Cross-party action on social care is now urgent, to create a sustainable system
The Chair of the Housing, Communities and Local Government Committee writes that his Committee and the Health and Social Care Committee have come together to agree proposals on social care funding. He urges Ministers to work together across party, to assess their findings and agree on a solution.
In the debate surrounding the future of social care, one area where there is wide agreement is that the system is in a critical condition. From the National Audit Office and the Kings Fund to the Nuffield Trust and the Local Government Association, respected organisations have consistently warned that without significant extra funding, social care is not fit to respond to the growing demand from an ageing population, both now and in the future.
The consequences are extremely serious and widespread, with people going without the care they need, quality of care falling and unpaid carers having to step into the breach. This all places significant pressure on care providers, the care workforce and the care market with Sir Andrew Dilnot, Chair of the 2011 Dilnot Commission, warning that the system was consequently now at risk of “fairly significant disaster”.
It is clear that after successive failed attempts at reform, the need for action is now urgent.
The inquiry by the Housing, Communities and Local Government Committee, which I chair, and the Health and Social Care Committee, has demonstrated how those from all sides of the political spectrum can come together to agree on the way forward.
The Government has delayed its much-anticipated Green Paper until the autumn to fit in with wider reforms to the NHS, but Ministers now have the opportunity to take on our proposals and run with them, building a political and public consensus around a sustainable way of funding care.
Our report calls for the introduction of a ‘Social Care Premium’, either as an additional element of National Insurance or with the premium paid into dedicated not-for-profit insurance funds, similar to the model used in Germany. To ensure fairness between the generations, the premium should only be paid by those aged over 40 and extended to those over the age of 65.
Of course, asking people to pay more is never popular, and this is why forging public consensus is going to be vital if we are to solve the social care crisis.
As part of our inquiry, we commissioned a Citizens’ Assembly, a representative sample of nearly 50 members of the public who were asked to consider the best way ahead. A key message to come out of the process was that people would be willing to pay more if there was an absolute guarantee that the money would be spent on social care.
We therefore propose that the extra funds raised should be held in an independent, dedicated and audited fund. This step will help to gain public trust and acceptance.
The Social Care Premium should be introduced alongside wider funding reforms, at a local and national level, which should include a specified amount of Inheritance Tax on estates above a certain threshold. This should help to avoid the catastrophic costs faced by some people who lose their homes to pay for care. Overall, if everyone pays a bit more, we can avoid people losing everything.
The ultimate objective should be to provide personal social care, such as help with washing, dressing and eating, free at the point of use to all those that need it. While this will not be affordable immediately, we should begin by extending free personal care to people deemed to have ‘critical’ needs.
We believe very strongly that the responsibility for the delivery of social care should continue to rest with local councils, but it must not be seen in isolation. It must also be considered in its wider context with a proper joined up approach with other services such as public health and housing.
We have shown the Government what is possible and if we are still talking about the issue in two years’ time, we will have failed.
We have taken the unusual step of specifically addressing our recommendations to both sides of the political divide, asking that both the Government and the opposition front bench accept them. Everyone must work together.
If we, on a cross-party cross committee basis, can unanimously reach difficult decisions and make clear recommendations, they can do the same. Ministers must now use our proposals as a basis for building the consensus that is needed for a sustainable system for those that need care now and in the future.
Clive Betts is Chair of the Housing, Communities and Local Government Committee and the Labour MP for Sheffield South East