Over 35 years of writing about social care I’ve seen shockingly bad services in the public, voluntary and for-profit sectors alike. Equally, I’ve seen outstanding quality in all three.
It rarely comes down to funding alone, though in theory it ought to be easier to provide first-class care at first-class prices. Leadership, training and values are more often the indicators of good or poor outcomes for the people who are supported.
Adult social care is a mixed economy and should surely stay so. But the Labour Party’s idea of a National Care Service (NCS) for England has prompted fears that independent providers would be squeezed out of a rigidly centralised system – understandable fears because Labour has been vague about the detail and slow to offer any reassurance to the contrary.
We are now getting the first clues to what an NCS would look like. The Fabian Society thinktank has been tasked with drafting a ‘roadmap’ for getting from here to there and its emerging conclusions suggest there ought to be little to scare the horses.
Andrew Harrop, the Fabians’ General Secretary and a past policy director of Age UK and Age Concern England before it, told a recent National Care Forum conference that the NCS would in his expectation be ‘a partnership, a network, not a single institution’ – in other words, not a mirror image of the NHS – and ‘as local and devolved as possible’.
Independent providers would have ‘a huge part to play’, Harrop said. ‘There won’t be a nationalisation, there won’t be a state takeover. There might be a role in some contexts for public organisations, but providers in the independent sector will still play a huge part in delivery.’
So far, so reassuring. But social care leaders need to pay much more attention to the development of Labour’s policy – and not just because polls suggest the party looks well on course to form the next Government.
First, the level of understanding of the care sector among Labour activists is low. For-profit operation is equated falsely with private equity and offshore investors taking inflated profits, not the typical small provider with one or two care homes or a domiciliary care franchise.
Second, the Labour Government in Wales has been consulting on proposals to ‘eliminate profit-making’ in children’s residential and fostering provision. That has a simple and broader appeal to many in the party on both sides of Offa’s Dyke.
And third, Labour’s shadow Health and Social Care Secretary, Wes Streeting, has yet to show much interest in the non-NHS side of his brief. He is given to provocative interventions and could spring an unwelcome surprise when he does turn his attention to it, however carefully the Fabians roll the pitch and notwithstanding the keen grasp of issues held by his experienced deputy, Shadow Care Minister Liz Kendall.
It’s admittedly hard enough keeping the show on the road in social care. But events are moving fast and care leaders must lift their heads from the day-to-day struggle and seek purposefully to engage the party that, on most forecasts, seems likely to be in Downing Street by the end of next year. The stakes are high.