New thinking is needed to solve the social care crisis
The general election has shown that social care matters to people. It will take courage, commitment and extra funding to reform the system, writes Barbara Keeley
Looking back, it seems hard to believe the Conservatives chose to launch their election manifesto by highlighting their proposals for social care. These now lie in tatters. Their proposals relied for extra funding on means-testing the winter fuel allowance and including people’s homes within the means-test for homecare. Abandoning these measures leaves the Conservatives having to look for different sources for much-needed extra funding for social care.
Now is the time for new thinking to solve the crisis in social care.
The Conservatives may be hoping that, as Brexit takes centre stage, the public will forget about social care. They would be wrong to think that. Without an immediate injection of new funding or any prospect of funding reform, councils will be forced to continue tightening eligibility criteria for care, care providers will continue handing back contracts and the number of people with unmet care needs will continue to rise. This crisis will not simply fade away if the government chooses to look the other way.
Faced with an already fragile care sector, the Conservatives managed to make things worse during the election campaign. Their manifesto proposals caused widespread confusion and fear, particularly among older people. The omission of a cap on care costs and Theresa May’s subsequent U-turn dominated the headlines. However, it was her decision to include people’s homes within the means-test for domiciliary care that sent the strongest message to older and disabled people – a message that said simply, “you are on your own”.
Asking people to pay for domiciliary care by taking a charge against the value of their home works against the aim of incentivising care within the home and keeping people independent for as long as possible.
It risks encouraging people to manage alone rather than seek help, putting their health and wellbeing at risk and placing an even greater caring workload on unpaid family carers. It also creates extra pressure on NHS resources, as we saw in the A&E crises of the last 12 months.
Allowing people to defer payments for care until after they die through the extension of the deferred payments scheme was not the right solution, as the reaction from the public showed. Implementation of the current programme of deferred payment schemes for residential care is patchy at best. And the Conservatives gave no explanation for how local authorities could meet the increased demand for social care that would be generated by raising the asset threshold while they waited for cash from the sale of properties to flow in.
Six years on from the Dilnot Commission report, which cost the public purse around £1m in today’s prices, we are back at square one.
So, where do we go from here?
First, the government needs to understand that social care is not just about older people. Around a third of social care funding goes on working-age people – those with learning difficulties, mental health issues and physical disabilities. It makes no sense for the forthcoming green paper on social care to focus exclusively on older people and the scope of the green paper must be widened to consider the social care needs of all.
Second, there is an urgent need to tackle the funding crisis in social care. The £4.6bn taken out of social care budgets since 2010 has had a serious impact on frontline care and health services.
£1bn is needed this year just to stabilise the care sector, which the Association of Directors of Adult Social Services says remains “on a cliff edge”. The government should match Labour’s election commitment to £8bn of additional funding for social care over this parliament.
Third, any long-term plan for social care needs to consider how to improve the quality of care. Too much of our current social care system, built on securing the lowest price for care, fails to value care workers, stifles the voices of service users and neglects the importance of prevention. This does not deliver good quality care.
This general election has shown that social care matters to people and the Conservative government would do well to think about that because the status quo is no longer an option.
Social care reform is difficult. Achieving it will take courage, commitment and extra funding. In this new political landscape it is more important than ever for political parties to reach out beyond Westminster, to listen to users and carers and to plan a new vision of care and support that works for all.
Barbara Keeley is Labour MP for Worsley and Eccles South and shadow cabinet member for social care