Prime Minister promised to ‘fix adult social care’ but we are still waiting…

Eighteen months ago, the Prime Minister promised to ‘fix adult social care’. We are still waiting.

Social care is an integral part of our social infrastructure. The Budget is silent on both. The pandemic continues to show that a decade of underfunding and treating social care as the poor relation of the NHS acute health services, has endangered the health and the lives of thousands of those needing care as well as those providing it whether paid or unpaid. The 2021-22 Provisional Local Government Finance settlement recognises that local government needs more resources for social care but 85% of it must be raised from the proceeds of increasing council taxes by 5%. The authorities with the greatest needs are the most deprived and therefore least able to generate adequate funds. The additional £300 million specific grant for adult and children’s social care amount to what the Local Government Association calls ‘a sticking plaster approach to funding ‘.[1] Local authorities cannot carry over deficits, so any overspend on statutory services will result in cuts elsewhere or selling off community assets.  This is inconsistent with the Budget which claims to be ‘levelling- up’ across the country as well as delaying increases in taxation for two years. Distributing resources for residential and nursing homes care directly from the Department of Health and Social Care, rather than local government as suggested in the recent White Paper[2] will increase the dominance of the private for-profit sector and fail to address these inequalities.

The Budget does include plans to pay employers to increase traineeships and work experience opportunities particularly for young people, as well as to hire new apprentices. This could be a means of attracting people into social care. Turnover rates are high and, in a workforce in which the majority (83%) are women, is comparable in size to the NHS workforce. There are currently over 100,000 vacancies.[3] The social care workforce has access to basic training, but much of it is optional, on-line and measured in days. Moreover, in England, there is not even a national body to set standards, develop and regulate training and oversee these proposed schemes and subsequent career and pay development. Without it there is no guarantee that employers in the fragmented and broken social care ‘market’ will be able and willing to develop and accredit the skills of both entrants to, and experienced members of their workforce. This Budget ignores the latest recommendations of the Public Accounts, as well as the Health and Social Care, House of Commons Select Committees together with the Migration Advisory Committee which would put social care training and pay on a par with level 3 health care workers. Preferably there would also be a period of shared training. Meanwhile, the capacity of both domiciliary and residential social care workers, exhausted by the pandemic, to provide the growing need for care will be diminished. There is not even a 1% pay increase on offer to them.

The estimated number looking after family members or close friends increased from 9.1 to 13.6 million during the pandemic.[4] They are completely overlooked. The Carer’s Allowance (£67.25), claimed by the 1.3 million carers who can no longer combine caring at least 35 hours/week with employment, will be increased by 35p (1p/hour) in April! To stay in paid employment, like the parents of young children who need childcare services, they need adequate social care services as well as entitlements to periods of paid and unpaid leave and the right to work flexibly. Following the recent rise in women’s state pension age to 66 years, a growing number of unpaid carers, 58% of whom are women, are having to combine paid employment with care. However, there is nearly a twenty-year difference in healthy life expectancies between women living in the most deprived areas and those living in the wealthiest. This means it is impossible for many of the poorest women to stay in paid employment beyond the age of 60 and instead, face both ill-health and poverty. Eligibility for the state pension therefore, should not rest on age alone but take account of health status and caring responsibilities. Between 2010/11 and 2019/20 the government saved £77 billion by raising women’s state pension from 60 to 66 years and by 2025/26 this will have doubled to over £180 billion. Some of this additional revenue should be used to fully address the crisis in social care funding as well as valuing carers both paid and unpaid more highly.

This blog was written by Hilary Land Emerita Professor of Family Policy at the University of Bristol. Hilary has also written about the crisis in social care in a letter that was published by the Financial Times in March 2021. 

[1]http://www.local.gov.uk/parliament/briefings-and-response-s202122-provisional-local-government-finance-settlement-lga

[2]White Paper CP381(Feb 2021) Integration and Innovation: working together to improve health and social care for all. White Paper

[3] Skills for Care (2020), The State of the Social Care Workforce 2019-20

[4] Carers UK, Carers Week (2020)The rise in the number of unpaid carers during the corona (COVID-19)outbreak