During his time in office, Boris Johnson long promised to ‘fix’ the crisis in social care ‘once and for all’. Whether or not his Government introduced the measures needed to begin to resolve the slew of issues facing the sector remains a subject of debate – and likely will do for some time as he leaves office and his successor takes the wheel.
Instability, uncertainty, and policy U-turns caused by political or party turmoil, however, are far from what is needed for the social care sector. It is imperative that the change in Conservative Party leadership – and subsequently, Prime Minister – does not result in the failure to enact the promised long-term sustained improvements.
Clearly, the challenges facing the sector are not going to be resolved with a ‘quick fix’, and yet successive Governments have failed to produce either the funding or long-term oversight which will lead to the sustainable, stable system which people need to be able to live and age well at home and in the community.
Thus far, none of the Conservative leadership hopefuls have yet demonstrated that they will give social care the focus required to deliver the meaningful change needed – in the form of dedicated funding, improved support for professional and unpaid carers, or a workforce plan.
The Government’s plans to fix the workforce crisis, funding gap (amounting to £7.8 billion by the Health Select Committee’s estimates), and pandemic-induced backlogs across the system, were of course pinned on the ‘Health and Social Care Levy’ announced in November 2021 – a UK-wide hike in National Insurance contributions that would raise £12 billion per year ringfenced for health and social care.
Despite national controversy and accusations of an impending cost-of-living crisis, all the MPs currently running in the Conservative Party Leadership contest voted in favour of the Government’s Levy (other than Tom Tugendhat, who was absent or abstained from voting).
It will therefore be disappointing to many in the care sector that there are, at best, rumours circling of leadership hopefuls planning to scrap the National Insurance rise – and at worst, solid pledges from candidates to reverse the Levy. Though now out the running for the top spot, Sajid Javid was the first to commit to scrapping the rise if he had the chance – despite pushing for it to be raised as high as 2% during debate on the proposals last year. Liz Truss, similarly, has pledged for the reversal of the National Insurance rise. What is missing so far, however, is an indication of an alternative plan for the sector should the Levy be abandoned.
The Health and Social Care Levy has by no means been regarded by anyone in the sector as the overnight solution to fixing social care’s problems – not least because in the first three years of the Levy only £5.4bn of the estimated £39bn raised is reserved for social care. Instead, the majority of the money is going to the NHS to tackle the Covid-19 backlog in elective surgery and other systemic challenges. However, the move did signal a step towards recognising the scale of the crisis, taking some action towards trying to reduce the current funding gap, and introducing a funding mechanism and loose promise that care would receive a greater share of the Levy from 2025 onwards.
Whilst the Conservative Leadership contest is only a week old, tax cuts have been at the heart of all the potential leaders’ policy announcements and the subject of great media and public interest. The cost of living crisis is of paramount importance to voters, and discussions about how best to strengthen the economy and support people through this challenging period are critical. However, that should not come at the expense of reforming the social care system to make sure that it works for people now and in the future.
There will be many who are unsurprised that meaningful change to the care system can so easily hang in the balance for those aiming to be in the top political job – not least because the sector remembers what happened to the Dilnot reforms proposed in 2011. The result of the Dilnot Report, which was commissioned by then Prime Minister David Cameron, was the 2014 Care Act which included a proposed cap on personal contributions to an individual’s care costs – only for this element of the Act to be long-side-lined and ultimately never implemented.
As is so often the case, and with the latest reform programme having already been delayed, social care is once again not being treated as a priority – this time by the people who are bidding to be in the top leadership position in the country. It would be a failure of responsibility if the Government’s previously flagship policy, and the long-overdue commitment to longer-term thinking and action on social care, were to suffer at the hands of an electoral race involving just 200,000 Conservative Party members. Those needing care now, and in the future, as well as the 1.5 million people working in social care, deserve better, and deserve certainty around the delivery of a long-overdue reform programme.