‘No easy solution’ to funding adult social care
ADASS calls for government to tackle social care funding in upcoming green paper
Published on 16th February 2018
There is no easy solution to tackling the long-term funding crisis facing social care, the Association of Directors of Adult Services has warned.
Following the publication of the Kings Fund report into approaches to social care funding, Margaret Willcox, president of ADASS, acknowledged that while there was no simple solution, there are options.
“Developing a solution will take political courage, engagement with the public and the wider care sector. The upcoming green paper is the opportunity for the government and the sector to develop this, and ADASS will be working hard to encourage all involved to take this opportunity, and put these essential services on a firm financial footing,” she said.
The Kings Fund report highlights that it is widely accepted that the system for funding social care is in urgent need of reform. A combination of an ageing population, growing demands for care, increasingly complex care needs and shrinking local authority budgets, the number of older people receiving publicly funded social care has declined and people’s needs are going unmet.
It adds that since 1998, there have been 12 green papers, white papers and other consultations, as well as five independent commissions, all attempting to grapple with the problem of securing a sustainable social care system.
The report explores the following possible solutions to set out the implications of each of the models which are most commonly raised in debates about social care funding:
- Improving the current system
- The Conservative Party’s proposals at the time of the 2017 general election (a revised means test and a cap on care costs)
- A single budget for health and social care
- Free personal care
- A hypothecated tax for social care
The analysis says that while there is scope for making small improvements within the current system, and this approach would recognise the great difficulty successive governments have faced in achieving major reform, it would not address many of the fundamental problems with the current system. It would also fail to protect people against ‘catastrophic’ care costs.
Conservative Party’s proposals at the 2017 general election would have, for some, resulted in a more generous system than the one currently in place. However, the report outlines that there are real concerns around implementing and operating such a complex system. There is also a question as to whether this would be the best use of additional funding for social care.
Whilst a joint health and social care budget might support progress towards more integrated care, it will not in itself address the differences in eligibility between the two systems, or generate additional revenue for health or care.
Introducing free personal care would mean increasing the government’s ‘offer’ on social care. But, given this would require an increase in public spending, there is a question as to whether this would be the best use of additional funding for social care.
The report adds that a hypothecated tax may help gain public support for raising additional funding for social care. However, this would represent a significant shift from the existing system, and could exacerbate the lack of alignment between the health and social care.
Margaret Willcox said: “This report sets out very clearly the crucial issue facing all of us – how do we fund adult social care?
“This vital care and support safeguards us when we are in our most vulnerable circumstances because of disability or ageing. It’s clear that the need to develop a long-term, sustainable funding solution is urgent and has long been recognised across all political parties.
“There have been significant challenges to resolving this issue, and this report helpfully sets out what they are and how they can be addressed. ADASS has seen first-hand in our work how care has shifted from long stays in hospital, funded by the NHS, into community care, funded by a mix of benefits, individuals and councils.
“When the NHS was set up, the role of councils was largely in providing social work, residential homes, home helps (who helped with shopping and cleaning) and day centres. Times have changed and now home carers do much that district nurses would have done and nursing homes much that hospitals would have done. But more importantly, social care has transformed lives through enabling people to live lives as active citizens in their local communities.
“However, insufficient funding, increased need as more of us live longer, and increased costs as we struggle to pay care staff, who do vital work every minute of every day, have meant that fewer people are getting the care and support they need and care providers are increasingly closing down, selling up or handing back contracts, which causes significant issues for the people who rely on these services. There are also significant impacts in terms of people needing acute NHS care.
“There is no easy solution to tackling the long-term funding crisis facing social care, but there are options.
“These need to be fully considered whilst bearing in mind the long-term impact on the economy of working in care, which benefits we prioritise and how we invest in our communities’ primary and mental health services,” she concluded.
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