Britain’s ailing adult social care system needs more than a one-off grant or regressive tax increases to be fit for purpose, writes Progress strategy board member Paul Brant
After a winter when even the Red Cross were driven to describe our hospitals as in a ‘humanitarian crisis’ , it was clear urgent additional cash was needed to ensure our health and social care system did not start to implode. The failure to provide the additional cash in the autumn statement of 2016 led even former Tory health ministers to criticise Philip Hammond.
It is important to firstly welcome the additional cash this budget round has provided for social care. However, it is an inadequate sticking plaster which is likely to fall off the wound shortly unless a long term solution is found.
The £2bn ‘improved Better Care Fund’ money announced for the next three years is good news. However it is only £1bn next year and the remaining £1bn over the two following years. As the money is only a one-off grant, it means it cannot be used to fund increased long-term care packages or placements. Long-term spending commitments can only follow long-term funding pledges by government.
Also the sums involved are not adequate to bridge the current spending gap. The all-party select committee identified a funding gap of £1.5bn for social care in 2017/18. The reason for this huge gap is the previous huge cuts to local government hitting the rising demand from an aging population,
The other stop gap help was the additional three per cent council tax precept allowed for the next two financial years. However, this is a regressive way or raising money, as even the poorest households have to pay part of their council tax bills directly. The other problem with this idea is that it raises more money in the richest council areas with the highest value houses. It is normally the poorest councils such as Liverpool which also have the highest need for social care – few self-funders, and much higher levels of ill health (often from ex-industrial workers). Seeking to fund social care via council tax is not a solution which Labour should accept in the long term.
Behind the rising demographic, other cost pressure are also building up with the care providers. Rightly, the increase in the minimum wage (which the Tories misleadingly badge as the national living wage) has been a long overdue boost to many care workers. However the employers (often charities) seek reimbursement from councils who just do not have the cash to indemnify them. In Liverpool, the additional costs are predicted to be over £25m by 2020. Also, compulsory pension costs on employers are pushing up wage bills. These are direct costs imposed by the government policy, welcome changes, but ones should be government funded. These costs explain the other main driver of the cash crisis in the system.
A long-term solution to funding our health and social care system is urgently needed. The announcement of the green paper on social care this summer is welcome, however it needs to provide more than the current sticking-plaster solutions, and as Caroline Fint MP rightly argued here, should really be hammered out on a cross-party basis if the solution is to last.
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Paul Brant is a member of the Progress strategy board and cabinet member for health and adult social care on Liverpool city council. He tweets at @PaulDBrant
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