we can highlight the good practice that we see, and celebrate that, and hopefully encourage others who may not have developed such good practice to look at what’s available out there.

The multi-agency action is something really important, where everybody takes their role. But it’s making sure it happens, and leading on it.  

That’s where, in a sense, if it’s a recommendation that’s just about schools, then Estyn would be following it up as part of their inspection frameworks. If it’s just about the local authority world, or ours, then we would be building that into our inspection frameworks. But we’re all involved—the three of us—in Inspection Wales, when we come together to look at Wales as a whole, what’s concerning us, where are the issues. We would be building in a multi-action response. At one point, we didn’t think we would have the resources to continue with some of this joint work. We do now have those resources, and so there’s a significant emphasis this year in how we work together, because there’s a huge value in independent inspection, but it is also very easy to blame other parts of the system. The huge value of joint thematics is it is looking at the system as a whole, and hopefully identifying where some of these flashpoint issues are, because ultimately what all the inspectorates want is better services, better support, in these instances for children.

Thank you.

Thank you. We now have some questions from Joel James, please.

Thank you, Chair, and thanks ever so much for coming in this afternoon. Yes, I just checked, just to make sure. I've only really got two questions, if that's okay. I note in your report, and funnily enough it's something that came up in the previous evidence session, about the difficulties you have in sharing information, and sometimes how the systems in place don't actually help with that. Obviously, we hear about GDPR and everything, and I remember when I was on a council, I was a corporate parent, but I couldn't actually find out who I was a corporate parent of in my ward, if that makes sense. So, if I ever wanted to look more into that, it was always quite difficult to find out if the help and support was actually there for them, for looked-after children. I just wanted to get an idea of that from you. Is it a case where systems need changing, or they're not in place, or is it that it's there but people just aren't utilising it properly?

I think it's fair to say that it's a mix of things. You will have seen in all of our joint thematics that information sharing is an issue that we highlight, and our perspective is that there are a couple of issues. One of them, I think, is maybe a lack of awareness that just putting something on your own internal system isn't job done, unless you know what's going to happen with that information. But I do think you've identified quite a significant issue, which is that there is a lot of nervousness about sharing information and, 'Am I permitted to do this? Is this something that I'm allowed to do?' And I think that pervades. We sometimes see it even in our own organisation.

I was just thinking exactly the same thing. 

Margaret is our SRO for our data sharing, and we sometimes get questions like, 'Can I share this?' and our attitude is, 'Absolutely, you share this.' And we wonder whether the emphasis needs to be much more on that this is about the child, and so the question should be not, 'Should I share this information?' but 'Why shouldn't I share this information?' But you also raised the other point, which is around some of the systems that exist. Scraps of paper are not conducive to effective information sharing. There is some really interesting innovation. You found it in your own report—the report you just issued in December—on children on the margins, about the MAST system in Neath Port Talbot. It started there and now it's in the Western Bay area. It's a very interesting example of how you can access, how you can know that the police are also involved in this family. And I guess our frustration with some of this is that we don't understand why some of this can't be scalable.

Everywhere we go, we see some brilliant practice and we see some brilliant innovation. We just don't see it everywhere. And what we can't understand is, when there is something like this, what prevents this moving forward in a really useful way. Because if you look back at some of the very difficult child practice reviews that we've had over the last few years, information sharing is usually a feature there. By now, with the technology that exists in—I was going to say 2024—2025, it must be possible to develop systems as they have done in Western Bay. There are some interesting systems in Cardiff as well. So, it seems there are solutions out there, but it's how we can make them all-Wales solutions. But I think this issue about, 'Can I share this? Am I creating problems for my organisation?' is massive and needs to be dealt with.

You mentioned that the solutions are there. Who should take charge, or the initiative on that? Is that something that the Welsh Government should try and get an active grasp on, or maybe you, or the local authorities, maybe?

I think it's one of the constants with our democratic set-up. We have 22 independent local authorities. There’s a great deal of sharing that goes on. One of our aspirations for the national office as it develops is—. There’s a real opportunity here to be using the good practice that is out there and trying to encourage its development across Wales.

