Posts Tagged ‘social care’

We need to have an honest conversation with the public about social care

28/09/2021, 10:07:45 AM

By Joanne Harding

This piece is part of a new book “Labour’s Reset: The Path Back to Power” which is being released today. The book looks at the barriers for voters in picking Labour, what the party can do in opposition to tackle these issues and the type of policy platform that would attract switchers to Labour at the election.

‘If you neglect physical infrastructure, you get roads full of potholes and buckling bridges, which prevent your economy functioning properly. The same is true if you fail to invest in social infrastructure.’ These  were the words Liz Kendall used as she addressed a conference of directors of social care back in April this year. I think we can all agree that social care has been neglected by successive governments for years. The question is what could and should Labour do to truly address what I believe to be one of the most difficult policy challenges of our times. One of the fundamental issues with social care is that people do not really understand what it is. It is incredibly difficult to define as it ranges from supporting a person to wash and eat, to administering medication, to safeguarding, protection of liberty and to end-of-life care. It is inextricably linked with health by virtue of some of the elements of personal care, yet it is so much more than health.

However, it does not have the same branding as the National Health Service (NHS) that we all recognise and hold dear to us as a beacon of all that is good. Politicians talk about health and social care, yet they continue to leave it out in the cold when it comes to policy and funding conversations. This lack of focus on social care is reflected in public attitudes – in polling conducted by Yonder for Labour Uncut, when respondents were presented with a list of 11 different policy and just 6% of voters picked social care as the highest priority.

It does not attract the same attention as a hero workforce and life-saving and ground-breaking treatments do. Nevertheless, make no mistake about it, social care encompasses every single one of these things and more.

Labour therefore has a role to play in changing the narrative among its members and the wider public. Maybe then, we can have a more honest conversation about the areas I feel we need to tackle if we are to reform and transform social care.

Funding reform

This will surely be considered the most contentious and difficult element of our policy work. If we truly want a publicly funded social care system in England, we need to establish how we are going to pay for it. Projected  growth on spending for social care is simply not in line with predicted growth pressures, which are rising at 3.7% annually in real terms. More than 1 million people aged 65 or over will require varying degrees of social care support by 2035; this is up from 783,000 individuals in 2015. As people live longer and advances in medicine and assistive technology support people to live with chronic and long-term health issues, greater strain will be put on an already creaking system.

We know we cannot simply stand still as we will have a predicted gap of £3.5 billion to fill by 2025 to maintain our existing standards of care, which are frankly failing too many people. Age UK reports that 1.5 million people living in the UK have an unmet care need and if current trends continue, this could grow to 2.1 million. Furthermore , the government have offered  short-term bungs over the years to paper over the cracks. Relying on a council tax precept and business rates cannot possibly be a sustainable funding model for an infrastructure that is so vital to a healthy society. It also creates inequity in local authorities that will be living with greater health inequalities and higher levels of poverty. Current provisions are  truly a postcode lottery.

Johnson’s statement to the House of Commons last week has done nothing to reassure those of us who live and breathe social care that reform is coming anytime soon. The  majority of the income generated by a regressive national insurance rise will not really go towards funding social care. For three years, all of the money will go towards easing the NHS backlog; in fact, only £5.4 billion of the £36 billion will head in the direction of social care. Councils may well be forced to raise council tax yet again in order to meet demand. Social care is in crisis right here, right now. The Tory Party’s talk of funding and reform are actually just warm words.


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Jack Lesgrin’s week: Government U-turns on Triple Lock and National Insurance, but still the young lose out

12/09/2021, 11:13:00 PM

by Jack Lesgrin

Double U-turn on Triple Lock and NI, but not on preferencing old over young 

Last week saw two U-turns by the government. First, they temporarily suspended the Triple Lock for pensioners because of an unusual and statistically anomalous rapid rise in earnings caused by the pandemic.

The second U-turn saw Johnson finally putting meat on the bones of his famous pledge, delivered in his first ever speech as PM in Downing Street in July 2019, to “fix the crisis in social care…with a clear plan we have prepared”. Tuesday’s mini-budget announced a National Insurance-funded Health and Social Care Levy. Note the sentence that preceded this: “My job is to protect you or your parents or grandparents from the fear of having to sell your home to pay for the costs of care.”

