The many seismic challenges we currently face, including continued recovery from a global pandemic, a cost of living crisis, energy instability and war in Europe, make this a time where bold, ambitious and historic policy decisions are called for.
While Franklyn D Roosevelt's ground-breaking New Deal led to lasting recovery for the USA following the Wall Street Crash and Great Depression, the bold public policy decisions of the post-war Labour Government redefined society in 20th century Britain.
With a new century becoming synonymous with the disconnect between rich and poor, young and old there is a critical need to reconnect society and ensure security, fairness and community become the defining concepts of our time.
Social care remains a stubborn policy failure which escapes the consciousness of those untouched by the need for support. While, for those impacted by this failure, the consequences socially, financially and mentally are often enormous – and growing. It is also doing lasting damage to NHS, care and councils with services suffering the cost of a demoralised and under-supported workforce.
It is too easy to focus on purely personal concerns when addressing the issues within social care.
Action is needed and it is needed now.
Instead, we aim to provide a set of principles around which effective policy formation, including effective financing, can begin. Without this there is a danger piecemeal ‘solutions’ to the problem continue when root and branch reform are needed.
These principles have been anchored around five areas of focus for the Commission.
Workforce
There is a need to make care a default occupation for people, especially those starting their career path and coming to the end of it.
This could be wedded in communities. A nationally recognised care service should be established locally to meet differing community needs which are locally defined by communities via council leadership, with those who need them put at the heart of services.
There should be an expectation – though not a compulsion – that younger people carry out a period of National Care Opportunity work in their locality, with incentives such as UCAS points.
But the overall principle should be that caring and empathy is an ‘uber’ skill, applicable to any career.
Similarly, vocational care work should be established as a realistic option for older people coming to the end of their working careers but still keen to contribute to their community.
While we recognise the need for increased pay for care roles, our focus is on strengthening the viability of care as a career path. A foundation qualification should be established which is applicable to both social care and health careers to increase the portability of careers between care, health and other sectors.
Value of social care
Care should be recognised as a basic responsibility of society and a responsibility for all.
Strong social care benefits the local and national economy as well as society through its preventative contribution to health and general wellbeing.
Strong social care can establish greater community cohesion and while the Integrated Care System model is showing signs of progress, similar care and health integration is needed at the national level.
Eligibility
There is an obligation on society to support ageing with dignity and it is the wealthy’s responsibility to contribute sufficiently to universal coverage.
The existing social contract is ruptured. There is a need to address in unison both society’s responsibility to support the dignity of the frail and the balancing of familial responsibility with societal responsibility.
We recognise the right to pass something on to family, but the bequeathed wealth of each generation should also enable society as a whole to tackle economic and intergenerational inequality.
People and Places
We are supportive of Integrated Neighbourhood Teams, which go beyond formal care and health integration and include voluntary, community and familial participation. This provides the opportunity to develop localised care and support structures which work within a national structure that allows localism to work.
Care is best done in the home and in communities. Institutional care should only be considered when there is no suitable community alternative. And the role of unpaid carers should be adequately recognised.
Innovation
Innovation and advancements in technology are positive, but need to be brought forward in ways that are humane and engage people in their design.
Innovation should assist care, not replace personal contact. It should be a flexible enabler to meet people’s needs.
To sum up, there is a desperate need for social care policy to rediscover the innate altruism that defines us.
While national structures and guidance are required care should ultimately be defined locally in a way that connects it with communities.
Through providing local definition to nationally establish principles an understanding of the primacy of care everywhere can emerge.
But it needs to emerge at pace.
Matthew Taylor is a public policy expert, former adviser to Prime Minister Tony Blair and currently chief executive of the NHS Confederation. John Ransford is former chief executive of the Local Government Association and an adviser on social care.
If you want to feedback your thoughts, email TheMJ editor Heather Jameson at hr.jameson@hgluk.com
