MPs voted to approve NHS and social care tax rise, to help fund health and social care. A proposal that the Prime Minister said is ‘reasonable’ and ‘fair’.
The Government has proposed to introduce a UK-wide 1.25% Health and Social Care Levy based on National Insurance contributions (NICs) ringfenced to fund the investment in health and social care. The levy will make available around an additional £12bn per year on average for health and social care across the UK.
A cap will be introduced on care costs in England from October 2023 of £86,000 over a person's lifetime. All people with assets worth less than £20,000 will then have their care fully covered by the state and those who have between £20,000 and £100,000 in assets will see their care costs subsidised. Sir Andrew Dilnot told BBC Breakfast this morning, ‘We have had the best part of 30 years, where there is a desperate need to do something about social care. Of course, there are aspects of the package that I would like to be more generous, I would like the cap to be a bit lower, the means test threshold to be a bit more, but we should definitely say that this is a major step forward.’
The sector has largely welcomed the Government’s commitment, but there are concerns on whether the money will come soon enough and if the promised funding, will be the substantial commitment to bring about the major changes that the sector urgently needs. The National Care Forum (NCF) has said social care needs ‘significant additional funding now’ and ‘the initial apportionment falls well short of the additional £7bn funding requirements determined by the Health and Care Select Committee. NCF believes the Government needs to redress that balance urgently but acknowledges that the announcement has been ‘a long time coming’ and that it is ‘a giant leap forward.’
Vic Rayner OBE, CEO of the National Care Forum, said, ‘It is positive to hear the Prime Minister acknowledge the interconnectedness of success between health, care and communities. A truly integrated approach to health and care, with social care as an equal partner in that system will necessarily put people and their needs at the centre… ‘The dial has finally shifted and at long last the cards are on the table – and for the not-for-profit social care sector, the brilliant workforce and people receiving care and support – we have to believe there is everything to play for.’
Kathryn Smith, Chief Executive of Social Care Institute for Excellence (SCIE), agrees that a fully transformed social care system needs to be personalised for people, using their assets rather than asking what is wrong with them and that it must put people who draw on services at its heart so that they are central to the decisions made about them. Following the announcement, Stephen Chandler, ADASS President, said, ‘We are keen to look at the detail, but we hope that this package of measures can begin to help us to tackle the many challenges we face today, whilst transforming care and support for the future. We look forward to working with Government to ensure that in the future everyone gets the care, support and safeguards they need to live good lives.’
Simon Bottery, Senior Fellow in Social Care at The King’s Fund, and CMM columnist, told BBC Breakfast this morning that, ‘This is a really good step forward for adult social care and some of the measures are very positive indeed. However, we are worried that it’s not the giant stride that the Prime Minister implied when he talked about fixing adult social care once and for all.’
When asked about the biggest concerns for the sector, Simon Bottery spoke of the ‘backlog of people coming forward looking for care’, the ‘chronic workforce vacancies in the sector' and said the recruitment crisis is ‘likely to get worse in the short-term.’ If the Government is to make real change happen, Simon Bottery said, ‘Fundamentally, we need to get more money into the system, more quickly. To do this, we need to be paying providers more, so they can pass it on to staff. Getting more money into the system, so local authorities are better able to address people’s needs more quickly, these things are crucial.’
Professor Martin Green OBE, Chief Executive of Care England, said, ‘We want to go through the plans carefully and it is our hope that social care will be rewarded and recognised rather than playing second fiddle to the NHS. It is essential that money reaches the frontline.’
The Associated Retirement Community Operators (ARCO) said today that the conversation needs to shift urgently to asking what kind of care and lifestyle people actually want and how to best provide it. Michael Voges, Executive Director of ARCO said, ‘Older people in the UK have amongst the fewest options in the developed world when it comes to housing-with-care. Action is needed to help expand new types of provision which keep people healthy, well and independent for longer and which reduce the strain on the care home system.'
