Senedd to debate more amendments to the Health and Social Care Bill

The Health and Social Care (Wales) Bill has reached Stage 3 of the Senedd’s legislative process. It contains several provisions, including to:

• restrict the making of profit by providers of children’s homes services, secure accommodation services and fostering services for looked after children; and
• enable the introduction of Direct Payments for NHS Continuing Healthcare (CHC).

Further detail of its provisions can be found in our Bill Summary.

• At Stage 1, three Senedd Committees scrutinised the Bill.
• At Stage 2, 97 amendments were tabled. These were ordered into 17 groups and debated in that order by the Health and Social Care (HSC) Committee on 28 November 2024.
• The Committee meeting minutes show that 43 amendments were agreed, all of which were government amendments.
• The purpose and intended effect of the 43 agreed Welsh Government amendments are set out in these two tables: Government purpose and effect table - 11 November 2024 and Government purpose and effect table - 18 November 2024.
• On 17 December the Minister for Children and Social Care (the Member in charge of the Bill) wrote to the HSC Committee setting out how she was “seeking to address concerns which I believe informed a number of the amendments tabled by Members”.
• The amended Bill is now at Stage 3 (the Plenary amending Stage). Tabling has now closed. A final Notice of Amendments and a Marshalled list have been published on the Bill’s homepage. Stage 3 proceedings and voting will take place in Plenary on Tuesday 28 January 2025.

This article sets out what happened during the HSC Committee’s consideration of Stage 2 amendments.

Eliminating profit and provisions about care experienced children

At Stage 1, we published an article about the main impacts this Bill could have on care experienced children and young people. Since then, at Stage 2, the following groups of amendments have been discussed and voted on, relevant to children ‘looked after’ by local authorities:

• Advocacy and assistance (7 amendments)
• Existing service providers: ‘reasonable profit entity’(7 amendments)
• Transitional period: timescales for transition (5 amendments)
• Transitional period: transitional arrangements for existing service providers (5 amendments)
• Oversight of, and support for, transition(5 amendments)
• Variation or cancellation of service provider registration (10 amendments)
• Out of area placements (4 amendments)
• Annual sufficiency plans (3 amendments)
• Supplementary placements (3 amendments)

20 government amendments were agreed

Of the 43 Welsh Government amendments on the Bill as a whole, all of which were agreed, 20 related directly to ‘looked after children’. These include:

• Amendment 15, inserts a new section 75A(2)(b) “to make clear that the local authority may not publish a plan unless the plan has first been approved by the Welsh Ministers”. This refers to new duty on local authorities in the Bill to prepare and publish an annual sufficiency plan. The plan should include: the steps a local authority will take to secure accommodation for ‘looked after children’; an estimate of the number of children who it will be unable to place; and an assessment of available  accommodation and the extent to whether that is within or near the local authority’s area.
• Amendment 18, relates to the applications by local authorities seeking approval to place a looked-after child somewhere other than a ‘not-for-profit’ entity, when the relevant transitional arrangements have ended. These are referred to as a “supplementary placement” and this amendment removed the words ‘that is providing the placement’ from section 13 of the Bill. The Welsh Government says “it is possible that those words may create the impression that approval is a foregone conclusion, which is not the case”.

No opposition amendments were agreed

Mabon ap Gwynfor MS and Altaf Hussein MS tabled a range of amendments, none of which were agreed. The Minister’s letter to the HSC Committee sets out how she is “seeking to address concerns which I believe informed a number of the amendments tabled by Members”. The opposition amendments included:

• Rights for ‘looked after children’ affected by the Act to have advice and assistance and the right to registered independent visiting advocacy The Minister’s response can be read in paragraphs 40-50 of the transcript.
• 15 amendments tabled relating to the transitional period. Of these, amendments 68 and 69, tabled by Altaf Hussein, related to the timescales for transition for restricting profit. During Stage 2 proceedings on 28 November, it was noted that the Minister had issued a Written Statement: Eliminating profit from the care of children looked after - update on timescale and permitted models the preceding day. Altaf Hussein therefore withdrew one amendment and the other was not moved. Commenting on the written statement, the Minister said “2030 is not a target date. It is the absolute end date.” 
• 4 amendments tabled relating to the requirement in the Bill for local authorities to take all reasonable steps to secure accommodation “within, or near to, the authority’s area”. The amendments seek to define the meaning of ‘near to’ as “within the area of one of its neighbouring local authorities” and that the local authority must take into account the child’s views, wishes and feelings when placing outside the home authority.
• Of the 8 amendments that were tabled relating to supplementary placements, only the 3 Government amendments were agreed. During the debate, the Minister confirmed that “the Bill will not enable Welsh Ministers to authorise an unregistered placement” and that this position would be “clearly set out in the statutory guidance to local authorities to support operation of the supplementary approval process”. The Minister also said that “such guidance would emphasise that the use of supplementary placements would not become the default position, particularly during challenging times”.

Direct Payments

2 government amendments were agreed

Of the 43 Welsh Government amendments on the Bill as a whole, all of which were agreed, 2 related to direct payments for CHC: amendments 27 and 28..

No opposition amendments were agreed

During Stage 2, opposition party Members tabled amendments on a number of issues including: planning to ensure there are sufficient numbers of Personal Assistants to meet demand; ensuring the United Nations Convention on the Rights of Persons with Disabilities features prominently in guidance; and requirements to review the CHC Framework. Amendments included:

• Personal assistants (2 amendments)
• Direct payments for healthcare: information, advice and support (8 amendments)
• Oversight of, and support for, direct payments in health care (9 amendments)
• Direct payments for healthcare: minor and consequential amendments (5 amendments)
• Review of CHC framework (2 amendments)

There was one issue on which the Minister offered to work with Members to bring forward a revised amendment at Stage 3. In response to amendments focused on improving information and advice and support around direct payments (including a right to receive support and advice), the Minister for Children and Social Care, Dawn Bowden MS, said:

I am happy to consider, as a matter of priority, an amendment at Stage 3 that works within the statutory framework created by the Bill to achieve the same ultimate aim regarding mandating the provision of information and support, and I would be keen to engage with Members regarding that amendment.

The HSC Committee’s Stage 1 report had recommended that the Bill be amended to include a ‘right to information, advice and support’ for individuals seeking to take up direct payments for CHC. It suggested this right would go some way to “mitigate the fear of the unknown with CHC for direct payment users”. The Committee also called for guidance to include information about transitions between social care and CHC, and to promote continuity of care for individuals moving between the two systems.

See our previous article for further information on what the Bill could mean for disabled people and older people.

What next?

Stage 3 proceedings take place in Plenary on 28 January.

Watch live on Senedd TV.

Article by Amy Clifton and Sian Thomas, Senedd Research, Welsh Parliament