The alliance of interests urging a better deal for social care can at times seem fragile. From large care provider groups, trade unions, charities and local authorities to individuals who employ personal assistants and family carers, it’s a broad and unwieldy church.
In the run-up to council budget-setting for April and the local elections in May, tensions surfaced over how some local government voices were portraying the rising costs of adult social care and children’s services at the expense of other municipal undertakings.
Most prominently, the County Councils Network (CCN) issued a press statement saying its research showed that adult social care and children’s services combined now accounted for 69% of a typical county’s total budget, even though ‘they are not used by the majority of the population’. Calling for ‘honest discussion’ of what councils should be expected to deliver against this backdrop, the network said there was ‘simply less and less each year for us to spend on highly valued services such as libraries, road repairs and street lighting’.
To be clear, the CCN did stress that care and support for all age groups were some of the most important services provided by councils, that they protected the most vulnerable in society and indeed that they changed lives. But its comments were seen by some in the care sector as sending a divisive, indeed provocative, message to voters. As The Times headlined its report of the statement, ‘Councils warn bills for social care are threat to parks and libraries.’
Election candidates and party workers who have been out and about on doorsteps in recent weeks will tell you that social care is rarely raised as an issue compared to, say, potholes. Yet as leading sector analyst Richard Humphries commented in response to the CCN, if you add together all those involved in receiving or providing care, it works out as at least one in four of the population at any one time – ‘hardly a tiny minority’.
We all learn the value of good care, and discover the problems in getting it, when we have personal experience. Humphries himself decided to pen his excellent 2022 book, Ending the Social Care Crisis, after wrestling with the challenges of arranging and sustaining care for his late father. As he writes, ‘It left me feeling a stranger to the system in which I had worked for over 40 years.’
For others without such knowledge of the system, the experience is typically a shocking eye-opener. Writer Adam Luck described his family’s struggle in a diary published recently in The Times Magazine, relating the two-month hospital stay of his 82-year-old mother, Ann, after a suspected mild stroke.
In a Kafkaesque saga, in which the family is first told to expect Ann’s imminent discharge after just six days, the apparent dysfunction between health and social care teams becomes almost literally maddening. ‘Please get me out of here, darling, I am going crazy,’ she repeatedly texts.
At various times, the family is told that responsibility for arranging Ann’s further care rests with either the social care team or the hospital’s integrated discharge team. Neither seems able to move forward. When there is eventually apparent clarity that responsibility should return to the NHS if three care homes say they cannot meet her needs, it is subsequently discovered the policy does not apply to the area where she lives.
As related by Adam Luck, his mother’s care journey was chaotic, deeply unpleasant for her and ruinously costly for the taxpayer. But as he concludes, it was ‘by no means unique’. The experience will, no doubt, inform his choices at the ballot box.
Given our ageing population, there will eventually be enough families like the Lucks to achieve a decisive shift in those election-time doorstep conversations from potholes to care. But it will be a long wait. Better, surely, that we redouble our efforts to preserve and strengthen the alliance for change around a common narrative that all stakeholders can own.
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David Brindle is a social care commentator and Chair of Ambient Support.
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