The United Kingdom Homecare Association (UKHCA) has criticised the Government’s focus and highlighted the millions of people who need support and care at home.
Dr Jane Townson, CEO of UKHCA, said, ‘Once again, the Government’s focus is on the 0.5 million people in institutional care, rather than the 15 million needing support and care at home. Home-based support and care play a vital role in enabling us all to live well at home and flourish in our communities. Investing in support and care early, preventing people experiencing crisis, helps to keep people out of more expensive settings of care, such as care homes and hospitals. This is better for individuals, better for the health and care system, and better for HM Treasury.’
The Care Workers’ Charity is very worried about the ambiguity of the Prime Minister’s statement and is unsure as to how much of the money raised by the levy he proposed will go to directly to frontline social care. The charity paid out £2.2m last year to social care workers in crisis, filling the gap between their salary and living costs.
Karolina Gerlich, CEO of The Care Workers’ Charity, said, ‘We are outraged that it appears only a very small proportion of the money promised will in fact go to social care. The sector urgently needs clarification and confirmation with regards to how much money will be directed to social care – if the healthcare-centred statement today is any indication of the proportion of funding the social care sector might expect to receive, then there is very little hope of any real reform and/or improvements benefiting the sector, its workforce and the quality of care received by those who draw on social care provision.’
Working age adults
There has been some concern from organisations and charities, who support working age disabled adults. Julie Bass, Chief Executive at Turning Point, said today, ‘While it is good to see some movement from the Government on its promise to fix social care, it is disappointing that there is no mention of social care for working age adults. Support for working age adults, for example people with a learning disability, represents nearly half of all social care expenditure but the sector is under-funded which means many individuals do not receive the support they need, and support staff only receive a low wage for what can be an extremely demanding job. The proposed reforms simply do not go far enough, and they fail to address a major part of the problem.’
One of the UK’s biggest social care charities, Community Integrated Care, commented on the Government’s social care proposals, adding, ‘Despite the rhetoric, we are no closer to fixing the generational crisis that is engulfing social care. Whilst reducing the cost of care for older people is vital, they represent only part of the community that social care serves. The Government has focussed on the recognisable, understood and politically positive aspects of the social care crisis, and failed to recognise the millions of family carers, disabled people and social care workers who have been left behind. This solution doesn’t ‘fix social care’ but instead tidies the tip of the iceberg.’
Dr Rhidian Hughes, Chief Executive of the Voluntary Organisations Disability Group (VODG), said, ‘We are concerned that Government’s approach to policy making could continue to leave disabled people living in England behind, as it has done so throughout the coronavirus pandemic, and we would encourage Government to prioritise solutions that work for everyone and enables older and disabled people to lead independent and fulfilling lives, in their local communities.’
According to Community Integrated Care, the sector loses 34% of its workforce every year. Frontline care workers are frequently paid £7,000 less than their counterparts in other public funded sectors. Half a million people have left employment in the past two years to become family carers. Hundreds of thousands of people miss out on vital support every year.
Mark Adams, CEO of Community Integrated Care, added, ‘The Government cannot represent to the public that this presents a fix. It needs to urgently work with the sector and people who access social care to truly build back better. This means fair pay, fair access, fair funding, and a genuine focus on driving innovation and quality, to ensure that every person can lead a good life.’
The Government’s approach to raise National Insurance has been questioned by the disability charity, United Response, which provides person-centred support to around 2,000 adults and young people with learning disabilities, mental health needs or physical disabilities. Tim Cooper, Chief Executive of United Response, said, ‘A fairer and more effective funding solution would be to raise income tax instead, ensuring that contributions are relative to earnings. The social care sector itself is home to a high proportion of low-paid staff – hardworking heroes who we rely on to maintain a broken system. This group should not be asked to fund these long-overdue changes.’
Visit the UK Government website to read the ‘Build Back Better’ report in full.
Social care organisations across England have joined together to launch #RememberSocialCare ― a campaign to honour the work of the adult social care workforce during the pandemic, and those we sadly lost.