Another Autumn Statement and another kick in the teeth for social care, writes ICG Chair, Mike Padgham.
Once again, an opportunity has been lost to make some inroads into the reform of social care that the country has been crying out for this past 30-plus years.
What hurts maybe more than usual is that the Chancellor delivering the statement has himself said that social care needs an extra £7bn a year just to stand still – a point he made when he, a former Health Secretary, chaired the Health and Social Care Committee that reported on the sad plight of the sector.
Memories perhaps are short, but it still hurts.
The ongoing Covid-19 inquiry reminds us of the long-overdue respect social care earned and the plaudits the sector received as our workforce fought the impact of the pandemic side by side with their NHS counterparts. We hoped for, and indeed were promised, that social care would never be cast into the shadows again, the forgotten Cinderella.
As I say, memories are short and social care is once again the poor relation, scrabbling around for scraps and struggling to survive.
It shouldn’t be this way.
Help for social care is just one of many issues sacrificed as the Government looked instead to cut taxes, ostensibly to get the economy moving but really with a view to the looming General Election.
Nobody is going to argue against cutting the tax burden but addressing the crisis in social care is pressing and just as important right now.
Another headline-grabber that nobody can argue against is the unexpectedly high increase in the National Minimum Wage. Everyone, especially providers, wants to see the social care workforce properly paid – they deserve much more than that minimum wage.
But it will have to be paid for. Providers had expected the increase to be to around £11 an hour but the increase to £11.44 is almost 10%, a huge extra financial burden for social care providers who are struggling to survive in the post-covid, high cost of living period we are struggling through.
Unless that increased minimum wage is matched by more generous funding for local authorities who can pass that money on to the social care providers they commission care from, the situation is going to get worse. We will see providers who are currently on the brink pushed over the edge by this increased cost. And that will mean a further loss of care provision at a time when we need it most.
Some better funding for local authorities from the Autumn Statement would have been a start.
Social care deserves better support from both a social and economic perspective. We need a thriving social care sector to give care to the 1.6m people who currently can’t get it and the hundreds of thousands more who are going to need it in the coming years. Part of the reason, but not the sole reason, hospitals are struggling with delayed discharges is that there aren’t enough social care packages and staff available for people when they can leave hospital. This in turn is contributing the hospital waiting lists and so the problems mount.
If the Government is not persuaded by the social imperative, then maybe economic arguments can hold sway.
A lack of social care means more and more working age people will have to take time away from work to look after relatives – taking them out of the productive employment market. And aren’t people on hospital waiting lists and unable to work also missing from the working economy.
And let us not forget that social care contributes £55.7bn to the England economy and could contribute more if properly funded and supported.
We need a bold, root and branch overhaul of the system that properly funds social care, including provision for proper pay and conditions for its workforce, on a par with their NHS counterparts. The maths is simple. Money must be switched from the NHS purse to fund social care, to pay staff what they deserve, help the sector meet demand, reduce delayed discharges and contribute to reducing hospital waiting lists. In time, the money saved by keeping people out of hospital will hugely offset any extra funding needed by social care.
A properly-funded National Care Service that brings NHS care and social care under one streamlined service without needless bureaucracy and duplication of effort makes sense from both a healthcare and a financial perspective.
It is simply common sense. But then when did common sense ever figure in political decision making?
The Autumn Statement has gone, without any lifeline for social care. So we must now redouble our efforts to get that vital reform included in the main political parties’ manifestos for the General Election.