2021 must be the year for action on social care
It is absolutely essential that the Queen’s Speech gives an assurance that we will see a fully worked-out and costed plan to put the social care sector on a sustainable path in 2021.
It’s been a quarter of a century since Tony Blair told the Labour Conference that social care was an urgent issue. He was right then, and it is therefore absolutely essential that the Queen’s Speech at the very least gives an assurance that we will see a fully worked-out and costed plan to put the sector on a sustainable path in the course of this year. The complexities and costs involved have defeated governments of all parties over that time, but further delay is unthinkable.
There are many problems to be solved but as ever how we pay for the necessary reforms lies at the heart of them. Jeremy Hunt, chair of the Health and Social Care Select Committee, says £7 billion extra is needed to put the system on a sound footing. How you raise that money is the most intractable problem. If you raise it all from taxation or National Insurance, working age people will be paying for their own care and the care of their parent’s generation, which seems very unfair. This is why the apparently simple solution of a “National Care Service” doesn’t work. It would be grossly unfair to anyone under the age of 40, who are having a tough enough time already.
Social care needs a 10 year plan to go alongside the excellent NHS 10 year plan, and I hope the government listens
I have argued in a paper for the Centre for Policy Studies that we should look to the pension system for an example where universal state provision can be successfully supplemented by private savings. This has the added political advantage that pensions are not a matter for serious dispute between the main parties, so a long-term consensus can be achieved. I also argued that although care needs to be delivered at a local level, and on a personal basis, the state funding should come from national rather than local taxes, as otherwise local authorities will be unable to afford services other than care as the demographic demands increase.
But even when the government comes to a decision on how to find the extra money needed there are other intractable problems.
Workforce planning. How do we find thousands of extra workers, which demographic change will demand, and how do we create a proper pay and career structure for them?
There is so much technology available that would improve the daily lives of those receiving care, but no discernible strategy for using it.
If we built differently, we could keep far more people in their own homes for longer, happier in themselves and less expensive for the system. There is a clear need in the planning system for a separate category of homes suitable for people who need support.
Integration with the NHS is the latest issue following the government’s white paper. We are promised new integrated care systems, but they must not simply be another way for the NHS to use social care to solve its own problems. The voice of social care (especially domiciliary care) is fragmented, and therefore hard to hear. Providers and local government must have a seat at the integrated care systems table if we are to achieve anything real.
This is a formidable set of challenges. Jeremy Hunt and I have argued that social care needs a 10 year plan to go alongside the excellent NHS 10 year plan, and I hope the government listens.
Twenty-five years is already too long to have reached a decision about how to solve the social care conundrum. This absolutely must be the year for action.
Damian Green is the Conservative MP for Ashford and chair of the One Nation Conservatives.
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