The government made the levy apply to some share income and on state pensioners’ income if they continued to work, in an attempt to mitigate criticism that using the National Insurance mechanism makes younger people, by definition of working age, subsidise benefits enjoyed by the elderly.

Yet this was only a fig-leaf, covering the sensitive nether regions of our system of taxation: namely that we have for too long preferred to tax income from work over other forms of income derived from other forms of wealth. Labour’s Shadow Chancellor, the excellent Rachel Reeves, eloquently put it thus: “Which types of income will be paying no additional tax after today? They include those who get their income from financial assets, stocks and shares, sales of property, pension income, annuity income, interest income, property rental income and inheritance income… Some 95% of the revenue the government plan to raise from this tax bombshell comes from employment. What a contrast.”


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Social care funding equivalent to 176,000 places for over-65s is about to be cut. In what world is this the right response to Covid?

28/05/2020, 01:21:49 PM

by Joanne Harding

Being appointed Executive Member for Adult Social Care at Trafford Council was one of the proudest achievements of my life. However, it is more than a role: it is personal.

In March 2019 I submitted a motion to Council, asking Trafford to adopt in full the recommendations of the Unison Ethical Care Charter.

As I delivered my speech, I held a photograph of my gran, Annie.

Annie was political, tiny and formidable, and I loved her.

She was an important influence on my life, and I wouldn’t be the woman I am now without having her advice and guidance.

I watched as she was ravaged by dementia: there was confusion; inability to recognise any of us; wandering and putting herself at risk, not able to feed and clothe herself; and needing assistance with the most personal of care.

I saw carers come and go, different ones trying to coax her to eat and drink.

I watched as they watched the clock. Knowing they had limited time to care for her, before they had to head off to the next person needing their support.

I watched as she sat motionless and lifeless, slumped in a chair, as she eventually had to be moved to nursing care.

The woman I knew as fiercely independent was now totally dependent on others to look after her. I remember feeling horrified and terrified in equal measures, every time I went to visit her at the care home that was just too poorly equipped to really care for my lovely gran.

Fast forward to 2020 and here we are in the middle of a global pandemic, with care homes on everyone’s lips.


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Expectations for Labour are high. Policy is the way for Jeremy Corbyn to meet them

28/06/2017, 10:36:47 PM

by Andy Howell

So, the deal with the DUP is well and truly in place. Tonight its MPs dutifully trooped through the lobbies with the Tories, blocking a Labour amendment to scrap the public sector pay cap. The deal buys May and Tories time although just how much will remain to be seen. It seems designed to last for two years by which point Tory optimists hope that a decent Brexit deal has been finalised. However, as always, political events do not aways go to plan and it is quite possible that this government will not last to the end of the negotiation period.

Corbyn is right to continue to make the case that Labour is ready to form a government at any time. At Glastonbury it is reported that he told organiser Michael Eavis that he could be Prime Minister within six months. This is not just a fanciful boast. The conference season will be a major test for May. If she continues to make the wrong choices, continues to appear wooden and inhumane and — critically — continues to be a subject for ridicule then the end could be quick.

In such a climate Labour’s biggest problem may well be the temptation to sit back and rely on its current campaign strategy and manifesto. At the moment both strategy and manifesto look to be effective but time always changes the context in which both must sit. The more that Corbyn is seen as a credible Prime Minister, indeed as the likely next Prime Minister, the bigger the challenge he faces in fleshing out the manifesto and in beginning to address detail.

Take one of the issues that devastated the Tory campaign plan, social care. The electorate was spooked by the Tory manifesto programme and singularly unimpressed by a series of subsequent U-Turns. Everyone in this country knows we face major challenges in this area. If we are not yet thinking personally about our own social care we will have parents and grandparents who, today, face the future with a great deal of uncertainty and fear. As we get closer to becoming a Party of government it will not bee enough for us to simply talk about more cash, we will have to spell out how and where we will make our investments. It might be acceptable — in a political campaign — to simply call for a new Social Care Service but it is clear that we might form the next government the health and social care sectors will look for more detail and will expect to be able to enter into a real dialogue with the opposition about the future.


