Comments by Juanita Elias, Commissioner on the Political Studies Association Commission on the Crisis of Care.
It is notable that the 2017 election campaign has generated considerable attentionaround the issue of social care. Today’s Daily Mail, for example, leads with a story about social care funding. This is in some ways quite remarkable, social care was certainly not under the spotlight in this way in the 2015 election. But at the same time, there have been growing concerns around the issue of social care funding and the impact of Brexit on the social care workforce. Chancellor Philip Hammond’s failure to mention social care in his 2016 Autumn statement led to widespread criticism and, following a winter of discontent for the NHS in which the inadequacies of the social care system were seen as a contributing factor, the 2017 budget saw the injection of £2 billion into social care. Social care, or at least the funding of social care – has emerged as a huge political priority. But, making social care a political priority, is not necessarily going to lead to changes that are workable or even practical – and changes to the funding of social care will not necessarily deliver fairer outcomes for older people, their families and their carers (both paid and unpaid).
It seems unlikely that the proposals in the Tory manifesto will deal effectively with the challenge of either delivering sustainable financing for social care, or reforming social care provision itself. The concern has already been raised that the proposed funding model will actually lead to most people paying more for their care. The manifesto pledges to put in place a £100,000 floor – with expenses exceeding that to be repaid after death. But this is an individualized funding solution and this is problematic. We do not know what kind of care costs we will incur in old age; will we die suddenly, or will we experience long term conditions such as dementia – a condition that requires long term personal care not usually covered by the NHS. The point here is that there is no notion of collective responsibility, as a society, for meeting the needs of an ageing population. As the Daily Mail headline suggests, promises that you will not lose your home to pay for care, may well be a vote winner amongst baby boomers – but we should be alarmed by the fact that there is no plan in place to reform how social care itself is provided. This is an issue that will require collective, rather than market-based and individualised solutions.
Social care in the UK is a sector in crisis – and this is not just because of the funding situation. The sector has come to be dominated by large for-profit providers providing low cost ‘one size fits all’ care packages. The care system itself is complex and difficult to navigate, and there is a considerable reliance on unpaid family members to provide care. The Conservatives have embraced commitments to better protect unpaid family carers (e.g. via career breaks) – and these protections should be welcomed. But without any effort to build a care system that works for all and is funded fairly, then this merely looks like a continued reliance on family members to compensate for the inadequacies in the social care system. As we highlighted in our report Towards a New Deal for Care and Carers – the current crisis of the social care system is creating significant pressures on unpaid carers, the majority of whom are women. The need for a viable, efficient social care system underpinned by a commitment to social justice for both older people and their carers, is what is currently lacking from the Tory manifesto.