While the outcome of the general election earlier this month may have come as a surprise to many, the subsequent naming of cabinet ministers has been altogether more predictable. Most of the Conservative incumbents have continued with their briefs, including Secretary of State for Health, Jeremy Hunt.
In a statement on his re-appointment, Hunt outlined his broad objectives: "My biggest priority now is to transform care outside hospitals - just as we have dramatically improved the quality of care inside hospitals in the last few years... we need a step change in services offered through GP surgeries, community and social care. That is my mission, and I know it is the mission of the whole NHS too".
Hunt's statement has elicited a number of responses from prominent voices within the social care sector. Nearly all have highlighted the mammoth task ahead, as the NHS faces the most unstable and challenging period in its history.
In the King's Fund's response to the statement, Chris Ham noted that the appointment "will bring some welcome continuity". Continuity is certainly important at this juncture. Particularly, the need to continue with the move towards integrated care. The Conservative manifesto promised to "join up homes, clinics and hospitals", and voiced support for the NHS Five Year Forward View, which promotes the integrated care model. This integration of social care into the NHS is an encouraging step for older people. The current uncoordinated system, which often provides sub-standard care, is nothing short of a national scandal.
However, integrated care can only provide better outcomes for older people if politicians back their words with the money needed to fund it properly. While the Conservative manifesto did promise to provide the NHS with the necessary £8bn a year up to 2020, it included no specific funding commitments for social care. Indeed social care funding was referred to as "the ghost at the feast" of the election campaign.
Commitments to providing a "step change" may be made with all the best intentions, but are ultimately meaningless unless they are financially credible. With a £4.3bn 'black hole' in funding faced by adult social care services alone over the next decade, it is currently unclear how such change will be delivered.
An important aspect of this funding challenge is the need to ensure that home care workers are paid the national minimum wage. This was something that the Conservatives made no mention of in their election manifesto, although the other political parties such as Labour did put more emphasis on home care, promising to recruit 5,000 home care workers which would be a 'new arm of the NHS' and pledging to end time-limited 15-minute visits, bringing in budgets to encourage improved home care.
Home care workers provide a lifeline to some of the most vulnerable in our society and will be a fundamental facet of the integrated care model. Yet figures obtained by Unison at the end of last year demonstrated that home care workers are amongst the lowest paid. Pressure from commissioners to tighten budgets means care providers are only paid for 'contact time' and not a penny more. Travelling between care visits is unpaid, which pushes real-world pay below the National Minimum Wage. We are very concerned about this at homecare.co.uk, as this is turn has a number of knock-on effects which lowers the standard of care, such as 15 minute 'flying' visits and high staff turnover.
Pay levels are just one element of the myriad challenges facing the social care sector. The debate over how best to face these challenges is complex and sometimes overwhelming. Any proposals for the future of social care, and for the NHS as a whole, must be founded upon a clear financial plan. Jeremy Hunt's mission statement is a good start, and his highlighting of social care suggests positive things for the sector. His job now is to put his money where his mouth is, and support this positive commitment to change with the funds needed to achieve it.