Centralising care won’t help anyone

By Heather Jameson | 29 July 2020
  • Heather Jameson

Fixing the adult social care system has been a priory for so long now that we might just need a new definition of the word ‘priority’.

After years floating around Whitehall, one can only assume the crisp white pages of the social care White Paper are now yellowed and crumbling – and still the system limps on with dwindling resources, crippling demographics and an under-appreciated workforce.

So it came as no surprise this week to see reports that the Government is mooting plans to hand social care to the NHS. ‘If in doubt, centralise’ is the motto of the Johnson regime.

It is not so much the right solution, more a knee-jerk reaction to the coming criticism of the COVID response in care homes. As COVID-19 pushes social care up the political agenda, the central Government instinct is to ‘take back control’ – and if that gives an impression of local government culpability, all the better.

The NHS, the beloved service of the British people, has many attributes that are deserving of a round of applause every week – pandemic or not.

Sticking to budgets is not its strong point. Nor is prevention, or housing, skills, wellbeing...all the attributes, which sit with local government, that continue to help people stay fit and well for longer, out of the health system, and away from hospitals and care. 

Instead, the NHS fails on prevention and focuses on picking up the pieces of ill health – often at the most expensive end of the system.

Worse still, there seems to be a widespread notion that local government wants to cling on to care in a bid to hang on to the extra cash. It begs the question, what exactly do people think care cash is spent on? It can’t all be frittered away, bolstering the biscuit budget and boosting fat cat pay.

In reality, without adult social care, councils would be self-sufficient on business rates, council tax, fees and charges. It would resolve the finance crisis in one easy move – and instead transfer it to the Treasury, which may be the stumbling block for the whole plan.

But it is not just the budget that matters, it is the people. Prevention, early intervention and joined-up public services at a local level is more cost-effective – and that is better for people.

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