At the end of the recent social care summit convened by The King’s Fund think-tank, delegates were asked whether the day of debate had left them more optimistic or less so about achieving lasting care reform. 54% said more and 46% said less.
Not a resounding vote of confidence, perhaps, but certainly something to build on. In discussion, optimists cited the sector’s embryonic fair pay agreement, its impressive embrace of digital technology since the pandemic and the passionate commitment with which Baroness Louise Casey seems to be leading her commission on reform. Unsaid, but in the back of minds, might have been the prospect of change in the Labour Party leadership putting more oomph behind her work.
Those inclined to pessimism, among whom care providers were notably vocal, cited the block on migrant workers, near-prohibitive costs of investing in new provision and, on Casey, politicians’ record of 30 years of failure to deliver reform. In passing, it was observed that declared pessimists happened to be all men and optimists all women. Make of that what you will.
One woman who was decidedly optimistic was Sally Warren, Director General for Social Care at the Department of Health and Social Care. No surprise there, you might think, but Warren – a King’s Fund alumna – commands wide respect for, among other things, saying it like it is.
Promising that the Government was ‘not holding back’ on reform despite Casey not being due to deliver her final report until 2028, Warren said, ‘There are some things that we absolutely should crack on and do.’ Progress was being made on Casey’s early recommendations around dementia, motor neurone disease and safeguarding and a further response on these would appear over the summer.
However, Warren went on to warn that the path to reform would involve ‘inevitably difficult decisions, trade-offs and compromises’, adding, ‘There will be a point where we disagree with each other.’ In case anyone had missed the message, she said, ‘We need to learn to be able to disagree with each other in a way that still allows us to make progress.’
This call for greater maturity in the reform debate chimed with conversations that have been taking place among sector leaders under the auspices of The King’s Fund with support from the Rayne Foundation and Joseph Rowntree Foundation. One emerging theme has been the need for the sector to speak with more of a unified voice; another has been the need for key players to resist the temptation to sulk when things do not go entirely their way, especially when it comes to money.
Are these messages being heard? A straw in the wind, maybe, but there was an interesting outcome when summit attendees discussing the provider market in a breakout session were asked what one thing might help make the market more sustainable.
Predictably, the most popular choice was better funding. But second and third were greater trust and greater collaboration. As Warren said, a commission of inquiry of itself achieves nothing; it is the response to that commission that holds the key to change. If the care sector can respond to whatever comes out of Casey with more trust and collaboration than shown in the past, we may finally get somewhere.
How can the sector ensure it speaks with a unified voice? What compromises could be made? Comment on this column or join the conversation to share your thoughts.
David Brindle is a social care commentator and former Public Services Editor of The Guardian.
Email: [email protected] LinkedIn: @David-Brindle