Steps towards a National Care Service in Wales
The Plaid Cymru led Welsh Government has published its National Care Service Programme (NCSP).[1]
The Programme is light in detail, without a historical context and it is surprising that the progress and gains over this period of a joint Labour/Plaid Cymru ambition and commitment has not been set out as the foundations of the NCPS. Someone new to this concept of a National Care Service in Wales, could be pardoned for thinking that this is a fresh and innovative development in Wales.
The Plaid Cymru Manifesto set out its aspirations for the National Care Service in Wales[2] and in Government, since May 2026, the Plaid Cymru has set out its Programme for the next four years and the NCSP is an integral part of this programme.[3]
The ambition for a NCS for Wales formed part of the Labour Welsh Government and Plaid Cymru Co-Operation Agreement in 2021 and at its core was a commitment to a NCS that was free at the point of need. An Expert group was set up jointly by the Labour Government and Plaid Cymru and the report entitled Towards a National Care and Support Service for Wales – Report of the Expert group was published in September 2022.[4]
The Labour Government published its Implementation Plan in line with its agreement with Plaid Cymru in December 2023.This was a three phase plan that stretched over 10 years.[5]
A major plank of the first phase was the ‘rebalancing of care and support ‘and to this end the Minister for Social Services provided an update on progress in March 2024.[6]
The recently published Programme is light on detail, has the breath of an early ambition for Social Care in Wales and feels like a wish list rather than an embedded concrete plan for social care in Wales.
In May 2023 we submitted a paper to the Health and Social Care Committee concerning the state of social care in Wales.[7] This paper included our initial response to the Report of the Expert Group set up under the Co-operation Agreement and outlined the continuing challenges facing Wales and the need to move from rhetoric to reality. It would seem to us that this remains so.
The fiscal challenges facing the Plaid Cymru Government cannot be underestimated and will have significant impact on the plan for a National Care Service in Wales that is free at the point of delivery. A new financial settlement for Wales, utilising its taxation powers and borrowing powers are matters that will shape the outcome. The Holtham report[8] set out the choices that Wales faces in funding social care and these choices are as real for the Burnham Government as it awaits the Casey Review.
Workforce is a matter that straddles countries of the UK and its use of labour from outside the United Kingdom, visas and the right to work and stay and family life are all matters that directly impact on the provision of social care and health care in Wales. These are not devolved matters and will require a UK wide initiative that starts with the acceptance that social care and health care is highly dependent on a workforce from outside the countries of the United Kingdom.
A frank and honest discussion about what is possible, what is what is achievable and the implications of any change will go a long way in moving forward the programme for a National Care Service in Wales.
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