THE BLOG

Social Care in Limbo

15/12/2016 16:19
Max Alexander via Getty Images

There is a strange predictability to news in the social care sector. First, the Care Quality Commission, or some other reputable body, publishes figures that show the black hole in social care finances is increasing. Then the government reheats one of its tired ideas and attempts to put a glossy new spin on it. This routine is then repeated ad nauseam.

We are seeing this peculiar ritual in action again this week. Despite it being evident that social care was in dire straits before the Autumn Statement, the Government decided not to act. Now - having tuned into the cacophony of protest from councils and social care bodies - there is talk of increasing councils' powers to raise tax to pay for social care. This is a revamp of the idea from the 2015 Autumn Statement, whereby councils could levy a 2 per cent precept for the same purpose.

Unfortunately, in doing more of the same, the implementation of this plan will suffer more of the same problems. It was claimed the 2 per cent precept would raise £2bn in revenue for social care if all councils levied the charge, yet thus far it has raised only £383 million. When compared to the £58.55bn the Government currently spends on health and social care for older people this is clearly peanuts.

But the 2 per cent precept was flawed on a much deeper level than not raising enough funds. The ten best off councils raise two-and-a-half times as much from the precept as the 10 most deprived councils. Per head the amount of money raised in Newham and Manchester is £5, while in Richmond on Thames it is £15. Yet these wealthier areas need the additional funding the least, since the wealth of their populations means few people are eligible for state-funded social care.

Unless some mechanism is introduced to share the funds raised from this tax more equitably, the benefits it does bring will fall disproportionately to wealthier areas. In principle a pot of money, no matter how paltry, is a good thing, but it must be channeled to areas of the country with the greatest need. But, again, such a mechanism would merely be plucking at the edges of what is needed and these proposals would just be to turn the heat up on a stew that has long gone out of date.

If the Government does insist on reheating old ideas, it would be better to tackle the Better Care Fund - the other notion from the 2015 Autumn Statement. New money for the Better Care Fund is only £100 million next year, but will rise to £1.5 billion in 2019-20. The additional money for the Better Care Fund should be brought forward to fill the funding black hole. This will only provide a stop-gap to the broader problem, but would be a better solution than the current proposal.

It may be an idle hope that the we will break out of this monotonous and deeply damaging cycle. It is a great shame, for there is no shortage of big ideas in this field. Why not actually integrate health and social care services, rather than merely say we want to integrate health and social care services. Why not allocate personal care budgets as well as personal health budget? There is a wealth of great, big ideas out there. Yet, I fear we may never break out of our tired routine, I imagine that shortly the Care Quality Commission will publish yet more dire statistics to predictable effect.

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