Reforming social care – what’s all the fuss about?
Despite growing demands from experts, users, carers and charities, along with a 2019 promise by Prime Minster Boris Johnson to “ fix the crisis in social care once and for all”, social care reform remains a distant goal. As increasingly more of us are affected, there is rising dismay at the looming crisis which is social care.
Unless you have experienced or studied the social care system in the UK, you may wonder what all the fuss is about? Why are cries for reform growing? Why was there so much disappointment when social care was not addressed in the recent Queen’s speech, budget, and relatively ignored in the February White Paper for health and social care?
Could extra funding solve the problem? Well, money is relevant and more would help, but the challenges are far more complex and deep rooted. A recent analysis from the Nuffield Trust identified ten systemic problems which need resolving before additional funding can begin to have any impact.
The reality is, that funding alone will not address the workforce challenges, or the lack of information, accountability or regulation which are endemic in social care. Indeed, further investment will not address the fact that social care is provided as a sprawling and complex market with different penalties, opportunities and perverse incentives for all concerned.
Although social care should, and does, extend far beyond care home provision, this sector does illustrate many of the inequality challenges. Funding arrangements for care homes vary between countries within the UK. In England, those with personal resources above £23,000 are required to pay for their long term care. These self-funders, are likely to shell out around £1000 per week, which is a much higher fee than that for residents funded by local authorities. The high rates for self-funders enable the subsidised local authority placements.
In most other circumstances, consumers paying out fees in the range of £50,000 per year might naturally expect a degree of control or assurance of the quality, or, indeed, safety of that service. However, the Government's Competition and Markets Authority (CMA) repeatedly finds this is not the case for self-funders. Self-funders are the most disadvantaged of all in the social care sector, the most vulnerable to inequalities in pricing, hidden costs and poor standards.
What's more, even with the will and the means to pay, social care placements are not universally available. Unlike our health services, long term social care is provided by businesses which often become unviable in the face of funding and workforce shortages and this is leading to care deserts. This term was coined by AGE UK in their 2019 analysis to describe around 30% of areas in England that have no available long term care beds.
This week is dementia action week, and those affected by dementia (1 in 6 people aged over 80 years) are especially hard hit by flaws in the social care system. So, the Alzheimer’s Society is calling on the Government to finally reform social care. You can help change your future prospects by supporting the Alzheimer’s Society and signing their petition. You can access their petition here and view the video below.
Everyone agrees, money alone will not fix social care. Comprehensive reform is required to build a system that is stable and sustainable and able to deliver the standards that vulnerable people deserve now and in the future.