Social care reform: BASW England response

On 7 September the Westminster government finally announced its long-overdue plan to reform funding of social care.

It is good that there is tangible movement on this issue – but there are very many reasons to be concerned about the detail of the proposals which raises more questions than answers about short and long term social care funding and models of service.

It has taken nearly two years since reform was first mentioned by the Prime Minister after the 2019 general election. This Government – like successive governments before - has delayed far too long.

The Prime Minister must ensure this move is at least the start of meeting the scale and urgency of the crisis facing social care across the UK.

'Health and social care levy'

An increase of funding for health and social care of nearly £36 billion over the next three years is proposed through raising National Insurance – to be rebadged in 2023 as a ‘health and social care levy’.

This requires the Government to break its manifesto pledge not to increase most forms of tax, including National Insurance. The government's commitment to reforming social care must not stall through becoming a political football.

Although the government proposes to widen the groups eligible to pay the new tax, this form of tax is probably the least equitable choice the government could have made.

National Insurance falls disproportionately on people on low incomes. With 8.4 million working-age adults in poverty, this is another hit for people trying to recover from the financial hardship of the pandemic and years of austerity while those on the highest incomes or share dividends will not pay proportionately.

A fairer tax on all forms of income fully linked to earnings and wealth would have been a much more credible move by a government committed to a ‘levelling up’ agenda.

Government must recognise the importance of social care in a fair, just and thriving society

The political and media debate on social care has been dominated by a focus on older people as recipients of adult social care. Yet a third of people using services and over half of expenditure is on working-age adults with disabilities and other social care needs.

In 2018-19, almost 300,000 people aged between 18 and 64 received council-funded social care in England[1]. Research from ADASS also found that whilst councils are delivering more care and support in people’s homes, people are waiting longer for vital care assessments and reviews. It suggests that that the number of people waiting for assessments and reviews has increased over the last three months.[2]

The government must go further than a funding formula and support wider plans for structural reform of social care. This includes shifting the narrative from social care being characterised as of minority social concern and dominated by older people’s needs.

The government must take this opportunity to create an understanding of the fundamental importance of social care to a fair, just and thriving society - alongside its difference from, as well as its interdependence with, healthcare and other services.

Local authorities need a full funding solution now

Today’s proposals will not end the complete lack of parity of resourcing between the NHS and social care.

Although we acknowledge the Government’s commitment to give NHS England an extra £5.4 billion over the next six months to tackle backlogs caused by the pandemic, we fear this is another example of funds being made available for health services at the expense of social care.

We are very concerned about the proposal to reduce backlog NHS funding and then divert more investment into social care in the long run. Is a future reduction in NHS funding realistic after the years of austerity, impacting the NHS as well as social care - and knowing that NHS funding may be politically more palatable and visible than social care in the run-up to the next election?

We still believe that local authorities need a full funding solution now to provide sufficient, high-quality social work and social care services, to stabilise supply and develop the workforce at a time of crisis in recruitment and retention across social care.

Only urgent moves to increase funding and to improve pay for social care workers will ensure a step change in dignity and wellbeing for all citizens who have the right to support to lead a life they choose.

BASW England reiterates previous calls made as part of our ‘ten reforms we would like to see in social care'.

We will continue to consult our BASW England members on the full extent of these plans and scrutinise the Government to ensure the best reforms possible can be delivered.

[1] https://www.theguardian.com/commentisfree/2021/jun/03/the-guardian-view-on-social-care-and-disability-a-cruel-policy-vacuum

[2] https://www.adass.org.uk/adass-new-rapid-survey-findings