Some of it—. And I don’t know, because I don’t know whether this is an expensive system, I just think it’s a very interesting system, and it’s a system that we’ll be looking at with our local authority inspection team to see if this is something that can be rolled out, are there barriers to this rolling out. And I suspect it’s not perfect, but, sometimes, perfect can be a real barrier for moving things forward, and if we wait for perfect solutions then I think we’re missing opportunities to do something that actually would help safeguarding children enormously.

Okay. Perfect. So, the final question I have, actually, is—. You mentioned there the report that the committee did in December, ‘Children on the margins’. One of the concerns that was raised there was about the single unified safeguarding review, and I think the children’s commissioner has also raised concerns there about—and I’ll just check my notes—how the governance of it is governed, I suppose, for want of a better word, and whether or not the recommendations could be rolled out fast enough. I was just wondering if that’s a concern that you have as well.

I’ve got really quite excited about the single unified safeguarding review, for three reasons. The first is that I can’t imagine anything worse than that you've experienced the death of a child in your family and you're having to do a child practice review and possibly a domestic homicide review, possibly a mental health review, and the family would have to go through those three reviews. So, the first huge thing I think is that there will be one review for these children.

I think that the second really exciting development is the Welsh repository, the fact that there’ll have to be a review report with recommendations and it’ll be lodged in the repository. And bearing in mind that this system—October, launched in December—is really, really new, there’s an opportunity, I think, to do something quite significant for Wales here. Because the opportunity for researchers to be able to search the repository and pull together themes, we are very excited about. Our local authority team will be going in and looking at themes, identifying issues, so that we can enhance the richness of the data we get about local authorities. And longer term—. So, things like the independent review of historic child sex abuse, it could be a place where those recommendations are stored. But it will depend on how the hub can be managed and enough resource going into that, to making sure that it achieves its promise. And I do understand the children’s commissioner’s concerns, but I think the good thing is that she’s also a member of the ministerial advisory board, and I’m confident, because I think the combination of the Welsh Government and the regional safeguarding boards having a role in the governance and what happens to these recommendations is a significant change. And I am assuming that one of the early questions that the board—I think that it’s meeting in January—will be looking at is what is the governance we can put in place to make sure that the recommendations and the work that goes on are delivered and developed.

Because, in social care, sometimes you look for these big projects—. It’s very early days, but I think this could significantly improve safeguarding in Wales, if it’s resourced and if the governance arrangements can be sorted out, because, a lot of reviews and a lot of recommendations, unless they can be collated and brought together, it can feel quite overwhelming. This is a real opportunity to bring together devolved, non-devolved, and what makes the most difference. What we all want is that these things won’t happen again. So, yes, quite excited at the moment, but it’s only January, so we’ll see.

Perfect. Thank you. Thank you, Chair.

Thank you, Joel. Now, we have questions from Vaughan, please. 

Thank you. Prynhawn da. 

Prynhawn da, Vaughan. 

I want to start by asking some questions about priority action notices. Now I know that, when your colleague inspectors, Healthcare Inspectorate Wales, issue an immediate assurance and improvement notice, it doesn’t always get attention, but, when it affects patient safety, it almost always does, and the relevant Minister will be contacted about it, and often publicly. With priority action notices, we don’t hear so much about them, but, in your report, in the extra information that you provide, which we’re grateful for, you set out that you issued 120 priority action notices for immediate action to be taken in respect of children’s care homes, and they affected 19 individual care homes.

Yes.

So, you also set out that it was primarily about leadership and management or care and support. So, I’m interested in if you’ve got examples of the sorts of issues that you identify in those areas and then what you do in terms of a follow-up process to make sure that the issues that you’ve identified for immediate action, how they’re actually followed up, and that you are getting the assurance that you’d want to give, not just to that home, but actually the children and their families and corporate parents and others.

Yes, this is a real tool that we’ve developed, and, Margaret, I think this is your area of—.

