Is the green paper actually going to be greener on the ‘other’ side of the fence? Is it better for social care if the green paper process is led by the newly named Department of Health and Social Care (DHSC) rather than – as it was originally intended – by the Cabinet Office?
Inevitably the answer is: it depends. There are risks around process, content and implementation. These risks are not insurmountable but neither can they be ignored.
In terms of process, there is a risk that the momentum that had been building behind the green paper – slow though it was – will be lost. The last thing that is needed is a further delay.
It will also be important to keep together the nucleus of the experienced team that had originally been assembled to produce the green paper.
Content-wise, it is essential that the green paper retains a broad remit under the DHSC. Social care reform is a challenge for the whole of government, and so an important test for the new department will be the influence it can have and its ability to engage the other departments. It will be important to understand and explore the critical links social care has to other policy areas such as housing, benefits and, of course, health.
But nor must social care be seen simply as a subset of, or adjunct to, the NHS. In some quarters, social care seems to be regarded largely as a way of minimising delayed transfers of care from acute hospitals. That bias must not be reflected in the content of the green paper.
More positively, although the green paper will focus solely on older people – a decision that has been rightly questioned by professionals and experts – the shift of the green paper to the DHSC may at least allow closer coordination with the planned workstream on working age adults. This will be led by the DHSC in partnership with the newly named Ministry of Housing, Communities and Local Government.
Perhaps the greatest risk, though, is around the implementation of the green paper’s recommendations. In purely policy terms, there was already disappointment within the social care sector at the departure from the Cabinet of Damian Green, who was felt to ‘get’ the importance of social care. Jeremy Hunt, on the other hand, has shown little interest in the area and has missed some obvious opportunities to demonstrate that he was interested in the social care sector.
But personalities are not the real issue here and, in any case, having social care added to the department’s title could well be a catalyst for a change in interest. No, the bigger concern is that the social care green paper will no longer be led by a minister who has cross-governmental responsibility, nor a minister who, in the case of Damian Green, was effectively deputy prime minister.
There have been commissions and green papers before and yet social care funding has resisted change for more than 20 years. The current Government lacks a parliamentary majority, and in these circumstances, producing policy that is not just coherent and comprehensive but is actually acted upon will be a challenge for anyone.
Simon Bottery is a senior fellow focused on social care policy at the King’s Fund