Every year the Oxford English Dictionary identifies a newly coined word that has taken on wide usage. For 2023 it was ‘rizz’ (meaning, roughly, ‘charisma’).
Social care also needs a new word to describe an annoying and potentially damaging trend that has been around since at least 2018. That was the year the Department of Health became the Department of Health and Social Care and, while this was a positive move, it also brought with it a tendency for Government policy statements to have the words ‘and social care’ added after ‘health’ even when social care had been given little or no consideration in development of the policy in question.
In the past, I’ve called this an ‘andsocialcareism’ but that’s far too clumsy a word. Instead, I want to suggest we call it a ‘hancock’ because one of the worst examples I have seen was from then Health and Social Care Secretary Matt Hancock, who replaced Jeremy Hunt in July 2018. In a 2019 speech, he described how he had, ‘spoken to doctors, nurses, paramedics, porters, and patients the length and breadth of this nation’. He then went on to outline four priorities for the health ‘and social care’ system – infrastructure, prevention, people and technology – without giving a single example of how these relate to social care. The speech is littered with health and NHS examples and policies but not a single one mentions social care.
A more recent but startlingly similar example of a ‘hancock’ was the announcement in December last year by the new Health and Social Care Secretary, Victoria Atkins, of her priorities for the health and social care system. The Secretary of State ‘pays tribute’ to NHS, social care and research staff for their hard work but goes on to outline Government achievements in health and research (50,000 additional nurses, 50 million more GP appointments, the rollout of lifesaving HIV opt-out testing etc.) but not social care. In fact, in the whole piece, the only relevant part for social care is a bullet point referencing Government support for older people to maintain their independence for longer.
‘Hancocks’ aren’t just in speeches, though, they are in policies. In October 2021, for example, the Government announced, ‘the most far-reaching review of health and social care leadership in 40 years’, led by General Sir Gordon Messenger and Dame Linda Pollard. In practice, the review quickly identified that the huge diversity of structures, systems and staff across the health and care system meant it could not possibly adequately cover social care. Yet when the review was reported in June 2022 with a focus almost entirely on the healthcare system, the announcement still boasted about the ‘biggest shake-up in health and social care leadership in a generation’. In practice, we are still waiting for a ‘far-reaching’ review of social care leadership (or, indeed, a workforce strategy).
This may all seem pernickety but ‘hancocks’ matter. They are small illustrations of a much broader policy assumption that what really counts in the health and care system is the NHS. Social care saw this perhaps most keenly during the early stages of COVID-19 when providers and commissioners felt that their needs for personal protective equipment and testing were not given the same priority as those of the NHS. All the signs suggest that the two main parties will focus on the NHS and avoid talking about the vitally needed reform of social care during the next general election.
So, while it is welcome that the department changed its name in 2018, it was never going to be enough. We now need to see a further shift towards genuinely treating social care as the equal partner that it is, not simply an added ‘and social care’ at the end of a list of health-focused policies.
Simon Bottery is a Senior Fellow in Social Care at the King’s Fund. Email: [email protected] X: @blimeysimon
Brilliant Simon – to the point as always.