Today’s Senedd roundup: Progress promised in provision of “compassionate” end-of-life care

Image by Mabel Amber, still incognito… from Pixabay

Owen Donovan, Senedd Home

The Motion

The Senedd:

• Notes the Cross Party Group on Hospices and Palliative Care’s report on Inequalities in Access to Hospice and Palliative Care.
• Acknowledges that approximately 23,000 people in Wales have a palliative care need at any one time, including over 1,000 children.
• Recognises that whilst some progress has been made in widening access to hospice and palliative care in Wales, there remains significant unmet need and under-met need and calls on the Welsh Government to address this.
• Calls on the Welsh Government to outline how Wales will become a ‘compassionate country’ and ensure the strengthened provision of palliative care is made central to this approach, fix data gaps, update funding mechanisms for charitable hospices and increase the level of direct funding provided to adult and children’s hospices.

Unmet and under-met need

Shadow Communities Minister, Mark Isherwood AM (Con, North Wales), said the cross-party group found that while access to palliative care has widened, there were still gaps, particularly concerning bereavement support offered to families of patients who’ve died in intensive or acute care.

“….despite their importance within wider care service provision, hospices are experiencing a number of challenges, which impact on their ability to provide sufficient support services. These include a lack of statutory Welsh Government funding, resulting in financial pressures that are restricting the ability of hospices to provide services; an out-of-date funding formula leading to a postcode lottery of services; and unmet need caused by a lack of specialist palliative care staff.”
– Shadow Communities Minister, Mark Isherwood

£28 million of the £36 million budget of Wales’ hospices was raised through fundraising and statutory government funding has “flatlined” and was lower as a proportion of all funding compared to England and Scotland. The need for reform was more apparent with 75% of the 34,000 people who die in Wales each year requiring some form of palliative care.

Helen Mary Jones AM (Plaid, Mid & West Wales) tabled amendments to the motion stressing the importance of carers and their particular needs depending on the circumstances of the person they’re caring for. She also acknowledged the progress made, but the evidence was now there on what needed to be done to make Wales a “compassionate country”.

Shadow Social Care Minister, Janet Finch-Saunders AM (Con, Aberconwy), said 6,000 people could be missing out every year on the palliative care they need. The funding formula hasn’t been reviewed for a decade meaning come hospices receive more funding than others.

John Griffiths AM (Lab, Newport East) raised concerns that hospices haven’t received a pay rise passported from health boards with a dispute over whether the money has already been provided or not. Mohammad Asghar AM (Con, South Wales East) said the report found significant regional variations as well as concerns over staffing pressures as the likes of GPs and district nurses who co-ordinate palliative care.

Weaknesses are being addressed

Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth), maintained that the Welsh Government’s policy is for anyone requiring palliative care to access the best possible care.

“We invest over £8.4 million annually to support specialist palliative care services and to take forward the actions in the delivery plan. We are making real progress. We have resources and facilities in place to support advance care planning to ensure that adults and children are central to the design of their care; we have a single all-Wales ‘Do not attempt cardiopulmonary resuscitation’ form to ensure that people’s wishes are respected; and we have a serious illness conversation training programme to ensure that our staff are equipped to handle what can be very difficult conversations with clarity and compassion.”
– Health Minister, Vaughan Gething

Comparisons with the rest of the UK on funding weren’t exact because of different ways different health services work with hospices. To meet the vision of a compassionate country, some taboos around dying need to be addressed and end of life care should be supported and celebrated. A fresh review is due to be published in December and a government statement on end-of-life care is due in the new year.

Vote

A softer-worded motion tabled by the Welsh Government acknowledging progress was passed by 27-9 with 11 abstentions.

Welsh Government “left with no choice” but to ask to extend the life of Pacers

The Motion

The Senedd:

• Notes the recommendation of the Enterprise & Business Committee in 2013 (full summary here) that the Welsh Government should develop and publish a rolling stock strategy as a matter of urgency.
• Regrets the Welsh Government’s failure to take appropriate action to address the issues highlighted as long ago as 2013; to meet the persons with reduced mobility (PRM) compliance deadline; to make a timely request to the UK Department for Transport for dispensation to keep non-PRM compliant trains in service from January 2020.
• Expresses concern at the ongoing disruption experienced by many Transport for Wales (TFW) passengers daily.
• Calls on the Welsh Government to give assurance that it has contingency plans in place to mitigate the potential loss of a large proportion of its fleet.

