Hannah Pearce, Head of Public Affairs, Age UK
In the division of jobs following the Coalition agreement in May 2010 it’s probably a fairly safe bet that there wasn’t a long queue of budding Ministers putting their hands up for the job of sorting out social care. The headache of how to deliver high-quality social care fairly, to an increasing ageing society with ever-complex needs is an intellectual assault course. Working out how to pay for it is ten times as difficult.
Tribute should now be paid to Paul Burstow MP and Norman Lamb MP as the successive coalition Ministers for Social Care who grappled hard with the issues and wrestled out a Care Act which contains much to welcome, including a cap on care costs, national eligibility criteria, a duty to promote wellbeing and improved provision of information and advice. They also both engaged seriously with those of us, statutory and non-statutory organisations, who support individuals and deliver care.
The argument that we failed to win under the last Government was the promise of adequate funding for a service that is on its knees. That is a huge pity and a daily disaster for hundreds of thousands of older people and their families across the country, struggling to manage without formal support. The question of funding for social care remains the challenge for us under the new Conservative-led Government.
Age UK’s most recent assessment of the shambolic system of social care found over 900,000 older people going without necessary care. The amount spent on social care services for older people has shrunk by over £1bn since 2010/11. Preventative services like meals on wheels and day care have plummeted by over two thirds, and the number of older people receiving homecare has fallen by a third. In 2010/11, 12.4% of all people aged 65 and over received social care but today just 9.1% of older people (849,280) receive any support. This comes as the number of people over 65 has grown by well over a million in the last decade and those aged 85 and over, the fastest growing age group and those most likely to live with multiple long-term conditions, including dementia, are most likely to need care. The result is care being severely rationed, and both paid and unpaid carers being stretched to breaking point.
There is precious little detail in the Conservative manifesto about the Party’s plans for social care. They confirm they will implement the care cap and the deferred payments systems which will be in place by 2016. The manifesto makes further commitments to the Better Care Fund, which is a valuable initiative to encourage local health and care services to work together. But there is no mention of increased investment in social care services. Let alone the additional £4.3bn estimated by the Association of Directors of Adult Social Services which will need to be found by 2020 just to keep services at current levels.
The Conservatives weren’t alone in this lack of manifesto detail, all the parties were complicit in trying to ignore the problem of social care, instead relying on people to muddle through. This is particularly frustrating at the same time as a sort of bidding war took place on the NHS where parties competed on how many billions of pounds of investment they would promise. But without the accompanying increase in funding for social care, we will continue to see increased demand for expensive hospital care as people are unable to manage at home. We’re all too familiar with the stories of people bouncing in or out of hospital, or hospitals unable to discharge older patients because there isn’t the support they need at home or in care homes to allow them to leave, contributing to the costs and pressures on the health service.
The danger is that Government once again puts social care in the ‘too difficult’ box or convince themselves that more thinking is needed. The three very authoritative commissions on long-term care by Sutherland (1997), Wanless (2006), and Dilnot (2011) have laid out the theory. We don’t need more analysis, we need more investment. Our priority for the next five years will be to ensure that more and more people don’t slip into the hole which has opened up between need and supply of care, that social care is a political priority and to convince the new Minister for Social Care that increased funding is unavoidable.
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