Social Care Needs a Plan. What We Heard From the Prime Minister Isn’t It.
Plan. noun. A set of decisions about how to do something in the future.
When Boris Johnson stood in the Commons two weeks ago to set out his government’s Health and Social Care plan, people may have been hoping for details on how they would fix social care. What might they do now and in the future to give us the social care system we need and deserve?
After all, when he stood on the steps of 10 Downing Street two years earlier, he announced that his government would “fix the crisis in social care once and for all”.
Yet, this recent announcement was less a plan, and more of the same vague promises and politics.
The government has introduced a lifetime cap on care costs of £86,000 for people in England, meaning people would not have to fund their care after paying this amount. They argued it would stop people having to sell their homes to pay for their care. But this claim is misleading. Only the actual cost of care is covered by this cap, leaving those in care homes to continue paying far more for other costs of care, including accommodation and food.
The government has said they’ll pay for this with an increase in national insurance contributions on employees and employers, raising as much as £12 billion a year over the next three years, described as a health and social care levy.
It remains to be seen whether social care itself will see the investment needed from this new tax. From the estimated £36 billion promised so far, the majority has been ring-fenced for the NHS. Just £5.4 billion will go towards social care – and only in three years’ time - with more than half of this set aside to cover the financial costs of the new cap, some way short of the amount likely needed.
The principle, and promise, of increasing investment into social care is important. It’s what the TUC, unions and those right across social care have long called for. But addressing the issue of a cap on care does nothing to fix the underlying structural issues affecting our care system.
Problems with no solution to fix
There was nothing in the Prime Minister’s ‘plan’ to fix the current problems facing social care, including capacity, financial support, quality of care and investment in more, and better paid care workers.
The families that draw on social care will have been hoping for investment to deliver quality care that supports them to live their life well. Yet, none of the £36 billion have been diverted towards the as-yet unmet care needs of some 1.5 million people. Moreover, there was not even mention of a plan to resolve this crucial issue.
Worse still, the increased tax revenue generated by the new health and social care levy will not cover the £600m shortfall in funding to councils, which are in charge of commissioning and providing social care. Instead it looks like local authorities will have to further raise the social care precept in council tax in order to continue funding care.
With regards to the care workforce - there is nowhere near enough funding. Despite promises of £500 million to support “professionalising and developing the workforce”, there was nothing in the announcement to increase pay. Given the ‘reward’ for experienced staff in care is an average of just 12p more than new starters, and care workers have continually cited wanting higher pay as their reason for leaving their job the government might have been better placed fixing pay as a priority.
Just last week, the TUC showed how increasing the pay of care workers to £10 an hour was affordable. Raising pay to this level would lift the income of 580,000 workers, with almost half a million women benefiting. Importantly, it is affordable, with the net cost to the Treasury being £227 million.
It is right that care staff get a raise because the work they do is so socially valuable. Not only would this show the UK’s commitment to recognising care work as the high-paying, high-skilled profession it is, it would provide a solution to tackling the 112,000 vacancies in social care.
Funding the fix
Given the government’s disjointed social care ‘plan’, it’s no surprise they got their funding back to front too.
It increasingly feels like social care is bolted onto a strategy to increase tax to pay for the NHS, with a promise of jam tomorrow for those who need help today.
Social care is an essential public service. But given it employs 6% of the UK workforce and contributes over £46 billion to our economy, it should be seen as an important part of our infrastructure too, in the way we view roads and railways.
To fund something as important as social care, we all should be contributing our fair share through taxation. And those with the broadest shoulders should be paying more.
This is why the TUC called for the government to equalise capital gains tax, raising as much as £17 billion to fund social care, with the wealthy paying their fair share.
At the moment, the money one makes from working is taxed at a higher rate than the money made from selling shares, or a second home. The average care-home worker can pay a bigger share of their income in tax to fund the social care system than the private equity magnate who profits from buying up care homes to re-sell them. This has been integral in helping the rich to become richer in recent years – with the wealth gap between the average family and the top ten per cent rising by an extra £44,000 during the pandemic alone.
Part of the funding for a new social care system should therefore come from starting to tax wealth on the same basis we tax income; a down-payment on the investment we need to ensure our social care system delivers high quality care and high quality jobs.
This would also be a fairer way to raise revenue, compared with the upcoming National Insurance increase, which will have a disproportionate impact on young and low paid workers. As it stands, instead of a pay rise, the only thing a care worker gets from the government’s plan is a bigger tax bill.
In Parliament, the government has won the battle on National Insurance increases. But this isn’t the end of this issue.
What the government has done well, is technically commit to funding social care for up to £12 billion a year. Right or wrong in its method, we must ensure this money comes the way of social care as soon as possible, and delivers the investment needed. Everyone in social care – those who draw on it, trade unions, local authorities, providers and all other stakeholders – need to make sure that the reforms we have called for are delivered.
Promises of a government White Paper run the risk of further delay to the reforms needed, so pushing for change is a priority. Meanwhile, in the long term, there is opportunity for us to ensure that social care – like all of our other public services – is funded through fair and progressive taxation.