Insights

Mark Raeburn: 6 minute read

Forget Brexit, what about the real challenge, Social Care?

As we walk gleefully along the road to Christmas, there is one more hurdle that we need to vault before we get to see jolly old St. Nick. It feels as though whoever wins the upcoming election, the British public will have some movement towards certainty on the matter of Brexit. It has been the country's main focus for far too long:

  • Conservatives – A Brexit that could be from medium to hard by end of 2020
  • Labour – A slower path through to certainty but following negotiation and then a referendum we would get certainty
  • Liberal Democrats – Brexit cancelled straight away

Health and social care are in crisis and are far more important than Brexit. Over the years this timebomb has been ignored and neglected, but at some point, it won’t be able to be ignored.

Subjects such as health and social care need to be prioritised as people are tired of empty promises. We want reassurances over the future as the media has shown the public the truth. Social care is not free and it can lead to you needing to sell your assets and live your twilight years with little left to your name. 

The Conservatives

The Prime Minister, Boris Johnson, famously stood on the steps outside Downing Street the day he was chosen as the next leader of the United Kingdom, to say that he would solve the social care crisis. Or in his words,

“Solve the problem of social care and end the injustice that means people have to sell their home to pay for their old age”

In reality, nothing concrete has changed. We have had many promises and plans on how increasing the productivity of the workforce and introducing technology will create efficiencies and in turn, save money.

The introduction of technology will aid efficiencies and create savings but where these savings end up has not been defined. At present, the productivity gains and introduction of technological solutions have been directed towards the NHS, which will filter down but these benefits will be minimal.

What we mean here is that without a coordinated plan of action that incorporates the NHS Long Term Plan with the Green Paper, any gains will be short term. They will be of greater benefit to those in power to win additional votes.

In a snapshot: Would you trust the Conservatives to progress and spend on social care?

We believe a marginal increase in spending social care will happen, but noting dramatic and therefore core issues will remain.

Labour

As the leading party that is looking to move in and sweep the current occupants of power off their seat, Labour can promise more. They need to win votes and prove that they can improve on the job that is currently being done. To that end, they need to make grand gestures and solving the social care crisis would be the grandest of gestures.

Labour in this endeavour has promised more than the Conservatives. They have promised to create a new National Care Service, one in which personal care will be extended to the over-65s. Funding for this will be paid for in income tax increases on the highest 5% of earners, plus increasing tax on private medical insurance. They are bringing their core values to light with this promise, taking from the wealthy to help the poor. It looks good for voters.

Whilst this looks great, there has been no mention on the workers for the National Care Service. One of the main problems with the current social care system is that they are underpaid as the perception of the work is less than that of the NHS. This is why the system is held up with immigration and those from other countries who fill the vacancies that those native to England do not want to do.

If Brexit comes to floriation then one of the primary concerns is that a large quantity of the workforce will need to leave, effectively overnight. This could then lead to home closures and those who need care being left in the dark. At any one point, there are an estimated 80,000 vacancies in regards to social care vacancies. This would increase following Brexit.

Therefore, despite the addition of free personal care, then has been no mention of how the workforce would be funded.

In a snapshot: Labour’s plans sound good on social care, but you have to be concerned with the amount of nationalisation and spending Labour has planned (even if they only target the top 5% of earners). We look forward to understanding the costed proposals as we progress with the campaign.  

Liberal Democrats

Within the majority of the articles that we have written on our website, we elude to Brexit being the cause for hesitation from the government. Hesitation in terms of commitment to social care and making the changes that are required. The Liberal Democrats it seems, agree. They have pushed at the front of their manifest promises that they would cancel Brexit.

This will naturally be more difficult to stop than simply saying, stop Brexit. It will be another difficult process but one in which they believe would be of benefit in terms of freeing up time and money for other frontline services. Social care would then be one of the services that would benefit from this or would they?

The resulting fallout from Brexit would no doubt be costly, arguably not as costly as Brexit but it would still cost. Money, therefore, would be needed in the short term to cover for the transition and this would then not be available from social care. We then tie this with the fact that regardless of the situation, Brexit won’t create new money, it will arguably save in the long term from loss of trading opportunities but it won’t generate new income.

Social care, the NHS and other frontline services still need funding and the Liberal Democrats have promised to do so by increasing income tax by 1p on the pound. This will then raise £6 billion and will, therefore, need to stretch far to fix social care, reverse cuts to public health and more mental health services beyond that they have provided no funding proposals for all these services. £6 billion only stretches so far.

In a snapshot: More money for social care is obviously well received, but a transformational agenda has not been provided.

Where is the Green Paper?

This is a question that we have been asking for the last two years and the easiest answer to this is, Brexit. The Liberal Democrats, therefore, have the answer to this problem, cancel it. Great but we still need a cross-consensus on the future direction of health and social care. They are inter-connected much like Ant and Dec.

Earlier this year we were in attendance at the annual ADASS Spring Conference. During the event, we listened to a talk by Caroline Dinage MP, during which she hinted that local authorities need to get on with it. The Green Paper will arrive but it will not be the silver bullet that many are hoping for. Your destinies (local authorities) are in your hands and the time to act is now.

Now, that conference was six months ago and we still do not have the Green Paper. We have an additionally missed Brexit deadline and a general election but no paper, no direction to the future of social care and this is backed up within the main political parties and their manifestos. Many promises have been made but as of yet, no concrete plans have been agreed and put into motion.

Whilst we agree that waiting for a decision higher up is not productive and can be harmful to the most vulnerable, action without direction can also be damaging. If everyone approaches the problem disparately then there will be a divisional divide in terms of care. We need to help people now but we need to house it under direction from the government.

Conclusion

Regardless of which party wins the election, we know that the pressure is on. Brexit, social care and the NHS, all of these need urgent attention but with Brexit and the impending loss that will emerge from there being at the forefront, money for other services will not be as readily available. Borrowing will be needed, pushing our national debt higher.

When you hear the term, ‘poison chalice’ being thrown around when people speak about the Prime Ministership, you can understand the reasoning but at the same time, you can be the man or woman who delivers change. Regardless of whether that is Boris Johnson, Jeremy Corbin, Jo Swinson or Sian Berry, you have the opportunity to create real change for those on the ground.

Reaching the age of retirement is something that we should look forward to and not fear. None of the top political parties has a long term view of social care and so who you vote for will have a lot to prove over the next few years. The election result is something that we are looking forward to seeing and working alongside local authorities across the country to enable the change that will hopefully be forthcoming.

Despite spending promises there is no defining reform agenda to improve care at the front line. Labour promises to repeal the 2012 Health and Social Care Act, and the Liberal Democrats to move some commissioning of NHS care to local authorities. Both are radical but largely administrative changes.

And despite the promised spending, there are structural questions of funding left unaddressed, such as the real lack of detail on funding social care properly. Labour comes closest with the free personal care pledge. But as we know from Scotland, personal care isn’t free but merely subsidised, with some users still facing significant costs.

Therefore it seems all parties fail on the key element of having a cohesive plan rather than a sense of direction…. 

After all, that approach worked so well for Brexit….