Spring Budget 2023: Social care and gender

The crisis in social care didn’t start with the pandemic, nor with austerity. Even before the financial crash, underfunding meant increasing numbers of people with unmet needs, others paying catastrophic costs for their care, an underpaid and undervalued care workforce, and increasingly unsustainable demands being put on unpaid carers. Regional and income-based inequalities mean that the poorest local authorities are the ones with the greatest social care needs. The system is in urgent need of reform and better resourcing.

The Health and Social Care Levy, which was proposed as part of the government’s ‘Building Back Better: Our Plan for Health and Social Care’ in September 2021, has now been cancelled and the proposed reforms to the funding model delayed by a further two years to October 2025. However, the long-term funding that is so urgently needed for recurrent expenditure on social care cannot wait until the NHS no longer needs extra funds. The backlog of routine treatment, surgeries and tests may take 5 to 7 years to resolve, so the NHS is likely to need more than three years of additional funding and the pressures of an inadequate social care on the NHS will continue.

‘Between 2020/21 and 2021/22, social care vacancies rose by 52% to reach 165,000 and workforce shortages are only likely to increase.’

The Government has put forward no clear plan for improving the quality of care, the treatment of care workers or reducing unsustainably long hours of unpaid care. Over 90% of the new funding to social care will be absorbed by the new cap-and-floor model for allocating care costs between individuals and the state, rather than towards improving the system.The proposed model will result in many people still going without the care they need to avoid paying unaffordable costs. This will lead to continued reliance on families, especially women, to provide informal and unpaid care.

Addressing issues of shortages, deskilling and retention in the care workforce, of which 82% were women in 2021/2022, is one of the most pressing challenges facing the sector. The adult social care sector workforce is affected by high turnover, little investment in training, low pay, and the consistent undervaluing of care work.

‘Any model in which people have to pay for their own care means that many will go without the care they desperately need to avoid paying its costs.’

The net costs of a reformed care system must be funded by central government from general taxation. Expecting local authorities to increase funding on social care through council tax will inevitably widen regional inequalities. Those with the greatest care needs have the least ability to raise taxes and have already had to make the greatest reductions in services.

The Women’s Budget Group proposes instead a high-quality universal care service that is free at the point of need, supports wellbeing, self-determination and enhances capacities; trains and pays its staff appropriately in line with the Real Living Wage; and ensures that unpaid care is genuinely voluntary. Our modelling estimates that this would generate 928,000 jobs in the economy as a whole (in care and across the economy from multiplier effect and increased purchasing power) and cost £31.9bn gross annually, 44% of which would be recouped through additional revenues.

Read and download the full briefing here