Entering Downing Street Boris Johnson said he was going to fix social care.
No matter how many times he shouted ‘And we fixed social care’ at PMQs, no one drawing on social care or working to provide or commission it believes this has happened:
- The core of the model to ‘fix’ social care, with its focus on a payment cap and floor won’t drive actual improvements to people’s lives and the funding allocated will be insufficient to generate the changes needed to make social care sustainable.
- Something called the ‘Health and Social Care Levy’ brought in when the NHS is in a terrible state is unlikely to release significant funds for social care soon enough.
The Levy allocates £30.3bn to England over three years. But social care is down for only £5.4bn of this, with the cap and floor likely to take up the vast majority.
Enter the Conservative leadership contest. Noises from the recent debates were worrying. One surviving candidate declared opposition to the National Insurance rise to pay for the Levy. The other faced accusation that he only supported it ‘because the boss told you to’, leading to worry his continuing support may be tested in the campaign. Though social care did get a couple of mentions, they weren’t reassuring in terms of securing even the financial support already promised.
This is causing real fear for people and across councils and social care bodies - this soon after a survey from the Association of Directors of Adult Social Services painted a grim picture of current ‘pressures’. The candidates need to be challenged to offer clarity on their positions.
Sadly, such shallow support for social care is not surprising. David Fothergill from the Local Government Association, at a recent House of Lords Adult Social Care inquiry hearing, reminded us that for the public, potholes trump social care. We clearly need a serious campaign to shift public perceptions - with successful examples from other countries such as Australia as our inspiration.
So, what do people, councils and support providers need from the two candidates on social care? Short term the absolute bottom line is a commitment not to take away the promised funds (and release them sooner). At a time when hundreds of thousands await support failure to do this will cause massive damage to people’s lives. People who draw on social care need their support stabilised right now. Support providers and people who manage their own support via direct payments need to be able to pay competitive salaries to recruit and retain workers. Councils need the funds for this.
But the new Prime Minister will also have an opportunity for a reset. There is a real opportunity to start to build something much better. This could take the generally positive high-level ideas in the recent reform White Paper but move on to develop a serious plan for a generational shift in what social care does and how it does it. This would be away from time and task, life and limb institutional models towards sustainable approaches that support people to have a life, not just stay alive.
The great news is that these approaches can already be seen in glimpses of the future around the country. To command public and hence political support they need to be presented as for ‘us’ not ‘them’, about good communities and lives for all of us. Though traditional cultures are strong in some places our movement, with people who draw on support at its heart, sees increasing numbers of places and organisations making change. Recent policy statements from bodies representing council leadership show they are ready to make generational change over the next few years. They just need a bit of help – to stabilise and then start to move forward.
Long term this really needn’t cost the earth because it should be focused on supporting communities to generate wellbeing in strong inclusive places and on helping people live well in their homes. It should help people avoid damaging isolation and make sure a crisis or stay in hospital doesn’t lead to expensive long term care away from home for most people. A short to medium term investment fund (perhaps five years) could light the blue touch paper for this transformation.
Our Social Care Future movement has a vision for this shift - developed by and with people who draw on social care:
We all want to live in the place we call home with the people and things we love in communities where we look out for one other, doing things that matter to us
Surely not too much to ask. So, Rishi, Liz - A little help?
Martin Routledge is convenor of Social Care Future