Cllr David Fothergill, chairman of the Local Government Association’s community wellbeing board, says the government’s social care plan contains far too little detail and no action at all on several crucial issues which need to be resolved and that the NHS cannot be fixed without also fixing social care.
The government’s apparent reliance on council tax, the adult social care precept and long-term efficiencies to meet core costs is deeply troubling.
Council tax raises different amounts in different parts of the country, unrelated to need, while social care has already had to meet a £6.1 billion funding gap over the past decade through savings and diverting money from other council services, cutting them faster than they otherwise would have been.
Instead, the Spending Review needs to provide an urgent cash injection of genuinely new funding to tackle the huge pressures facing the care system now, including on staff pay to help address recruitment and retention, which has been severely stretched to breaking point by the pandemic.
Of the estimated £36bn the new UK-wide health and social levy will raise over three years, only £5.4bn is to be ringfenced for social care in England.
Unlike for the NHS, none of this money appears to be allocated to help tackle the significant pressures facing social care now. The LGA says that addressing the NHS backlog and freeing up hospital beds cannot be done without also fixing social care, which will require additional support for those discharged in the community.
The lack of any itemised breakdown of how this share of the levy will be used for social care is creating concern, while urgent clarity is also needed on how much will go to adult social care beyond the three-year period and an absolute guarantee that this will be delivered.
Funding the plan’s cap on care costs and increased financial means tests thresholds will absorb a substantial part of the £5.4 billion and the costs of this financial reform will continue to rise into the next Spending Review period.
Councils are concerned that this will leave little or nothing to pay for other desperately needed reforms such as investing in prevention, care worker pay, quality, access, innovation and new models of care, and meeting unmet and under-met need. The upcoming Spending Review must tackle these issues head on.
While protecting people from paying ‘catastrophic costs’ for their care is important, the LGA says the introduction of the care cap is an enormous undertaking and councils should receive all the support they need to implement it.
It is good that the government intends to co-produce the planned white paper on wider adult social care reform. This should be published before the end of the year and should draw on the huge body of work the LGA and other social care partners, particularly those with lived experience, have done in recent years, backed up by additional new funding.
Social care was facing an uncertain future even before the pandemic, which has exposed and exacerbated some fundamental weaknesses in how we continue to pay for and provide care and support.
The government’s long-awaited plan has some potential promise on how care is paid for and the contributions people themselves make, but has left open many more questions which need answering urgently.
As it stands, it will not improve access to or quality of social care services, or provide an uplift on care worker pay, in the here and now which would better support people to live the lives they want to lead and in turn strengthen our communities.
We need a cast-iron commitment from the government that the white paper, together with the Spending Review will result in a long term plan and a steady stream of investment into social care.
It is vital we understand what proportion, if any, of the future funding from the levy is set aside for this purpose, for the benefit of the millions of people who work in and draw upon social care.
The bulk of the cost of publicly funded social care is already met through council tax. Increases in council tax, including the social care precept, has always been a sticking plaster solution to a complex funding problem and should not be relied upon further.
Increasing council tax to pay for social care is a double whammy for hard-pressed residents, who may feel they are shelling out twice for a service now that the levy is being introduced.
The Spending Review should be used to set this plan straight and provide upfront, desperately needed new funding to meet immediate demands and pressures in our care system so that people can live their best life. The Government must see this as investment in people – in all of us.
Photo Credit – National Cancer Institute