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Why is the government delaying on social care?

12/07/2012, 07:00:39 AM

by Peter Watt

It may have been a dream once, but free social care for adults who need it is not going to happen.  The majority of adults in this group are aged over 65, about 1 million of them.  The state does not currently pay for all of their care and so many have to pay some or all of their costs.  The reality is that whoever is in government in the future, this situation is only going to get more difficult.

Right now, if you think that you need social care then the local authority has to carry out an assessment of your needs and then and assessment of your finances.  Firstly they see if you are sufficiently impaired so that you need help and then they decide if you or they have to pay.

Increasingly though, the thresholds being used by councils to decide if you are sufficiently impaired are being raised; it means that the numbers of people that they have to provide help to can be reduced along with their costs.  But it doesn’t mean that the needs are less!

So many people who need help with washing, cooking, dressing, and so on have to pay someone to do it.  And similarly many people who need to go into residential care have to pay.  Essentially if you have savings of less than £14,250 then care at home is free; between that point and £23,250 the costs are shared and after that you’re on your own.

If you need residential care and own your house then, unless your partner is continuing to live there, then you will probably have to sell your house to pay for your care.  Quite frankly the situation is a nightmare for hundreds of thousands of families.  You don’t think about it until it is too late; you don’t know what it is you may have to pay for and you don’t know for how long you will have to pay!

The result is that 800,000 older people are going without the care that they need or are relying on friends and family, whilst a further 500,000 are paying for their own care.

But the answer is not to pretend that somehow it can all be solved just by throwing money at the problem.  Or that it is all the fault of the government and cuts.  Labour had 13 years to solve it and didn’t; we don’t have the money and quite simply we’re not going to have it.

The need to reduce our structural deficit means that there are hard choices to be made by this government and the next.  The fact is that many older people do in fact have the resources that mean that they can contribute to their care.


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Can trees really be more “sexy” than people?

07/07/2011, 08:49:18 AM

by Peter Watt

Prepare to be bored. This post will probably not particularly interest you. At a push, it may strike you as being earnest, but quite frankly, not very sexy. It doesn’t slag anyone off. It doesn’t condemn the leadership and it doesn’t insult Nick Clegg or a single Tory. It does though raise an important issue of social justice and fairness.

On Monday, just before the appalling revelations about the News of the World, hacking and Milly Dowler broke, and understandably dominated the headlines, the Dilnot report, “Fairer care funding” was published. It is the final report of the commission on funding of care and support, which has spent a year looking at how we can pay for the care of vulnerable adults over the coming years. It is a massively important and well-crafted report that sets out a realistic financial model of how we can pay for the costs of an ageing society in years to come. I have written about this issue before, because the status quo simply cannot continue – the system as it is, is broken.

Labour needs to take a fair bit of responsibility here. After all, we had thirteen years to fix the system and didn’t. We had a number of our own reports and commissions and then we quietly buried their conclusions. You can understand why. It is a brave politician indeed that stands up and says to the public, “You know that you think that the NHS will look after you when you are unable to look after yourself, well actually it won’t and in fact it never has”. But, as research undertaken by Dilnot makes clear, the truth is that people do assume that. And it really isn’t something that you spend a lot of time worrying about when the issue doesn’t affect you.

The cold hard reality is that the costs of paying for social care are, on the whole, borne by those that need the help. So if you need hot meals delivering, help at home, a few days a week at a local day centre or to move into residential care and you have more than £23,250 in assets, then you have to pay. Your savings are used up, your family may have to chip in and your home may be sold so that you can receive the care that you need.

With local councils’ budgets being tight, you have to be pretty infirm to be able to get any help provided at all. If you think that you need help, then your local authority should first carry out an assessment to determine how infirm that you are. This assessment will categorise your needs as being low, moderate, substantial or critical. Generally they will only help if your needs are substantial or critical. You will then be assessed financially and it will be determined how much, if any, of the help you are entitled to will be paid for.

If you need help and live in a home that you own, your assets will clearly exceed £23,250.  And just to bring it life, “moderate need”, for which you are very unlikely to get any help at all, means that you may not be able to get to the shops, bath or shower or get out to meet your family or friends independently.

