Opinion: Government’s new social care strategy ‘nowhere near a breakthrough’

The UK government have outlined how they propose to help the social care sector during these difficult times. Chair of Ambient Support, a UK charity that delivers care and support across the county, David Brindle, considers whether the suggested plans are worthwhile. 

So, we are to be bolstered. That’s the term used by Liz Truss in her Tory party conference speech for what adult social care can expect from the government, ‘so that everyone gets the care they need’.

Well, I suppose it at least gets us as away from semantic debate about whether social care in England is being reformed, or indeed already has been, as Boris Johnson, Truss’s predecessor as prime minister, claimed in his self-basting valedictory speech as he left Downing Street.

But Truss’s comment prompted lively discussion on social media about what being bolstered might mean. Cushioned was one of the politer interpretations. The £500m ‘discharge fund’ announced the previous week by health and social care secretary Therese Coffey is indeed a plump cushion, but plainly just the latest in a depressing annual series of panic bungs to help the sector stagger through winter.

As far as fundamental reform goes, and the kind of serious extra funding (perhaps £7bn a year more) that independent experts say is needed, we are nowhere near a breakthrough.

Even what little reform is scheduled is now in grave doubt. The County Councils Network is asking for a 12-month delay in the planned introduction in October next year of the £86,000 cap in personal liability for lifetime care costs, having commissioned research suggesting that the scheme is proving at least half as expensive again to administer as the government had calculated.

Old social care hands see history repeating itself. In 2015, in response to similar urging by local government leaders, ministers cancelled the plan then to bring in a cap the following year and deferred it to 2020. It has since been further postponed to 2023.

The CCN is also seeking a two-year delay, to 2025, in introduction of self-funders’ right to ask their local council to negotiate their care fees on the same, usually greatly preferential,  terms that the council itself secures for state-funded individuals. As the existing 2023 date for this draws ever nearer, care commissioners and providers alike remain perplexed as to how it can work.

Optimists cling to the hope that Coffey described the discharge fund as a ‘down payment’ on a longer-term intention to ‘rebalance’ funding between the NHS and social care. This followed comments by Truss during the Tory leadership campaign that social care should in due course expect ‘the £13bn’ – the full annual yield of the health and social care national insurance levy introduced earlier this year, of which it was initially due to get just 15% over the first three years.

However, the levy is now being scrapped and it is unclear where replacement funding will come from, especially in light of the economic crash triggered by the government’s mini-budget and the consequent likelihood of further deep spending cuts.

Meanwhile, what of the £500m? The nights are drawing in, the temperature is dropping, and it is getting very late to allocate cash relief to a care sector on its knees. Moreover, it’s clear that the bulk of the emergency funding will be targeted to pay for extra care packages in areas with the worst hospital discharge challenges. 

Yet again social care finds itself playing second fiddle to the NHS. Only if and when this mindset changes will we start to make progress.

Photo by Jordhan Madec and PublicDomainPictures