At the bottom of the cascade

Rhun ap Iorwerth AM (Plaid, Ynys Môn) said the lack of forward planning on rolling stock was causing a period of uncertainty for passengers. Trains themselves are now hard to come by, in part due to the previous franchise. “Cascading” – moving older trains between franchising” – sounds romantic, but Wales was often one of the endpoints.

One of the consequences is that if the “Pacer” trains are removed for non-disability compliance at the end of the year, nearly half the rolling stock in some parts of Wales would be lost.

Shadow Economy Minister, Russell George AM (Con, Montgomery), accused the Welsh Government of “peddling myths” that rolling stock was a matter for the UK Government for the past decade or more when responsibilities were passed to the Welsh Government in 2006. They were warned in 2013 and failed to heed those warnings.

While not necessarily accepting the content of the motion, even Labour AMs weren’t particularly happy with the current situation. Dr Hefin David AM (Lab, Caerphilly) told the chamber he’s been contacted several times on overcrowding, poor carriage conditions and season ticket prices. He said the Economy Minister had, perhaps, been “overselling” TFW’s immediate potential when they took over the franchise.

In practical terms, he thought it would be foolish to withdraw Pacers if there was nothing to replace them, even going so far as to describe the maintenance work at Canton depot as “heroic”.

Concerns over possible fall in passenger capacity on new trains

Like many other AMs, Delyth Jewell AM (Plaid, South Wales East) had her own experiences of the issues, particularly overcrowding and one incident of violent behaviour by a passenger. There are indications that capacity on some services – namely the Rhymney Valley – will actually drop once interim Pacer replacements are themselves replaced by new trains from 2023.

Work on doubling the Ebbw Vale-Cardiff line has seemingly halted, while progress on reopening stations at Crumlin and Magor have no firm commitments – later seconded by John Griffiths AM (Lab, Newport East). She also asked for clarity on a possible fare reduction in January.

“It’s great to see that there are more and more rail passenger users. That’s a testimony to the fact that people are now switching on to those modes; they’re seeing congestion on the roads and so on. But I have to say, I’m fortunate in that I get on the train in Maesteg or Ewenny Road or Garth, I’m always guaranteed a seat; even on match days, I’m guaranteed a seat. But actually, even on a normal day in peak time, by the time you get to Bridgend, it’s filling up; Llanharan, it’s full up; Pontyclun, it’s standing room only.”
– Huw Irranca-Davies AM (Lab, Ogmore)

Government “didn’t want to tie franchise bidders hands”

Economy & Transport Minister, Ken Skates (Lab, Clwyd South), underlined that no rolling stock strategy was produced to prevent the (at the time four) franchise bidders from having their hands tied.

“Now, if, six years ago, we had chosen what types of trains we wanted to run across Wales, the scope for fresh thinking would’ve been severely hampered. For example, how would we have ensured that half of the new trains would be built in Wales, given that CAF hadn’t even begun looking at Wales at that time? Would we have developed a new, low-cost approach to overhead electrification? Would Members have accepted a strategy that relied upon battery, overhead and diesel hybrid trains? How would we have balanced the ambitions for a flexible metro with on-street running within a fixed budget envelope?”
– Economy & Transport Minister, Ken Skates

He thought it was “disingenuous” to claim the Welsh Government has done nothing. Also, Porterbrook – one of the train suppliers – is two years behind on a project to convert some old Thameslink trains into Pacer replacements. He wasn’t happy that Pacers may need to be used for longer than was promised, but TFW has been forced to do it.

Vote

A more favourable Welsh Government-worded motion noting various investments and expected improvements – as well as calling for the UK Government to develop a new rolling stock model – was approved by 31-16.

Photo by Manfred Richter from Pixabay

Senedd “not the place” to introduce a workplace parking levy

Yesterday, Jenny Rathbone AM (Lab, Cardiff Central) put forward an idea for a proposed law which would set a levy on workplace parking spaces, with a view to using the revenues raised to invest in public transport and both walking and cycling.

