Social Care and the 2019 General Election

This blog has been co-authored by Shahnaz Akhter (Research Assistant, University of Warwick, Department of Politics & International Studies)  and Asna Wajid (Student Research Assistant, University of Warwick, Department of Politics & International Studies)

With another general election approaching on December 12th, this blog adds to the discussion of how the major political parties in England deal with social care. Social care emerged as a huge issue in the 2017 election, but has been conspicuously absent in the 2019 ‘Brexit election’ (as it was in the 2019 Conservative leadership contest). Nonetheless, there has already been some analysis of social care commitments in the party manifestos from the Kings Fund and CommunityCare. The Association of Directors of Adult Social Services has set out what adult social care needs from the next government, and Carers UK has circulated a Manifesto for Carers. The Women’s Budget Group have added to this discussion by pointing to the critical gender issues at stake in current discussions of health and social care funding, issues that was also the focus of the PSA Commission on Care Report (2016). Alongside gender issues, The PSA Commission on Care has consistently highlighted the neglect of BAME older people within government policies and approaches to adult social care.  In a blog written earlier this year, for example, Anna Killick provides context to the problems facing BAME people, including the many difficulties that this group faces in accessing social care, and the consequent lack of satisfaction with the current social care system.  In this blog, we go through the three major parties’ manifestos and, where possible, highlight what these policies could mean for BAME people.

The Conservative Party.

The Conservative Party manifesto on social care makes four significant claims:

  • Nobody needing social care should be forced to sell their home.
  • Additional funding of £1billion
  • Extending the entitlement to leave for unpaid carers
  • Prioritising finding a cure for Dementia

The manifesto further states ‘Because this is a long-term problem that will affect so many people, any solution has to be able to survive long-term. The Conservative manifesto certainly makes lots of bold claims about the future of social care, but is rather short on detail. We do not know, for example, whether the Conservative Party would seek to maintain the current separation between health and social care, or look to develop a more integrated service. If it is the latter, then it is important to consider whether a potential future trade deal with the US could increase costs within the health service, that would lead to a shrinking of the pot available to fund social care. So any claims about adult social care provision and funding must be evaluated within the light of the unredacted files uncovered by the Labour party, which showed that the NHS would a possible subject of trade negotiations with the USA.

The £1bn spending claim should also be viewed with caution, with the Conservative party providing no context as to where this additional funding would come from. If Boris Johnson’s government return to power and fail to negotiate a Brexit deal, a report from the Kings Fund highlights the negative impact on small scale social providers, whose ability to specialise to meet the needs of individual communities could be undermined. The report states, ’[w]e are particularly concerned about the fragile state of the social care provider market and the impact a disruptive no-deal Brexit could have on it. Increased operating costs coupled with financial uncertainty could see providers exiting the market or going out of business entirely’.

The proposal to extend the entitlement to leave for unpaid carers should certainly be welcomed. However, given the extent to which so much care work is performed, unpaid, by family members, it is not clear exactly who would benefit from such policies (e.g. there is little support for those who provide long term unpaid care for older people within families). The Conservative party manifesto offers no specific policy to address disparities within adult care provision for the BAME community.

The Liberal Democrats.

The Liberal Democrats manifesto makes the following claims:

  • Commission the development of a dedicated, progressive Health and Care Tax, through a reform of the Health and Social Care Act.
  • Support the creation of a new Professional Body for Care Workers, to promote clear career pathways with ongoing training and development, and improved pay structures
  • Increase funding of the NHS by a ring fenced £7 billion a year through an additional 1p on Income Tax

Of the overall £35 billion extra, £12.9 billion would go towards social care. Its manifesto for social care like its overall campaign, highlights the impact that Brexit could have on the NHS, and to a lesser extent social care.  A Guardian article examining the Liberal Democrats’ funding plans quotes Helen Buckingham from the Nuffield Trust who raises caution on funding the additional cost from Income Tax, in that it ‘raises the worry of whether NHS and social care funds fall if economic trouble knocks tax yields down’.

Whilst the manifesto states, ‘[t]oo often, people are left stranded in hospital after they finish their treatment and no longer need to be there because the follow-up care and support they need to go home is not available in the community’, there is no specific mention of the differing needs faced by BAME communities accessing social care. However, its proposed cross-party and social care convention does offer an opportunity for those groups whose focus is on BAME communities to shape the debate.  The manifesto also addressed the Carer’s Allowance, raising it from £123 to £150 a week providing more support for carers.

The Labour Party

The Labour party manifesto on social care begins with the pledge that they will guarantee that universal health care and services are made accessible to BAME, LGBT+ and disabled patients. By focusing on reaching the most deprived communities, pledging to ‘work across government to end the racial disparities across our health care system’, it is the only manifesto of the three major parties which specifically addresses the needs of BAME communities. Its manifesto makes the following claims:

  • A comprehensive National Care Service, which will provide community –based, person centred report.
  • A cap of £100K on contributions
  • Provision of social care packages to all elderly people.

Labour’s social care policy specifically examines the needs of the older community, highlighting that 2.6 million carers have had to quit their jobs to provide care for family workers.  The free care packages offered to all elderly people translate into a saving of £7, 321 a year, with a cap of £100K in contributions. Paul Johnson from the Fiscal Institute points out that these care packages do not extend to those in care homes.  The Nuffield Trust further cautions on Labour’s plans, ‘[re]forming the social care system is also not just about funding. With 110,000 job vacancies in social care, any proposal needs to address that growing staffing crisis – whilst bringing stability to those organisations providing care.’ Viewed within the context of the staffing crisis and the possibility of a Brexit deal which impacts the social health care system, the proposed recruiting figure of 24, 000 extra nurses and an extra 4,800 health visitors must be viewed with caution.

Where next?

Social care continues to attract attention without necessarily attracting the requisite funding or a strategic plan. The marginalisation of BAME needs for social care is worrisome as this group of people increases in number, in age and in need of social care. The lack of strategic vision is not just in terms of funding but also employment in this section in the debates about migration and Brexit. The PSA Care Commission had advocated a National Social Care Commission to ensure that social care got the attention and resources it needs; this needs to be a commitment for the next government together with a focus on an inclusive social care that address the needs of all communities and groups of older British people.

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