Yes. So, our process for securing improvement and enforcement is a graduated process, and it depends on the level of risk or the impact on children. Now, before I go any further, what I would say is that if we find significant, immediate risk to children, where we felt it was unsafe for them to remain in a care home any longer, we do have powers to take immediate action. So, luckily, that doesn’t happen very often—very rarely. So, aside from that, you’ve asked the question about priority action notices. So, when we inspect services, if we find that there are issues that are creating risk for children—. The types of things that might be—you’ve asked about the types of things—it could be around, in leadership and management, that we don’t think the responsible individual is adequately quality assuring what’s happening in the service and therefore not picking up on issues as they happen, and therefore that’s having an impact on children, or could pose a risk to children. If it’s in care and support, it could be around care planning, for example, if the care planning is not as good as it should be, it’s not being updated as it should be, or if indeed we don’t think that the children are getting the care that’s actually in their care and support plans. Then we may—. We first of all have a risk assessment that we undertake. The inspector will undertake a risk assessment to determine how risky that is, how likely it is to reoccur. They may raise it as an area for improvement, but, in the case of priority action notices, where we feel the risk is higher, we will issue a priority action notice. And what that means is, and what we’re saying is—the clue is in the name—that they have to take priority action. And once that happens, that service is prioritised for another inspection.

Our frequency of inspection for children’s homes is every 18 months, but, if we issue a priority action notice, we return to that service within a maximum of six months, often sooner, depending on the issue we found. And when we go back to inspect that service, if that improvement hasn’t been made, that service is then escalated into our improvement and enforcement pathway. And what that involves is, first of all, a formal meeting with the provider. And in that meeting, we are asking about why is the situation as it is, when we’ve pointed it out before to them, asking them to discuss whether there were any mitigating factors, or what actions they’re taking. It’s also referred to an improvement and enforcement panel. Now, that panel is made up of senior managers within CIW and our legal advisers and the inspector themselves and their team manager. And that panel’s purpose is to discuss, ‘What action are we going to take?’ There’s a variety of actions we can take. We’ve got lots of statutory action we can take. For example, we can place conditions on the registration of the provider to prevent them from taking any more young people into the home, right up to that we can cancel the registration of the provider.

So, for example, with those 120 priority action notices that we issued for those 19 services, that was throughout 2023-24. We had already inspected—and bear in mind that those inspections will be happening throughout the year, so, some of them could have happened between January and April of that year—we had already gone back and inspected nine of them and found that they had made the necessary improvements, so, we were content with that. And of the remainder of them—we would have inspected them all in the first half, now, of 2024—only—not 'only'—five of them did get—what's the word; escalated—escalated through our enforcement pathway and referred to a panel, and of those five—I'll have to remember my numbers—I think two of them had improved. Now, with statutory notice—. Before we can cancel a registration of provider, the law requires us to issue what's called an improvement notice. That's a statutory notice, and what we're saying in that notice is, 'Our intention is to cancel your registration unless you make these improvements.' And in the case of two of those providers, they made those improvements, and so that's good news. With one of them, we're in the process of cancelling their registration as we speak, and another of them decided to deregister themselves once we started that enforcement process, which can happen sometimes, and the remainder service is currently dormant because they're doing refurbishment to refurbish that home, because a lot of our issues with that home are actually in relation to the environment and how suitable it was for young people. So, that's just an example of the types of actions that we take.

Okay, that's really helpful in terms of understanding the process you run through, but also the issues and what improvement can look like and time frames. I'm trying to understand: so, in that, there's the point about safety and the risk in that as well as how supportive the environment is around the care that that child or young person requires. What I don't understand about the figures, though, is 120 notices for 19 individual homes. So, is that that, within the priority action notices, you could have multiple notices for an individual home—

Yes, it is.

—because bearing in mind you said you wouldn't have done six visits per home in that time frame.

Yes, I can explain. So, when we issue priority action notices—. Because we're a regulator, once we get to statutory notices, we then have to turn to say, 'Well, what regulations do we think that they're breaching?' So, often, an inspection, if we find an issue—we might find more than one issue—that might pertain to a number of areas in the regulations, so it is possible following inspection for us to issue four or five priority action notices, which would be about individual things that we want that provider to do, to take priority action on. So, hence the 120 for 19 services.