Getting the behavioural change we need

Jenny Rathbone said the proposed legislative solution would tie in well with policies such as a future Clean Air Act and the national development framework. It would force employers to consider the number of workplace parking spaces the provide. The policy has been implemented elsewhere with some success:

“Nottingham introduced a workplace parking levy in 2012. This is a lot easier to implement than a standard congestion charge, and they were clearly outlining that the first 10 parking places are free. It does not apply to disabled parking places, front-line emergency services or vehicles being used for the transport of goods to and from as part of their business. Staff parking at hospitals and other premises are also exempt. The impact has been fantastic. The air quality has improved, nitrogen oxide emissions have gone down and it’s generated £44 million in the last seven years, ring-fenced for transport projects.”
– Jenny Rathbone AM

She acknowledged that Welsh local authorities already have this power under existing legislation, but no Welsh council has so far implemented it with Cardiff the only one actively considering it. This proposed law would focus attentions on an all-Wales basis.

Nick Ramsay AM (Con, Monmouth) had come concerns. He agreed on the need for getting people out of private transport but believed this could end up being a tax levied on the people who can least afford it. This policy might work well in urban areas, but less so in places where private transport is near enough essential, like Monmouthshire. He did suggest though that a levy could be used to nudge people into buying electric vehicles by exempting them.

Plaid Cymru supported the proposal. Llyr Gruffydd AM (Plaid, North Wales) said there were many cross-policy benefits such as improving the environment and potentially improving people’s health. He did, however, suggest that any levy would need to be proportionate to a person’s salary.

David Rowlands AM (BXP, South Wales East) believes such a levy should only apply to public sector employers, while Michelle Brown AM (Ind, North Wales) suggested it could result in businesses being charged twice for the same thing – business rates and this proposed levy.

Talk to your local councils

Economy & Transport Minister, Ken Skates (Lab, Clwyd South), noted the extensive powers councils already have for this and, as such, perhaps didn’t have the response Jenny Rathbone would’ve liked.

“….there is nothing stopping local authorities from doing what Jenny Rathbone is, I feel correctly, advocating. The powers are there, the reasons for taking action and to utilise them are clear. And so, Dirprwy Lywydd, I’d urge supporters of the scheme to press their local authorities to consider this proven intervention.”
– Economy & Transport Minister, Ken Skates

The motion was defeated by 14 votes to 12.

Youth Parliament seeking to develop mental health leaflets with the Senedd

Some councils still charge for free breakfast clubs

Parents have told BBC Wales that they continue to face “unfair” charges for their children to attend school breakfast clubs at some schools. While all children are entitled to free breakfasts, the report says six local authorities charges fees or ask for donations.

The Welsh Government has said that no charges should be applied to school breakfast clubs, telling BBC Wales: “Free school breakfasts are just that – free. On no account can a school apply any costs to children and their families for any element of the free breakfast session.”

GCSEs “shouldn’t be ditched”

Responding to a recent report from the Future Generations Commissioner, Qualifications Wales said that GCSE qualifications should remain in place for the foreseeable future, saying the GCSE brand was “valued”.

The Future Generation Commissioner’s report called for a narrative-based assessment pointing out individual students’ strengths and weaknesses, but Qualifications Wales said: “We believe that keeping the GCSE name enables us to make all the necessary changes to the design of qualifications, while also reaping the benefits of retaining a name that is valued and widely recognised.”

Business case for third Menai crossing “not as strong”

Following the indefinite postponement of the Wylfa Newydd nuclear power station on Anglesey, the Economy Minister has reportedly accepted that the case for a third crossing of the Menai Straits was no longer as strong.

A preferred route for the new crossing was announced towards the end of 2018, but the postponement of the nuclear energy project has resulted in a failure to agree on a partnership deal with the National Grid.

Call for Welsh Tory chair to stand down

The former deputy Conservative chair in Wales, Lee Canning, has called on the Chair of the Welsh Conservatives, former AM, Byron Davies, to stand down over his handling of the Ross England scandal.

Lee Canning has taken up a position with the Abolish the Welsh Assembly Party and told BBC Wales: “I do want to reiterate that I do have a lot of friends in the party that put in a tremendous amount of hard work but there are issues there that do need to be remedied and I think the best way for them to be remedied would be for Byron to stand down.”

Byron Davies described Canning as a “disgruntled failed candidate” and refused to comment on the Ross England investigation further.