This article forms part of the LGA think piece series 'Towards a sustainable adult social care and support system'.
Bold action on funding reform is the birthday present that social care deserves on its 70th Birthday
Next month the country will proudly celebrate the 70th birthday of the NHS. But there is another, less celebrated, but equally important birthday which will pass without any fanfare - that of social care, which came into being with the enactment of the National Assistance Act on the same day as the NHS in 1948.
The Act did away with the Elizabethan Poor Law and, in its place, put a duty on local authorities to provide accommodation for the elderly, frail and infirm who required support. The act also made it compulsory for all residential care homes for the disabled and elderly to be registered and to enable them to be inspected.
Local authorities were given the power to make arrangements for promoting the welfare of people who were blind, deaf, or disabled by illness or injury. They were also given powers to inform people about the services available to them, support people to work, supply advice on living with disabilities and provide recreational facilities.
In essence, the Act gave birth to the modern social care system. But at the same time it caused a split between NHS and social care provision with which politicians and system leaders are still grappling today.
Despite this historic split today’s social care system is intertwined with the NHS, particularly where people who are ready to leave hospital need a package of rehabilitative or long term social care closer to home.
When there is insufficient social care in the community, it puts pressure on the NHS through delayed transfers of care, which have reached record highs under this Government. A recent report by IPPR and Lord Darzi estimated that these delays were costing the NHS £3 billion each year.
That is why the Prime Minister’s recent announcement of new NHS funding was doubly disappointing, in that it committed no money for social care. This is a wholly damaging false economy which will heap pressure on the NHS and see even more people go without the care they need to live with dignity.
Worryingly, there seems to be no end to the crisis in sight. The Health and Social Care Secretary’s decision to delay the publication of the Government’s Green Paper on the funding of social care has set the timetable for action back even further.
Since the election there have been numerous calls for cross party talks or even a Royal Commission to break the deadlock. There will be a time for cross-party talks. Indeed, in last year’s General Election manifesto we said that, as we develop further our proposals for the future, we would seek consensus on funding.
But cross-party talks can only be effective when all the parties have agreed their own funding positions. The delay to the Green Paper shows that the Government is further than ever from having its own solution.
In addition, all the parties also must agree to stop using the corrosive language of previous discussions which poison the debate and stop reform from moving forward.
In last year’s Budget Statement, Philip Hammond referred to reform of inheritance tax as a "Death Tax". The tone, as well as the content, of cross-party talks needs to be elevated to gain wider public support.
Time is of the essence. With a funding gap set to reach £1.5 billion by 2020, growing failures of care providers and flagging care quality, the system needs urgent funding from this Government. But after the Government’s damaging U-turn on their social care proposals during the General Election, they lack the courage and the leadership to take the bold steps required. Social care does not need another royal commission or Green Paper. Ideas for long-term reform are numerous and abundantly available.
By contrast, Labour pledged at the last General Election to invest £8 billion across this Parliament with £1 billion up front this year to begin to stabilise the social care system, enough to raise flagging quality by paying care staff the real living wage and reducing unmet need for social care.
We recognise the need for a longer term plan for funding care that removes the danger of catastrophic costs while acknowledging that people across society will have to make a contribution.
That’s why our approach will adopt the principle of sharing the risk for paying for care by implementing a cap on care costs at a lower limit than the £72,000 figure legislated for but later abandoned by the Government.
This will be a pivotal step that helps us transform the social care system so that it puts the independence and wellbeing of people first, demonstrating that social care is a vitally important service in its own right, not just a means of reducing pressure on the NHS.
Hopefully by the time of its next big birthday, we’ll be celebrating our social care system as well as our NHS.
Barbara Keeley MP, Shadow Cabinet Minister for Mental Health and Social Care