I think it is really interesting that you can have children's care homes that are being deregistered through enforcement and it doesn't have the same focus as an HIW notice in the public domain where there's a patient safety issue, but the risk for those children and young people is real, and that's why the enforcement is being taken. And there's a point more generally for us.

I just want to move on, though, to a point around—. In your report you talk about suitable placements. There's a challenge if a home is closing, because it's going through an enforcement action, or you've cancelled their placement, that obviously means forced change, because there's a safety issue, but you make a broader point in your report about the lack of suitable placements for looked-after children. And I think, in the last year, 17 per cent of children had two placements and 9 per cent had three or more placements, and you talked earlier, Gillian, about the fact that children need stability and certainty, and that's a marker of what that isn't.

We've had a lot of talk about the Welsh Government plan to eliminate profit from children's care homes, and some people talk about that as a risk in terms of some people moving away from the market, or whether actually it will help to deliver the stability that everyone is looking for. So, I'm interested in your view on how big a risk those plans are, and, if there is a risk, what you'd expect providers to do about that, and, obviously, the conversation you're having with the Government about it.

So, if I give you some context to where we're at with the eliminating of profit agenda, I think it's got to be seen in the context of the wider transformation ambitions, and part of that is the need to encourage more foster carers to come into the system, because whereas, for some children, residential care is exactly the right solution, for many others, foster care would be the perfect solution, but, where it doesn't exist, then those children may go to a residential care home. And I think the other thing is the principle of removing profit from children's care homes seems to be widely accepted, partly because the current position doesn't seem to be sustainable. But if I give you some numbers, I think it explains the scale of the task. So, as of 31 December, two weeks ago, we've currently got 339 care homes for children—that's 1,196 places—but, of those, 255 are for profit, that's 915 places, and 84 are not for profit, that's 281. This year, from April until the end of the year, we registered 34 new services, but, interestingly, again, the majority were for profit, 26, and eight were not for profit.

As we've looked back over the last four years, in 2022, 19 per cent of our care homes in Wales were not for profit, and then, in 2023, the position was exactly the same, we had more care homes, but the proportion was still 19 per cent. We suspect it's because people thought this change was never going to happen. But what we've seen recently is, as of the end of 2024, we were up to 23.5 per cent of children's care homes being not for profit, but, interestingly, at the end of the year, on 31 December, 33 per cent of children's homes were not for profit. That's largely because of the significant investment local authorities have made and the increased number.

I think we would be concerned if the transitional arrangements didn't exist as they do now. As you know, from 1 April 2026, we will not able to register a care home or a secure accommodation or fostering service that's for profit, so we cannot register. As from 1 April 2027, a not-for-profit service won't be able to expand. Originally, the transitional arrangement started in 2027, which would mean we'd have another two years to change the balance between for profit and not for-profit. We welcome the extension to 2030, because from 2030, no new placements of a child in Wales will be able to be made to a for-profit provider unless there's ministerial consent, and, similarly, there are plans to prevent any child from England being placed in a for-profit.

I think what we welcome, Vaughan, is that there's no hard cliff edge, because our concern was, for a child, this is their home. If a child is settled and stable, to dislocate that would be very difficult, but there is no need now to move children, because the transitional provisions allow the fact that there is no hard cliff edge. We welcome that, because I think we would all want to ensure that children have as little disruption as possible.

I suspect, as the market realises that this is real—. It's interesting; we've gone from 19 per cent to 33 per cent. What we'd expect to see this year is, again, an increase in the number of not-for-profits, and to commend local authorities that they have done an awful lot of work. They said in their evidence to this committee before, or was it the Health and Social Care Committee, that it takes two years and £1 million to develop a children's care home from planning to delivery. But what we've seen is they've certainly been investing the time and the energy to try and move this.

I think we've seen some of them being quite innovative, working with not-for-profit organisations. Perhaps the local authority provide the premises, and the not-for-profit organisation provide the actual service. I think that that's quite innovative. If you think of that 33 per cent, and 2030 is the date they all have to get there, it's still five years. That's 64 per cent that have got to achieve in those five years, and it's a lot for a local authority to do. So I think that type of innovative provision is a good thing, and we'd like to see that happening across Wales.

