Care sector underfunded and in urgent need of reform

In its report published today (June 16), the Public Accounts Committee (PAC) says the pandemic’s ‘devastating impact on the care sector’ has emphasised that ‘care is not properly funded, lacks transparency and urgently needs reform.’

Governments of all political persuasions have promised social care reform for the past 20 years: ‘white papers, green papers, consultations, independent reviews and commissions’ yet, ‘reform has not occurred’.

Commitments the government has previously made to the PAC, to ensure long-term funding is in place; to set out plans for tackling the problems faced by the social care workforce, have not come to pass.

The costs of Covid-19 and the dramatic fall in care home occupancy from around 90% at the start of the pandemic to 80% by February 2021 put many providers at risk of failing, but DHSC has ‘poor oversight of the system and seems complacent about the risks of local market failure’.

The government has provided a welcome, significant short-term support to help providers through Covid-19 – now the committee says it is vital that DHSC clearly and in detail ‘sets out how it will help providers move beyond it’.

The current system ‘does not work for local authorities or those paying for their own care’. Funding cuts have meant most local authorities pay providers below the costs of care and providers live ‘hand to mouth’, unable to take the long-term decisions which would improve services.

While information about care quality is available, there is a lack of transparency about what people or local authorities get for the money they spend.

Social care is a ‘people business’ and the long-overdue workforce strategy must “tackle low pay, improve career development and tackle unacceptably high turnover. Care workers suffer greatly from a lack of parity with the NHS in terms of pay, conditions and status.”

Meg Hillier, chair of the committee, said: ‘Carers, younger and older adults needing care, and home care have seen decades of neglect, and the 1.5m who work in care deserve much better.

‘The reforms to address this now must include a long-term funding plan that allows local authorities and providers to innovate and improve services. We cannot afford more broken commitments on care.’

Independent Care Group (ICG) chair Mike Padgham said the report is yet another damning indictment of the way it cares for the country’s oldest and most vulnerable.

‘Here we have yet another damning indictment of the way governments have betrayed us over social care reform.

‘How many times do we have to tell them the house is on fire before they call the fire brigade?

‘We have been campaigning now for a generation and this latest report is just the latest. But our fear is that the government simply isn’t listening. Despite promising to get social care done, it just keeps pushing reform further and further down the road.” He said reform had to come now. The situation is becoming critical.

‘Many are now facing dire financial difficulties because their occupancy rates have not recovered since Covid-19 and they have been battered by other soaring costs associated with the pandemic, including higher staffing costs, extra PPE costs and high insurance premiums.

‘Providers who look after people in their own home through homecare – which is clearly a central plank to the Government’s future policy for care – are also suffering significantly.

‘There have been provider failures already and more are inevitable unless action is taken urgently.’

‘We must act fast, or we will not have a social care sector left to reform.’

Professor Martin Green, chief executive of Care England welcomed the report and said an occupancy guarantee as well as measures to reward and professionalise the workforce would be ‘enormously helpful’ to the sector.

‘This hard-hitting report makes it absolutely crystal clear that reform is not only necessary but essential.

‘We hope that the government will adhere to the excellent recommendations and ensure that social care gets the attention it deserves, it is not just a case of money but system review.

‘Social care is linked intrinsically with the NHS and it is, therefore, futile focusing on one and not the other.

‘Care England has long called for an occupancy guarantee as well as measures to reward and professionalise the workforce, these recommendations, if enacted, will be enormously helpful.’

A Department of Health and Social Care spokesperson said it will consider and respond to the committee’s recommendations in due course.

‘Throughout the pandemic, we have sought to protect everyone working in the social care sector or receiving social care, particularly older people who are more vulnerable to the virus, and have provided almost £1.8bn for the sector, including infection prevention, control measures and prioritised the sector for the vaccine.

‘As previously announced, the Health and Care Bill will introduce plans to develop and support improved adult social care oversight across England.

‘We are committed to sustainable improvement of the adult social care system and, as affirmed in the Queen’s Speech, we will bring forward proposals later this year to ensure every person receives the care they need, provided with the dignity they deserve.’

Photo Credit – Georg Arthur Pflueger