In its report published today (June 16) the Public Accounts Committee says the pandemic’s “devastating impact on the care sector” has emphasised that “care is not properly funded, lacks transparency and urgently needs reform.”
Governments of all political persuasions have promised social care reform for the past 20 years: “white papers, green papers, consultations, independent reviews and commissions” yet, “reform has not occurred”.
Commitments the Government has previously made to the PAC – to ensure long-term funding is in place; to set out plans for tackling the problems faced by the social care workforce – have not come to pass.
The costs of COVID-19 and the dramatic fall in care home occupancy from around 90% at the start of the pandemic to 80% by February 2021 put many providers at risk of failing, but DHSC has “poor oversight of the system and seems complacent about the risks of local market failure”.
The Government has provided welcome, significant short-term support to help providers through COVID-19 – now the Committee says it is vital that DHSC clearly and in detail “sets out how it will help providers move beyond it”.
The current system “does not work for local authorities or those paying for their own care”. Funding cuts have meant most local authorities pay providers below the costs of care and providers live “hand to mouth”, unable to take the long-term decisions which would improve services.
While information about care quality is available, there is a lack of transparency about what people or local authorities get for the money they spend.
Social care is a “people business” and the long overdue workforce strategy must “tackle low pay, improve career development and tackle unacceptably high turnover. Care workers suffer greatly from a lack of parity with the NHS in terms of pay, conditions and status.”
Meg Hillier MP, Chair of the Committee, said: “Carers, younger and older adults needing care, and home care have seen decades of neglect, and the 1.5 million who work in care deserve much better. The reforms to address this now must include a long-term funding plan that allows local authorities
Responding, Cllr David Fothergill, Chairman of the Local Government Association’s Community Wellbeing Board, said: “Social care and its 1.6 million-strong workforce have risen to the unprecedented challenges caused by coronavirus, doing all they can to help keep those who draw upon these services safe and well.
“As this survey highlights, our recovery from the pandemic must include not only short-term help to deal with the immediate and rising demand for social care services, but also secure the long-term future of how we provide and pay for care and support.
“People of all ages who draw upon and work in social care need to have certainty for the future and we call on government to bring forward its proposals, including a timetable for reform, as soon as possible and before the summer parliamentary recess.
Vic Rayner, CEO of the National Care Forum (NCF) –said: “The Public Accounts Committee (PAC) share the ambitions of the NCF in relation to the urgent need for long term planning around the funding and workforce for social care. The Committee recognise the impact of funding cuts and how that results in authorities paying below the cost of care. This is not sustainable and the medium term response to date has involved short term sticking plasters which have done enough to steady the ship, but not to stop the water rising. The timing of the Report is very pertinent, as it recognises the intense financial pressure that providers face, and the need for the government to lay out the vital support needed to comply with government guidance in a manner that will enable care providers to plan and prepare for the ongoing challenges that COVID-19 presents to those running care services.
“The Report brings to the fore the very real challenges of cross subsidy arrangements within care, determining that those who pay for their care often do so at a price that is much higher than that which any local authority will pay. However, the Committee does not go far enough in terms of calling out the inequity of that cross subsidy arrangement, and they should be arguing for a fair price for care – one where everyone pays the same – whether they have their care paid for by the local authority or they pay themselves. NCF have called for this in our Reform Agenda, as we agree with the Committee that the costs of care should be transparent, but at the same time, they must be paid for. It is absolutely not acceptable for any government or local authority to countenance the position outlined by the Committee where it states that ‘most local authorities pay providers below the cost of care’.
“Furthermore, the Public Accounts Committee calls for a long term workforce plan. Investment in the social care workforce is essential to address issues around pay, professionalisation, skills and competences, and will also support key challenges for the sector around recruitment, retention and turnover. We agree with the Committee that a concerted commitment to social care reform must be laid before parliament as a matter of urgency if we are to make the vital changes that are so urgently needed.”