Thank you.

Thank you. Before we move on, are you okay to stay an extra five minutes, or do you have to rush off? Because I think we're going to run over time. 

It's absolutely fine.

We're fine.

Is that fine? Thank you. Next we have questions from Cefin, please. 

Diolch yn fawr iawn. I just want to concentrate the first two questions on unregistered placements. During the period covered by the report, could you tell us the total number of children who are placed in unregistered placements? Do you as an inspectorate look at each case individually to see whether the threshold for criminal investigation and prosecution is met? Because you've previously said that you would do this.

Are you happy to take this, Margaret? We look at services rather than children, but we can give you the detail for that.

Gillian is correct. Our remit is on the service that's operating. Very often, they are for one child, because very often, it's a situation where it's an emergency situation where the local authority has tried to find provision for a child and they can't. But they're not all for one child. Sometimes, there's more than one child in a service. So, because we don't collect information on individual children, it's the service, we can't say definitively that there are x number of children living in services that are operating without registration. Does that make sense?

Yes and no. I guess you'd know how many children are in those unregistered services, wouldn't you?

We might know, but it's not something that we would be recording. Our system is set up to look at, 'This service is being operated by x local authority, or x provider that is operating without registration' and that's what we're dealing with. When a local authority notifies us about a service that's operating without registration, we do have, similar to the process that I described about our graduated securing improvement process, a graduated process that we go through with that local authority. We monitor that service, we are talking to the local authority every eight weeks, we ask for assurances about the extent to which they have sought other placements for that child, or children if there's more than one child living there, and also assurances that they have assured themselves that that placement is as safe as possible and in the best interests of that child.

In terms of criminal prosecution, yes, criminal prosecution is our only power that we have in relation to services that are operating without registration. When it comes to criminally prosecuting—I think, Gillian, with your background, you'll probably agree—you wouldn't go forward to prosecute something unless you believed that there was a reasonable prospect that you were going to succeed with that prosecution. With cases like this, it is exceptionally difficult when a local authority can demonstrate that they have taken every effort possible to find an alternative placement for a child. The other point about criminal prosecution is that if we believed a child was at risk in a service, we absolutely would use that power, but we do get assurances. What I would say is that with services operating without registration, we know—and Gillian has just described—that we have more services registering every day. This year, in the year we're talking about, there were 48 extra services registered. At the same time, 11 services deregistered, and that meant that we had a net increase of 37 services, giving us 43 extra places. Despite that increase, we still see that we have insufficient places for children, and therefore, we have children living in services that are operating without a registration and without the safeguards and protection that we would want them to have.

In our discussions with directors of social services, they tell us that this is something that keeps them awake at night also; this is not something they want to be doing. They are also concerned. But, in many ways, this is a system problem. Children who are looked after and these children we're talking about often have very complex needs. They don't just have social care needs, they have quite complex education and health needs, often CAMHS needs, and meeting the needs of looked-after children is a corporate parenting and a multi-agency responsibility. And it really takes joint resolution. Despite the improvements and more services—and Gillian talked about 20 new care homes from local authorities registering last year—we remain concerned about the number of services that are operating without registration. But we are starting to see, and we really are hopeful that this will continue, what we think is a downward trend.

For example—I'll just get my figures correct—we had 23 care homes operating without registration in December, but at the beginning of this financial year, we had 34. And that's consistent, we're starting to see that reduction. That may be because local authorities are registering more care homes and therefore they're using those care homes for these children. We would like to see a continuation of that. Registration is there for a reason; it gives protection. It's not something that we remain happy about. We do monitor these very, very closely, these care homes. But we don’t have powers of inspection, so we can’t go in and inspect them.

So, are you suggesting that those numbers are on the decrease, then?

Yes. We're hopeful. That’s what we think we’re seeing happening.

Can I bring Carolyn Thomas in quickly here, please?

