Care body quits fees group due to "morally bankrupt" system

The decision by Care Forum Wales (CFW) to resign from the North Wales Care Fees Group comes amid claims that the region’s councils are “deprioritising care” even though they have been given more money by the Welsh Government to pay for it.

The group includes representatives of each of the six local authorities in North Wales, the Health Board and Mary Wimbury, the chief executive of CFW.

A recent investigation by CFW revealed that the fees paid by local authorities in the North are up to £11,000 a year less per person than those on offer from their counterparts in South Wales.

They say the issue was brought into sharp focus when Torfaen Council announced big increases in their rates – 17 per cent for residential care and 25 per cent for nursing care.

It means that a 50-bed care home in Torfaen will receive £546,000 a year more for providing residential EMI care than a similar-sized home in Anglesey, Wrexham and Flintshire for exactly the same levels of care.

In the cases of Denbighshire and Gwynedd, it equates to an extra £494,000 a year and £444,600 more than a home in Conwy.

According to Ms Wimbury, the group’s work on setting fees was “completely disregarded” despite council leaders and chief executives emphasising the need for higher pay rates for staff.

The North Wales leadership board of council leaders and chief executives had recognised that social care was underfunded and had written to the Welsh Government to raise the issue.

In the resignation letter to the North Wales Care Fees Group, Ms Wimbury said: “It appears all North Wales local authorities are currently deprioritising care in their own spending, with fee increases in general not coming close to matching what the sector needs to meet inflationary pressures.

“We are continually told that is all local authorities can afford yet we see percentage increases in fees significantly lower than the increase those same local authorities are seeing in in their Welsh Government settlement – it would therefore seem clear that this is because other areas for spend are being prioritised.

“For some years now there seems to have been a significant disparity between fees paid in North Wales and those in South East Wales in particular and this is starkly highlighted by Torfaen, who have undertaken a detailed exercise this year to understand providers’ true costs which have led to increases of between 17 and 25 per cent.”

Almost all fee increases in North Wales were between 6.21 per cent and 7.4 per cent despite local authorities receiving a settlement of between 8.8 and 9.5 per cent from Welsh Government.

The only exceptions were for rates for EMI residential and nursing care in Denbighshire and Anglesey where the starting points were incredibly low.

Consultation with providers on fees had been “cursory at best and non-existent in four counties in North Wales”, flying in the face of guidance from the Welsh Government.

Ms Wimbury added: “Given the complete disregard so far in setting this year’s fees of the work undertaken by the North Wales Care Fees Group to start to rectify the issues in current fees we can see no point in continuing to participate.

“The group has not conducted any meaningful engagement since November and, despite the impression given in some local authorities’ fee notifications, did not take a final decision on the formula for this year.

“We feel instead the group has been disregarded and its existence used to limit local discussion and engagement with providers and obfuscate the decision-making process.

“We will therefore be withdrawing from the Group unless or until there is an absolute assurance from those in leadership positions across North Wales that our concerns will be taken seriously.

“We are aware that an increasing number of providers are also voting with their feet and setting their own fee rates to match their actual costs.

“We would remind local authorities that for the rate they set to be legal, it must be possible to generally source care in their area for that cost.”

It was a view echoed by CFW chair Mario Kreft MBE who says the funding of the social care sector has been mismanaged for more than a quarter of a century.

Mr Kreft said: “We have a system that is self-perpetuating that has created a morally bankrupt vicious circle.

“We have long endured a tapestry of social care services across Wales which were not only underfunded but also promoted inequality.

“That tapestry has been held together by social care workers and is now threadbare.

“The social care sector was in a fragile state well before the pandemic and what we are calling for is an urgent national action plan which can ensure fairness and equity in the system, and it’s patently neither.

“We need to build a sustainable care system that will truly be an effective scaffold for the NHS.

Mario Kreft MBE, chair of Care Forum Wales

“The main problem at the moment is that we have an unjust postcode lottery of fees as a result of having 22 local authorities and seven health boards often doing their own thing, creating a totally dysfunctional system.

“The public has a right to know why people are worth so much more in some parts of Wales than they are in North Wales.

“It really is time for the Welsh Local Government Association to get a grip of its members so that we can have a national structure that is open, honest and fair.

“I fully support the words of the First Minister when he spoke about the fragility of the social sector even before the pandemic began.

“What Torfaen has done is about sustainability for the future and they have shown the way forward to the rest of the councils and health boards who commission services.”