Suddenly finding that you or a loved one needs help either at home or residential care can be frightening, stressful, emotional and financially catastrophic. Help at home can cost between £10 and £20 per hour. The average cost of a room in a nursing home is £36,000 per year. The bills really do start to rack up quickly.

So back to Dilnot. These are not proposals for the state to pay for everything. The commission accepts that individuals should contribute something from their own assets towards the cost of their care and accommodation. Instead, there is a proposal for a partnership between the state and individuals that removes the uncertainty. Under the proposals, we will each be responsible for meeting some of the costs of our care but the extent of our exposure will be capped at £35,000. The capital limit will be raised from £23,250 to £100,000. After that the state will kick in and pay the rest.

The proposal means an extra £2 billion or so in spending by the state a year, about 0.25% of public spending. And for that we get peace of mind that in our old age we won’t face the fear and uncertainty of not knowing how much or who will pay if we need it. Most people will still pay something towards their care. But for that £2 billion we can ensure that those with modest means will not be unduly penalized following a life of hard work and saving. And we can ensure that the poorest are protected.

It might not be at the sexy end of politics. But it matters. Right now the government is deciding on what to do with the recommendations. To be fair to them; it is a tough call. Like any balanced proposals, there are elements that will both appeal and repel the various strands of political opinion. And that is why we should all be helping to persuade them that this is not about party politics or point scoring. It is bigger than that.

Ed Miliband has promised to enter into all party talks and that is to be hugely welcomed. But we should all be writing and emailing our MPs to say that the government should, after considering and consulting, support and implement the commission’s findings as soon as possible. When there was a proposal to privatise a small proportion of the national forests there was uproar. Hundreds of thousands lobbied their MP. It sent a signal. Well this isn’t about trees; it’s about people. And that same uproar sadly appears lacking.

At the moment the government is promising a white paper by the spring. If the timetable slips, then it will be a sure sign of prolonged delay. Right now people are suffering, frightened and uncertain about their future because of a broken system. This is an opportunity to fix it.

Peter Watt is a former general secretary of the Labour party.

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Abuse of vulnerable adults: why no inquiry?

23/06/2011, 07:21:44 AM

by Peter Watt

Imagine if there had been a succession of child abuse stories in the media during the last six months. There would be an outcry. Every Baby Peter story that emerges, in all its grisly detail, somehow diminishes all.

The abuse of and suffering by the vulnerable affects all decent people deeply. We find ourselves asking, “how could this happen”? And “why did no one notice”? And worst of all, “what does this say about us and society”? Parents fear for their children and their children’s future. We collectively demand that something is done. Those involved become tabloid hate figures. Ministers condemn the perpetrators as evil and establish commissions to look at lessons to be learned. Our response is horror at the pain, misery and humiliation. We have a shared feeling that this abuse shames us all. And we have an angry determination that this abuse must stop.

The result is that over the years, there has been a succession of official commissions and investigations into the abuse of children. The Maria Colwell inquiry, the Cleveland inquiry, the Broxtowe inquiry, the Victoria Climbié inquiry (the Laming report) and most recently the Baby Peter inquiry.


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Where’s the social care in the health and social care bill?

23/03/2011, 03:00:23 PM

by Peter Watt

There has been, rightly, an awful lot of attention given to the government’s health and social care bill. It proposes opening up the delivery of NHS services to any willing provider and the introduction, in some instances, of competition on the basis of price rather than outcome. Controversial stuff. Especially as the Conservatives promised no “top down reorganisation” during the election.

But there is one aspect of the bill that hasn’t been much commented on. It is misleadingly named. It is a “health” bill, certainly, but it is not a “social care” bill at all. This is not a pedantic point. The bill does not cover the social care system, which provides care and support to hundreds of thousands of people across the country in their homes and in residential settings. Last year, social care cost the state in the region of £27 billion. And individual families billions more on top. Many people do not realise that social care, unlike health, is not universally free.

Basically, if you have assets of more than £23,500 then you have to pay. If you become old and infirm, and need help staying at home, you will probably pay. If you need to move into a residential home, you will probably pay. With the average cost of a room in a nursing home at £36,000 pa, it won’t come cheap. (more…)

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