I remember the social services department phoning round desperately trying to find a space for somebody, and that was quite a few years ago, when I was a councillor. I know of the funding that local authorities have received to actually build care provision themselves, not only for the children and families to have places within that local authority area where they are—because some of these placements are miles away—but it’s also a cost-saving thing for the local authority in the end as well, because some of these placements are really expensive. So, it’s an invest-to-save to be able to invest in their own local authority provision. I'm sorry, it’s not a question, but I wanted to come in on that, because I totally understand. I’m really pleased to hear that there are more provisions now, and that there is this direction from Government and local authorities to invest in their own provisions as well, which is really welcome.

I think as well, for us, it’s a balance. For us, the priority is what’s happening for the child and keeping children safe, and, sometimes, children do well in these services. If they were at risk, we certainly would look to escalate and use our powers. But what we wouldn’t want to do is to force a local authority to move a child, where, actually, they were doing well where they were and they were safe where they were, and, in most cases, what would only happen is they would just move to another service that was operating without registration.

If I can maybe just move that conversation on, I'm just wondering what your view is on the potential impact of the health and social care Bill on unregistered placements. Given what the Welsh Government have said, that unregistered placements could not be approved as supplementary placements under the provisions of the Bill, do you think that provides us with that watertight protection of young children?

What we’re not seeing is an increase in unregistered placements now, as the world out there realises that these provisions are coming into play. We’ve been quite encouraged to see this downward trend in unregistered placement and the increase in the number of primarily local authority care homes, and it does feel that there is a readjustment going on. It’s a costly one, but I think it’s back to your comment: we have not met a local authority director or head of children’s services who doesn’t worry about every child placed in an unregistered setting. I think our view is as long as they are doing everything they can to find a registered setting, even if that means developing a registered setting for the child, and that child is safe, we would be very reluctant to prosecute. But it is enormously costly. We’ve got instances of one child who’s got six local authority staff looking after them in an unregistered setting.

I’m going to ask my final question in Welsh, so if you could put your headsets on.

That’s a really important issue. Our annual report talks about a 35 per cent increase in the number of notifications we received about children going missing between the end of 2023-24 and 2023-24. And looking again this year, in the year to date, we’ve had 2,123 notifications of children going missing from care homes, and if it continues at that rate, it’ll be another increase this year.

I think part of the problem that we face with the notifications we have is there’s a real challenge about the definition of what is a child going missing. And so would we describe a teenager who lives in their family home as missing if they turn up half an hour late from being out with their friends? I suspect that we wouldn’t. But because these are very vulnerable children, what tends to happen is a child has a curfew of 9 p.m., they’re not back at 9 p.m., the home reports them as missing, they come onto our statistics. And so what we’ve looked at over the last few years—. The 2,123 notifications this year is 490 children. And looking at those 490 children, 221 of them had one episode of being missing, 64 of the children account for over 1,000 missing episodes, and one child had 62 missing occasions, and on every occasion, he’d gone to his friend’s house, and that’s where he was. There are issues that come at the beginning of this, but I think what we’ve looked at is there are eight services that had almost 30 per cent of all the notifications of being missing. We’ve looked at these, and I think, if I give you some examples, it shows you the problem with the complexity of it. One: there were three children that had gone missing on 41, 27 and 10 occasions. Some of these notifications were submitted when the child was absent for 30 minutes, and they knew where the child was, but they’d not returned on time. Another: two young people, 78 notifications, one had gone missing 55 times, and another 22 times, but they knew where the children were. The third is the one I think we would all be concerned about, and what we would probably all regard as the big issue with missing children, and this is a child—. It’s a home where there were 64 notifications, and they refer to one child, and this child is subject to a child sex exploitation review and strategy meetings.

