The Government’s Social Care White Paper: ‘a good vision without a meaningful strategy for delivery’

Initial response from the Women’s Budget Group

This afternoon the Government published its long-awaited White Paper, setting out its 10-year vision for adult social care. The paper sets out a vision that many of us would share; to provide ‘support to those who need it so that as many people as possible can live the life they want to lead’. However, the £1.7bn over three years, promised by the Government, falls far short of what is needed to realise that vision. Like with the big changes announced in the 2014 the Care Act that were undermined by a lack of money, the Government is still not committing adequate levels of funding to match the strategy it is proposing for social care.

The white paper sets out how £1.7 billion of the £5.4 billion over three years raised by the Health and Social Care levy announced in September, will be invested. £3.6bn of that funding is already committed to introducing a cap on care costs. The Women’s Budget Group has already critiqued these proposals , arguing that the levy neither raises sufficient revenue to address the crisis in social care,  nor does it raises this money in a fair way and the proposed reforms still leave many with unmet care needs.

The paper sets out proposals for spending over the next three years of what the Government promises is a 10-year strategy. After this time, the amount of money from the Health and Social Care levy going to social care is due to increase. However, we are concerned by the statement in the paper that ‘as we implement the cap on care costs and remove the unpredictable care costs  people can face, the proportion of the levy that is required to support investment in adult social care in England will increase.’ This suggests that the increased proportion of the levy spent on social care may only be to meet the costs of the cap and floor model, and that there will be no additional funding for the care reforms needed.

Some of the areas to receive funding over the next 3 years are :

• £300m will go towards housing investment, to integrate housing into local health and care strategies, with a focus on increasing the range of new supported housing options available.

• £150 million of additional funding to drive greater adoption of technology and achieve widespread digitisation across social care. Whilst technology has a role to play, social care is a relational service – most people who receive care rely on people to provide that care. Improving the quality of care then will come, in most part, from investing in the workforce, making sure they are well trained, well paid and have good working conditions.

• £500m will be invested in training, qualifications and mental health and wellbeing for the 1.5 million-strong social care workforce over the next 3 years. This investment is welcome, as is the recognition for the need to support the mental health and wellbeing of the care workforce, however there was no mention about improving pay or expanding the workforce, both of which will be necessary if trained staff are to be recruited and retained. The NHS Pay Review Body reported that the Government estimated that £1.2bn would be needed just to bring the pay of the lowest paid care workers in line with their NHS peers.

• £25 million to work with the sector to kick-start a change in the services provided to support unpaid carers. The recognition of the role of unpaid carers is a step in the right direction, however unless they are also given the option of not caring, through greater investment in paid care workforce, then unpaid carers are still being too heavily relied upon.

While these investments are welcome, the plans fail to address the need to improve pay to social care workers, expand the workforce, and improve access to services and levels of services for the 1.5 million older people and many more working-age adults currently with unmet care needs. In order to ensure everyone’s care needs are met.

We need a high-quality universal care service

While the flaws and underfunding of our social care system have been exposed and exacerbated by the pandemic, the pressures on the system will not go away without major reforms. Meeting the multiple and complex needs of everyone that requires care, requires significant investment to create a high-quality universal service.

We need a universal care service to 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.

The UK Women’s Budget Group and the New Economics Foundation will shortly be publishing a report on Universal Quality Social Care.

For more information see in our briefing Social care, gender and Covid-19.

For more information, please contact Georgia Sangster at georgia.sangster@wbg.org.uk

1 December 2021