The social care system is unsustainable and in crisis. Sustained financial cuts mean local authorities are struggling to meet their statutory duties towards both the carers and those with care needs. The broken system is impacting other public services too; forcing the cancellation of operations and queues in A&E because the provision of support at home is not good enough. This is an urgent issue requiring immediate political attention.
Despite the crisis – much like every other aspect of public life in Britain this year – the ongoing Conservative Party leadership election has been dominated by Brexit. The candidates’ bold endorsement, reluctant acceptance or outright rejection of a ‘no deal’ scenario are the dividing lines on which the debate has played out. This should not come as a surprise. It is the issue with which the Conservative membership are most preoccupied, and it is this group that will crown the victor.
But where is the discussion of policy? And how has social care received so little attention? Early in the election, Dominic Raab proposed a £100,000 cap for lifetime social care costs and Jeremy Hunt identified the need for an improved system. Rory Stewart mentioned it a few times, but it has hardly strayed from platitudes and generalities. Where are the policy proposals?
At the 2017 general election, Theresa May’s ill-fated proposals for social care were introduced to the Conservative Party manifesto with little consultation. Even after a hasty U-turn, the affair lost them significant electoral support. Since the election, we have been promised a Green Paper on social care, but its publication has been repeatedly delayed.
Adequate funding and the provision of good quality care for older people remains one of the thorniest social policy issues of the day, but almost 60% of Conservative MPs believe there is a crisis in social care so surely the candidates chasing the keys to Downing Street should address this alarm. Here we will explore those policy positions (or lack thereof) for each of the candidates.
Starting with the frontrunner, Boris Johnson – the former Mayor of London and Foreign Secretary – there is little to report. As Mayor in 2010, he championed equitable access to high quality health and social care services by focusing on the commissioning process but it is difficult to find anything he may have said since then. Since his return to Parliament in 2015, he has not spoken on social care nor championed reform in any meaningful way.
Similarly, the Home Secretary, Sajid Javid, has so far been silent on the issue. In 2018, speaking from the dispatch box, he described it as ‘a long-term challenge that requires long-term systemic change’ and announced extra funds – but the story goes cold from there.
Michael Gove has not spoken of social care in Parliament in the last decade. Most of that time was spent as a senior member of the Government, heading up Education, the Whips Office, Justice and the Environment; but even as a backbencher he stayed quiet on this significant issue. In 2013, he described a ‘personal’ mission to reform social care for children and families – by which he meant reinforcing the need for individual responsibility – but he has hardly touched the care of older people. The exception is his campaign launch speech where he committed to introducing social care insurance supported by the state to avoid people losing their homes to cover the cost of care.
Jeremy Hunt was the runner up in the first round of voting. He was the Secretary of State for Health for close to 6 years from 2012 to 2018, with the Social Care remit added to his portfolio for the last 6 months in the job. That tag-on portfolio seems to have had some impact because he has committed to using the boost in the economy (that his premiership would inevitably facilitate) to invest heavily in ‘social care and defence’. Otherwise, his only intervention on social care since the contest began has been to call for greater integration with the health service. He has described delivering reforms that sort out both funding and quality issues as ‘the litmus test of whether we are really serious about looking after older people with dignity and respect’.
Rory Stewart, the outsider attracting public interest for his unique campaigning approach, has pledged as part of his leadership pitch to resolve the social care challenge for poorer and more vulnerable elderly people (without providing any estimated costs). He has talked of feeling a ‘sense of shame’ where the social care system has failed people and welcomes engaging other political parties to devise a long-term solution. Although Stewart has not made any concrete proposals, he has made a concerted effort to identify the issues and suggest a direction of travel.
The prime ministerial candidates have not appropriately responded to the crisis in social care. Some have toyed with general sentiments but others – the frontrunner included – have not even mentioned it. Thankfully, there is still time for them to give their pitch; and they should do so now because it is an issue that cannot be swept under the carpet any longer.
The PSA Commission on Care report has been published since 2016; identifying the problems and proposing comprehensive ways forward. It is not good enough for the politicians to avoid addressing this fixable crippling issue. When the most vulnerable in society are systematically failed by the state, it is neglect.
Having covered the remaining contenders, it is worth an honourable mention of the candidates who have not made it through to the next stage of the election. They helped to influence the debate and will now be courted by more successful rivals wishing to pick up their supporters.
Mark Harper is a regular contributor to debates on social care in the House of Commons, and his pitch for the Conservative leadership paid similar attention. He flagged the need to fix the social care system but gave little detail on what this might look like; favouring calls for the publication of the long-awaited green paper in lieu of any policy specifics of his own. He was eliminated in the first round.
Another elimination was Esther McVey. In contrast, she has said almost nothing on social care during both her time as an MP and her short-lived leadership campaign.
The final first round elimination was Andrea Leadsom, former Leader of the House of Commons. In 2012, she proposed a ‘post-retirement carer’s allowance’ available only to retired carers who continue to be the sole carer for a loved one. However, she did not repeat this proposal during her bid for the leadership, instead calling for a cross-party commission to look at social care to minimise the party politics.
Hunt’s successor as Secretary of State for Health and Social Care, Matt Hancock, withdrew from the race after the first round of voting, having only received the support of 19 colleagues. For those of us hoping to have social care on the agenda, Hancock was the one to watch. He pledged to boost spending to the tune of £3.5 billion; argued tax is ‘inevitably part of the solution’ to the funding crisis; and proposed a voluntary insurance scheme for lifetime costs. He put his ministerial portfolio at the heart of his pitch, and it will be interesting to see who he endorses to continue that approach.
Eliminated at the second hurdle was Dominic Raab. Seemingly without hesitation, he jumped out of the starting blocks with policy on social care. He recently embraced the Dilnot Commission’s proposal to cap people’s lifetime social care costs; offering a figure of £100,000 with the caveat that it merits consultation. This all fits into his wider support for individual social care plans and viable insurance policies offered by private companies.
The Blog Post has been written by Ben Hayday a final year Politics undergraduate at the University of Warwick.