And so there can be an anxiety about, ‘This child is missing, I must report it as missing’, even though they’ve rung around a few times, the child wasn’t answering their phone, they’re now answering their phone and they’re at their mum’s house, or they’re at their friend’s house. And then there is the child who is in very unsuitable company, where they don’t really know where they’re at, and I guess the conundrum is how we can work with those children that are in situations that are really difficult for them, and separate them out from the children who—. If anyone has teenagers, teenagers sadly do not always come home when their parents tell them to at 9 o’clock at night. But because of their vulnerability, you can’t ignore this, but how we deal with it—. One is an issue, certainly, around better definition. The other issue is that every child is supposed to have a child information form filled up when they get to a care home, which talks about the child, their needs and their vulnerabilities, and there is a matching process that needs to go on, because if you’ve got four children in a care home, you need to make sure that the four children gel, that there are no issues that, if one has been sexually exploited, and another child has history of some form of exploitation—you wouldn’t place them in the same home. And sometimes these forms are not always filled in in the way they should be. There is all-Wales guidance, and some local authorities have third party 'welcome home' interviews with the National Youth Advocacy Service and Barnardo’s.

And I think what’s also important is that, when a child comes back, they should be welcomed back and not punished, because what we want is for the care home and the social worker to get under the skin of, 'What is it?' Is this a child who's simply out with friends and they're saying, ‘I don't want to be home at 9 p.m., I'm coming home at 9.30 p.m.’? Is this a child that is in wildly unsuitable company and needs a great deal of wraparound to help them through that? And so the more information that the care home has, the social worker has, I think they're probably best placed. But this issue of welcoming a child back rather than any form of punishment, and trying to get under the skin of why children go missing, because on the face of it, those figures are really, really alarming—. And then, as we dig down, there's this huge difference between a child that, okay, should be back at 9 p.m., and they shouldn't go and stay at their girlfriend's house overnight, but they're 15 and they're 16, and in a parental home it would happen, and then the children who we would be desperately worried about if no-one knows where they're at, and they're in circumstances where they're vulnerable for any form of exploitation.

So, I guess what we will continue to do is look at these homes that have the most number and try to delve beneath them, because we also looked at the silent ratings of some of these homes. We're not publishing ratings at the moment, but we're doing silent ratings, and most of these care homes are good care homes.

Okay, diolch. Thank you.

Thank you. We now have some questions from Natasha, please.

Thank you, Chair. I'm going to ask you: there has been a significant rise in the number of concerns, and I quote the word ‘concerns’, formally recorded about children's day-care providers, and that they are regulated by Care Inspectorate Wales. So, the increase we've noticed here in the committee has gone from 324 concerns, from between the years of 2020-21, and has risen to 552 in the years 2023-24. So, can you please explain to the committee why there's been such a substantial increase and what have these concerns actually been regarding? 

Interestingly, the concerns in 2022-23 were at 591, in 2023-24 they were 526, and this year, to date, we're on 392, compared to 534 and 576. So, we are actually starting to see a decrease in concerns in our childcare and play work, which we found quite encouraging. 

Okay, but then the rise initially from 324 to 552. I can take COVID, and I think everyone here can take COVID into account to a certain point for the rise that you experienced. But, as I mentioned, what were some of the concerns actually about?

Are these childcare and play figures or adults and children's? 

These are children's day-care providers’ concerns. I believe so. It’s children's day-care providers, isn’t it? Yes.

Children's day-care providers.

And did we provide those figures?

According to this.

Can we write to you to clarify this? 

Yes, please. They're not figures that I've got from my database.

Yes, that's absolutely fine. Shall I continue with the next one?

Yes, please.

Okay, fine. There were more than 4,600 new childcare places in 2024 compared with 2021. But during the same period, the number of formal concerns about childcare recorded by Care Inspectorate Wales rose by over 70 per cent. So, is there any link in your view to this? And if 'yes', does it relate to the pressure on childcare providers to meet the demands of the childcare offer for Wales?

Our figures don't show that. Our figures show that, overall in childcare and play, we've had a reduction in the number of childminders, we've had a reduction in out of school, and we've had an increase in the number of places in full day care. It's gone from, in 2022, 39,412 places to 42,629 places. But the number of concerns is very, very similar. In 2023 we had, in total, 535 concerns. In 2024 we had 552, which is an increase of, actually, 20, which is a small increase. And I think we've been encouraged, actually, that the increase in childcare and play day-care services—we've not seen any diminution in quality. And our ratings are showing that—I think it's 77 per cent of all ratings awarded in childcare and play are 'good' and 'excellent'. So, I'm not quite sure what the figures are that—

Could I humbly ask, once the meeting is over, if you wouldn't mind sharing your figures with the committee, because I think there's some sort of miscommunication with some of the stats that we've been provided with and what you're quoting? So, at least that way we can see where there's an issue, if there is indeed one there. 

