“Radical Change” Needed for Adult Social Care Says MP

Additional Government spending on social care is “unavoidable” to prevent other essential council services being “swallowed up”, says former cabinet minister Damien Green.

Speaking in a parliamentary debate earlier this week Mr Green said:
“We need to find an acceptable way to allow those with the capacity to improve their own provision to do so.”

He added: “I suggest we should create what I call the care supplement: a new form of insurance designed specifically to fund more expensive care costs in old age, just like the private pension system that tops up the state pensions of millions of people. It would allow people to buy insurance at the level they can afford in order to provide peace of mind. I do not think that the care supplement should be compulsory, as indeed auto-enrolment for pensions is not compulsory, so we would not get into the slightly sterile debate about death taxes and dementia taxes, phrases that both of the main parties have thrown at each other over the years.”

“I have been told by successive Ministers that that system would be too complicated, and that we cannot set up an insurance system. All I say in response is this: of course, setting up a new system is complicated and difficult, but we know that the current system is not working. If we carry on doing the same thing, the system will continue to be frail and rickety for years—possibly generations—to come, which is not acceptable. We have to do something radically different. If somebody can come up with a better way of getting some of that wealth to pay for social care, fine, but we have to try something radical.:

“Funding is one key issue, but since the debate is about adult social care, I will identify four areas in which we need new thinking if we are going to fix social care. The first is the workforce, which has already been mentioned. It needs to be bigger—bigger by more than 100,000—and to achieve that, it needs to be better paid and have a higher status. I would like nurses working in the care system to be on the same Agenda for Change pay scales as those in the NHS, otherwise they will keep moving from the care system to the NHS.”

“The second area is the voice of care within the new integrated care boards. That change represents a chance to improve the integration of the health and care systems without creating another massive bureaucracy, but I slightly fear that the ICB system is settling down with the voice of care providers not being loud enough at the table. Local authorities are clearly a key player in the system, but so are other providers, and their voice needs to be heard.”

“My third point is about the use of technology, not only for sharing information between different parts of the system, but for giving those in receipt of care more control over their daily life. We are not exploiting the range of available technology anything like enough to do that and, if we get it right, the prize is that more people will be able to stay in their own home for longer. That is better for them, most importantly, but it is also better for the taxpayer, so it ought to be a high priority. It is particularly important for people living with dementia.”

“The fourth area is an extension of that notion of people staying in their own homes for longer through the provision of housing. As it happens, in one of the Minister’s previous incarnations, I spoke to him about this issue. We are failing to build anything like enough supported housing for older people, particularly in retirement villages. Taken together, the last two measures I mentioned—technology and the provision of suitable housing—would mean that many people were able to stay in their own home for longer. As I say, that is a double win: it is better for the taxpayer, but most importantly, it is better for people as well. Most people want to live in their own home for as long as they can.”

“My original idea for a universal care entitlement accompanied by a care supplement would take the burden of social care funding away from local authorities, which is good, and, more importantly, offer certainty and security for the increasing numbers who will need social care in old age. No one would have to sell their house and see their inheritance disappear, everyone would have the chance of receiving better care and fewer people would be left unnecessarily in hospital beds as they wait for social care to be available. I am conscious that none of this is easy and that it will take political courage and possibly political consensus to achieve, but it is absolutely necessary if we are to provide peace of mind and security to frail, elderly people who richly deserve it.”

The Government has faced criticism after deciding to push back long-promised social care reforms to October 2025.

Opening the debate Labour MP Simon Betts said:
“Although social care, as a responsibility, lies with the Department of Health and Social Care, it is ultimately delivered through funding from local councils. I want to concentrate on the challenge that that poses for councils. This is not a new matter and is not without a lot of commitments. Only last year, the right hon. Member for South West Norfolk (Elizabeth Truss) said that she would spend £13 billion raised by the levy on social care. Well, the levy seems to have disappeared into other uses, as has the £13 billion.”

“The right hon. Member for Uxbridge and South Ruislip (Boris Johnson) said:
“I am announcing now—on the steps of Downing Street—that we will fix the crisis in social care once and for all”.

“Not to be outdone, the right hon. Member for Maidenhead (Mrs May) said that her Ministers”

“will work to improve social care and will bring forward proposals for consultation.”—[Official Report, 21 June 2017; Vol. 626, c. 35.]

Let us go back a bit further. David Cameron said:
“A commission will be appointed to consider a sustainable long-term structure for the operation of social care.”—[Official Report, 25 May 2010; Vol. 510, c. 31.]

I will not just be party political in this, because Gordon Brown said:
“Alan Johnson and I will…bring…new plans to help people to stay longer in their own homes and provide greater protection against the costs of care.”

“The one thing that Prime Ministers have in common over the years is that they all promise to deal with the problems and funding of social care. The other thing that they have in common is that none of them has actually done that, and that is something of concern and it is why we still have the problems today.”

Communities minister Lee Rowley said “significant additional funding” has gone in to social care and “is going in over the course of the remainder of the spending review period, £2 billion of additional grants in 23/24, £1.5 billion, nearly, of additional funding in 24/25”.

He added: “Money isn’t everything, but ultimately there is a recognition, I think, on all sides of the House that there are challenges around adult social care and more money has gone in.

“In the conversations that I’ve had with local government over the past few weeks there is a recognition that this settlement has provided a good level of funds, that it will be moving in a positive direction, and it is providing the stability and greater certainty that they have requested and which we have responded to as a Government in that regard.

“We need to support the most vulnerable and those who are in need, irrespective of age and irrespective of condition.

“And what we are trying to do over the course of the changes that are coming in the financial year to come is to try to provide additional funds, additional support, additional taxpayer subsidy to do that and to ensure that local government can continue to build and improve for the long term.”