A sea of disappointed faces: that’s what I saw when discussing the social care White Paper with my Age UK colleagues. I don’t want to underestimate the hard work that will have gone into creating this well-written document, but in the end it doesn’t grip the most pressing issues facing social care – funding and staffing – and, largely as a result, it fails to do the job that was needed.
After waiting so long for the social care Green Paper that never was, and given the parlous position social care is now in – made worse by the pandemic – a broadly sympathetic narrative on social care was never going to pass muster, unless accompanied by a big slug of new Government funding.
In truth, social care observers weren’t expecting this: the die was cast on funding at the Spending Review. This turned out to be largely an exercise in smoke and mirrors where care was concerned. Once cost increases are factored in, there was little if any more money for care services for the next three years. What new cash was made available is almost exclusively for the Government’s cap on catastrophic care costs and its consequences.
The £1.6-7bn left over provided the platform for this White Paper: enough to do something, but not very much and certainly not sufficient to drive the transformational change we need.
This was the difficult hand dealt to those charged with writing the Paper, and given these limitations they did a fairly reasonable job.
The positive vision the Paper articulates has been widely welcomed. Although lacking in ‘star announcements’ and ‘rabbits from the hat’, some of its measures, over time, should help.
But as long as there is no solid information on what is going on in social care, it is easy for the Treasury to bat every request for help away.
Similarly, the section on technology contains much good sense. The specifics may not be very eye-catching, but ensuring care homes have decent broadband and care agencies access to software to help them with rostering, are both long overdue steps.
That is the problem with the Paper in some ways: social care has been neglected for so long that some of its best measures are things most people would reasonably expect to be in place already.
The commitments on housing are thoroughly welcome but woefully underpowered in terms of the resources available. Most older people age in place and there is an interesting commitment to creating a handyman service to help speed up the installation of aids and adaptations. How substantial and available this provision will actually be, we’ll have to wait and see.
Also notable were the commitments to trial new approaches to care, and to expand respite and day provision in the community, to help those receiving care and their unpaid carers, too. All good stuff, but only modest interventions will be possible.
Meanwhile, the sections on the workforce are a step forward and could be really important over time, but there is a very obvious attempt to avoid the elephant in the room – ‘rates of pay’.
This is deeply regrettable, as getting more money into care workers’ pockets now is the single most important intervention minsters could make to help stabilise the service.
A wise social care person told me she found some of the words in the Paper exciting, or at least they would have been, had there been £15bn to put them into effect.
To that extent we are where seasoned observers say they have been over and over again: lots of vision, but coming up badly short where the financials are concerned. This creates a difficult situation for us all, because there is a risk that faced with criticisms of this kind, politicians conclude that whatever they do for social care it is never enough.
They have a point, but then that is largely because there is so much catching up to do.
The sense of disappointment is also heightened because of the ‘promise’ the Prime Minister made to ‘fix social care, once and for all’. He obviously hasn’t achieved it, or got anywhere near it yet. Perhaps if he had never made such a pledge, we would appreciate this White Paper as the ‘step on the journey’ it is. No more, no less.
Caroline Abrahams is charity director at Age UK