In the context of an election that was called by Theresa May to deliver an endorsement for her Brexit strategy, social care was certainly not the issue that was expected to dominate headlines. And yet it has done so. It has also triggered a significant backlash in the polls against the Tory manifesto resulting in one of the most significant manifesto U-turns in living memory. Labour’s focus on social care, on the other hand, has helped its ratings enormously.
Social care is the one issue that marks the massive differences between May’s Conservative party and all the other main opposition parties. In these infographics below we present what each party’s manifesto says on the topic of social care and a short analysis provided by Care Commission student research assistant Arzu Naghiyeva.
Will this issue influence who you vote for?
Adult social care
Align the future basis for means-testing for domiciliary care with that for residential care, so that people are looked after in the place that is best for them. The value of the family home will be taken into account along with other assets and income, whether care is provided at home, or in a residential or nursing care home.
Introduce a single capital floor, set at £100,000, more than four times the current means test threshold; people will always retain at least £100,000 of their savings and assets, including value in the family home.
Extend the current freedom to defer payments for residential care to those receiving care at home, so no-one will have to sell their home in their lifetime to pay for care
Our forthcoming green paper will address system-wide issues to improve the quality of care and reduce variation in practice by ensuring that the care system works better with the NHS, promoting technological solutions to prolong independent living, and by investing in dementia research.
Give informal care workers a new statutory entitlement to carer’s leave, as enjoyed in other countries.
Means-test Winter Fuel Payments, focusing assistance on the least well-off pensioners, who are most at risk of fuel poverty. The money released will be transferred directly to health and social care.
Ensure that the NHS and social care system have the nurses, midwives, doctors, carers and other health professionals that it needs.
In contrast to other parties’ models, which spread the social care funding burden across the population, The Conservatives propose to only tax pensioners and those who need care; the future sustainability of the proposed model, that relies on accumulated housing wealth (which may not be there in the future), is questionable. With no clear statement on what the quickly proposed (non-manifesto) pledged care cap might be, these reforms to social care funding could generate significant regional disparities. The manifesto does not address the problem of market-failure in the sector, issues pertaining to the quality of care citizens should be entitled to, or labour practices in the sector. Further analysis of the Tory manifesto by the PSA Commission on care can be found here.
Adult social care
Address the immediate funding crisis by increasing the social care budgets by a further £8 billion over the lifetime of the next Parliament, including an additional £1 billion for the first year.
Repeal the Health and Social Care Act that and make the NHS the preferred provider.
Ensure that everyone with a long-term condition, such as those with diabetes, will have the right to a specialised care plan, and access to condition-management education.
Ensure high-quality, personalised care for people approaching the end of their life, wherever and whenever they need it.
Lay the foundations of a National Care Service for England in the first term of the next Parliament. This will be built alongside the NHS, with a shared requirement for single commissioning, partnership arrangements, pooled budgets and joint working arrangements [to address the growing demands arising from late-life illnesses].
Implement the principles of the Ethical Care Charter, already adopted in 28 council areas, ending 15-minute care visits and providing care workers with paid travel time, access to training and an option to choose regular hours.
Increase the Carer’s Allowance for unpaid full-time carers to align the benefit with rates of the Jobseeker’s Allowance.
The manifesto underlines the social care funding shortage, thus promising to commit to increased funding, proposes reforms that partially recognize the importance of informal care providers and their needs. The manifesto also makes an explicit commitment to improving labour standards in the sector. However, it remains somewhat unclear about the longer term plans for a national care service and how it might be funded.
Adult social care
Putting a penny in the pound on income tax to give the NHS and social care services the cash they need.
Direct this additional investment to the following priority areas in the health and care system: social care, primary care (and other out-of-hospital care), mental health and public health.
In the longer term and as a replacement for the 1p Income Tax rise, commission the development of a dedicated Health and Care Tax on the basis of wide consultation, possibly based on a reform of National Insurance contributions.
Establish a cross-party health and social care convention, bringing together stakeholders from all political parties, patients groups, the public, and professionals from within the health and social care system to carry out a comprehensive review of the longer-term sustainability of the health and social care finances and workforce, and the practicalities of greater integration. We would invite the devolved administrations to be a part of this work
Introduce a statutory independent budget monitoring agency for health and care, similar to the Office for Budget Responsibility.
Finish the job of implementing a cap on the cost of social care, which the Conservatives have effectively abandoned.
Move towards single place-based budgets for health and social care by 2020, allowing local areas to decide how best to provide the full spectrum of care for their community.
Remodel the healthcare funding system to eliminate perverse incentives, by moving away from payments for activity and introducing tariffs that encourage joined-up services and promote improved outcomes for patients and better preventive care.
Ensure those who work in the social care sector are properly trained, with accessible career pathways, and are suitable to practice by introducing a statutory code of conduct backed up by a care workers’ suitability register.
Raise the amount people can earn before losing Carer’s Allowance from £110 to £150 a week, and reduce the number of hours’ care per week required to qualify.
Give the NHS a legal duty to identify carers and develop a Carer’s Passport scheme to inform carers of their NHS rights, such as flexible visiting hours and access to support.
Provide more choice at the end of life, and move towards free end-of-life social care, whether people spend their last days at home or in a hospice.
Evaluate the valuable work of hospices with a view to putting them on a more sustainable financial footing and allowing them to expand their services.
The manifesto underlines the lack of funding for adult social care, and proposes immediate (and low-level) income tax to ensure adequate funding; it recognizes the importance of informal care providers, underlines the necessity to address their needs, however, does not clarify how.
Adult social care
Increase investment in social care for the elderly and all those who need it.
Scrap NHS Sustainability and Transformation Plans and roll back privatisation of the NHS
Introduce a single budget covering health and social services, to make life easier for people who need to access several types of service.
Bring mental health care in line with physical health care and ensure people experiencing mental health crises are supported close to their home and support networks.
Increase funding for local authorities so they can provide good quality public services.
This manifesto is very close to the Labour proposals in increasing spending and reversing the NHS internal market, but not as detailed on social care and also not explicitly funded.
Further analysis of the election campaign, and party manifestos and their commitments to adult social care can be found at the following links:
Melanie Henwood ‘What do the party manifestos say about social care’ The Guardian 24th May
Kings Fund Health and Social Care Tracker
Gordon Rayner, ‘Theresa May under pressure to say who will pay for social care after U-turn on ‘dementia tax’’ The Telegraph 22 May
Juanita Elias ‘Social Care and the Tory Manifesto’ PSA Commission on Care blog
Women’s Budget Group ‘What are the most important issues for women in the General Election 2017’
Fawcett Society ‘Women and the General Election 2017’
Rosie Harding ‘How the parties differ on their plans to fix Britain’s Social Care Crisis’ The Conversation 2nd Junehttps://theconversation.com/how-the-parties-differ-on-their-plans-to-fix-britains-social-care-crisis-78647