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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