Earlier this month I published five tests of the Government’s announcement on reform of the funding of social care:
1. Does it generate sufficient funds immediately to close the gap between the population’s current care needs and the care services available to meet them?
2. Does it provide stable, reliable and sufficient funding for social care services in the long term so this question is resolved now and for future generations?
3. Is it fair in the way it raises income from the population given the financial pressures on younger adults, and the growth in unearned income from rising property values of many older people? And is it fair in the way that the money is spent on those with care needs?
4. Will it lead to a better deal in the pay, conditions and career prospects of the social care workforce and will it improve service effectiveness and efficiency?
5. Does it support greater integration of health and social care services to provide a better, seamless experience of personalised care for those who receive support?
I regret to say that it appears to fail on all counts – not even a bronze compared to the gold standard desired, expected and needed. The Health and Social Care Select Committee chaired by former Secretary of State for Health, Jeremy Hunt, previously called for an additional £7bn a year for social care. Yet, of the additional £12bn per year being raised for the next three years, only £1.8bn (15%) will go to social care – the rest going to the NHS; and of that around half will pay for the cost of the new care costs cap meaning just under £1bn will go to actually fund more or better social care. This will not mean a better deal for the low-wage care workforce or address the problems of workforce shortages and high staff turnover that inevitably lead to poorer care for those in need.
The new health and social care levy, if fully ring-fenced, could provide a long-term funding solution for social care but it will not do so if the vast bulk of that levy goes into the NHS. Local authorities responsible for social care will remain having to go cap-in-hand to the NHS for additional income, and history tells us that the demands of clinical care (with or without the pressures of a pandemic) will always trump those of social care.
The lack of fairness in the increase to National Insurance contributions to fund the levy is self-evident, and the £600m raised through the extra tax on dividends is just 5% of the total - little more than political cover to claim the levy is broad-based when in reality it is taking from the poorest to protect those with large capital assets through the care costs cap of £86,000.
One glimmer of hope is that Government have promised a new White Paper on the reform of social care. It is, to say the least, odd that this will be published whilst the current Health and Care Bill is going through Parliament rather than being a part of it. But it does at least mean there are still things to play for in securing a stronger social care system for the future.
Phil Hope is co-chair, Future Social Care Coalition and former minister for care services