UK Policy Briefings
Government’s announced plan will not “fix social care once and for all” – we need a free universal social care system
Date Posted: Tuesday 21st September 2021
In 2019 the Prime Minister pledged to “fix social care once and for all” during his tenure. Two years and a pandemic later, the Government has announced plans which fall short of what is needed to support people who need care, workers in the sector, and unpaid carers.
The Women’s Budget Group welcomes the recognition by the Government of the need to address the crisis in social care but we lament the limited focus on collective funding for collective provision. The proposed reforms do not go far enough, still leaving millions of people with unmet care needs, burdened with high care costs and millions more providing unsustainably long hours of unpaid care.
The plans contain little or nothing for social care in the short term because the revenues gained by the rise in National Insurance (NI) will initially go to the NHS to address the urgent patient backlog in the healthcare system. The Government plans to transfer funding to social care after three years, but we have concerns about the extent to which this will happen.
The plans also contain very little in terms of the reforms in the social care system. Although a cap and floor model was announced, this doesn’t address the issue of providing social care to all those who need it, the quality of the care provided, and the conditions of those who provide it (both paid workers and unpaid carers).
In this briefing we set out the issues with the Government’s new social care plans and why our alternative proposal of a free universal high-quality social care system is needed urgently now.
We identify five main issues with the social care plans:
Issue 1: Funding announced is insufficient for reform commitments
Issue 2: Conflating long-term investment in social care with rescuing the NHS from short-term pressures is the wrong funding approach
Issue 3: Insufficient plans and funding to improve workforce conditions, pay and quality of care
Issue 4: Cap and floor model stills leaves many without the care they need
Issue 5: Nothing in the announcement for the people using and needing social care now
We propose a high-quality universal care service
Meeting the multiple and complex needs of everyone that requires care, as outlined in the Care Act 2014, cannot be done through a cap and floor model with little money for reform. It requires significant investment to create a high-quality universal service.
A universal care service should ensure that people’s needs are met in a way which supports wellbeing and self-determination. This means going beyond a focus on personal care to cover other activities of daily life including buying and preparing food, maintaining relationships and taking part in the life of the community.
A universal care service should provide care of high quality. This means a well-trained workforce with decent pay and conditions. Better rates of pay and improved conditions would address the problems of high turnover in the sector, which currently have an impact on the quality of care.
A universal care service should aim to reduce reliance on unpaid care which leaves millions of unpaid carers facing high levels of stress, difficulties staying in paid work and at increased risk of poverty. Increased formal care could free unpaid carers to spend time with the person they care for.
A universal care service would begin with a set of measures that are implementable in the short term:
- making social care universally free at the point of need, by abolishing the means test;
- widening the availability of social care, by ensuring the universal application of the national eligibility criteria set out in the Care Act; and
- improving working conditions, including introducing a sector minimum wage in line with the Real Living Wage.
It would move towards:
- widening the availability of social care further, by changing the national eligibility criteria set out in the Care Act to cover a wider group of people who need care; and
- improving care quality by providing improved training for all social care workers and increased wages in line with increased qualifications.
In the initial phase this would mean annual investment of £44bn (£28bn more than the current £17bn spent on long term care). In the longer term, a wider definition of needs and improved quality would lead to higher take up, which we estimate could cost an additional £30bn.
This would bring UK spending on social care in line with that in Sweden and Norway as a share of GDP.
We calculate that such investment in a universal care system would stimulate the economy to generate over one million jobs overall, many of which would be filled by people previously unable to take employment because of caring responsibilities.
The increased direct and indirect tax revenue generated by that additional employment would cover 28% of the universal care system’s costs, reducing net costs.