The tragic circumstances we have seen in care homes during coronavirus have again exposed the fragility of the system. Of course, voices in local government have been shouting for a long time about the financial crisis facing social care arising from the dents made in a can that has now been kicked down the road so many times it is withered and misshapen.
While policymakers have woken up to the challenges facing social care, they seem obsessed with one small part of the issue. Some of the ideas being talked up – particularly those postulating a centralised ‘National Care Service’ – have a narrow view of social care consisting primarily of ensuring the supply of care homes and supporting discharges from healthcare.
There is still a tendency to see social care through the prism of what the health service needs – but the system is far broader. Every day, councils provide care for a range of adults – including those with chronic conditions, mental health impairments, or substance addiction.
For the system to become truly effective it also needs to look at how it is properly integrated with other services – not only health, but housing; children’s services; even economic growth. This can only be done effectively if it is run locally.
Perhaps real reform might come from reimagining the present divide between ‘health’ and ‘care’ and instead use the pandemic as a springboard to a new integrated system which is split between ‘acute’ and ‘community’ services.
Yes, sometimes care needs to be in institutions, but increased technological advances mean that in the future it is far more likely to be provided in people’s homes. We need to create a system which can evolve to meet these more sophisticated needs – a good start might be to examine how we can incentivise more ‘retirement communities’, which is persuasively argued in a recent report.
The pandemic has shone a spotlight on social care and the urgent need for reform and as the country looks towards ‘recovery’ it needs to be a key aspect of what we do differently. Government needs to not only resist kicking the present can down the road any further but instead to boot its dented frame into touch for good. Post-COVID, we need an entirely new can.
Jonathan Rallings is senior policy officer for social care at the County Councils’ Network