Of course. Apologies, because we were thrilled that the committee was looking at childcare and play today, because it's a huge part of the work we do, a lot of services. We think the story around childcare and play in Wales is a really good one—the extension of the childcare offer and we're seeing more services coming into the field, but we haven't seen a diminution in quality as a result of the increase. So, I'd be concerned—. I don't know what the figures are you're referring to, but I'd be concerned if the committee felt that the childcare and play story was not a very strong one. And we're doing a lot of work in terms of quality meetings. 

One of the things that the ratings has done for us is shown a significant proportion of good and excellent ratings, and what we've been thrilled at is the willingness of the sector who have four 'excellents' to share what's made them excellent. So, we think childcare and play is a really encouraging story for the committee, and I'd hate the committee to leave today not—.

So, we've had our figures from StatsWales. We'll write to you after the committee to clarify exactly what these figures are. Is that okay? 

Absolutely fine. 

Thank you so much, Chair. 

[Inaudible.]

Yes, of course. 

[Inaudible.]—childcare and playgroup provision changed over the years so that they had to follow several policy areas. I remember it being tricky at the time because they had to be up to certain standards, which is really important.

Absolutely. 

So, providers and staff have to be inspected, make sure there's fresh food and follow a curriculum, the foundation phase curriculum. I remember at the time thinking, because they're not funded the same as core education, it was really tricky because of having that funding in place for providers—all these asks of them. I'm sure it's everything, but it's really tricky, the funding.

Now, in England, there has been policy change of offering free childcare for children from nine months of age. We as politicians get, 'It's been offered in England but why not here?', but over here we're saying that it's really important to make sure that children that go into placements here—that the provision is right as well and that they're looked after properly. The ratio as well is really important.

Yes. 

So, just your views on that, really. 

So, as you'll know, Wales hasn't changed the ratio as it has been done in England. Apart from the very large services, the manager doesn't need to be supernumary, and so, that provides some flexibility.

Can you remind me of the ratio again here?

I can't remember the ratio. 

It used to be one in three and it's one in four now, isn't it? 

It depends on the age of the child and how many children you've got, so my memory is not going to be able to retain that. But I think with 77 per cent of ratings as 'good' or 'excellent', it's clear that something is going very right in childcare and play. It's an invaluable part of the fabric of local communities, because, from our perspective, it not only helps parents to work, but good childcare and play, nurtures the independence of children and their skills at this age. One of the concerns we had around the pandemic was the impact on this group of children, as our providers are reporting to us, of their school readiness.

And so we think that the services that we have and the figures that we've got in terms of priority action notices, 77 per cent 'excellent' and 'good'—it's quite an interesting picture of a sector that is working very hard to give the best possible support for children. And the quality meetings that we've now introduced in addition to inspections, to look at—. Because part of our issue is if you're getting ratings, and their 'good' and 'excellent', is there some autonomy that comes with that? Do we need to flex some of our discussion? The latest development is we're starting to publish, on our websites, practice worth considering—I will send the committee a link to that, because it's so encouraging to see some of the terrific work that is going on in childcare and play. But like with our other work, where it isn't, we can and we do take action. But the ratings are particularly encouraging, and the work of the sector to look after children and get them to that point of independence. I'm very glad we didn't reduce the ratios in Wales; we would've had concerns around quality with that.

Thank you.

Thank you. Thank you very much for joining us this afternoon. Your evidence has been really valuable to us today. Thank you so much.

Diolch yn fawr. Thank you.

We appreciate the invitation. I'm particularly excited about the childcare and play work.

Thank you. 

I will now move on to item 6, which is papers to note. Full details of the papers are set out on the agenda and in the paper pack. Are Members content to note the papers together? Yes.

As agreed during item 3, we will now move into private session for the rest of today's meeting.