Rethinking Social Care

On the 18 March 2021, Matt Hancock Secretary of State made a statement to Parliament about the support the government is giving to the NHS and social care to help recover from the pandemic. After referring to the vaccination supply, good news from Gibraltar, the end of shielding and more funds for the NHS he said ‘I remain equally committed to supporting the vital work of our colleagues in adult social care.’ He went on to describe the opening up of care homes to visitors and some additional funds for PPE and infection control. Whilst this additional support for care homes is positive, residential care is just one aspect of social care support and this statement illustrates the lack of understanding about the crisis in social care that has been going on since well before the pandemic. The government and the prime minister promised a green paper with proposals for change but this has been postponed with no commitment for its delivery. This failure is causing hardship and often unseen difficulties for people at a time in their lives when they are most vulnerable.

Social Care is still often misunderstood. Many people still see it as a service to support older people but it is much much more, providing a wide range of flexible support to disabled people and people living with long term conditions of all ages, to enable them to live the lives they want. However, delivery of good social care in this country has been undermined by more than a decade of austerity, lack of proper funding and most importantly a lack of proper debate about how much we value disabled people and older people with care needs, what kind of society do we want to live in and how do we maximise the life chances of everyone. This has meant we have ended up with a confused, bureaucratic system that is heavily rationed and targeted on those with only the most severe needs and the lowest incomes, and that is means-tested and causes financial hardship and inequity for individuals and families. 

A lot of the debate about reform of social care has been technical argument about where the money to fund the service should come from, examples have included compulsory insurance cover for old age, additional special national insurance contributions and tax rises none of which have proved popular. This is because it feels like we are pouring good money into a poor service. There have also been proposals for integrating social care into the NHS, but this is a structural solution that does not address the problem and may saddle the NHS with unsustainable costs.

We need to think about things very differently before the funding and structural solutions are imposed. We need to stop seeing social care as a remnant of the workhouse culture, a last option safety net. We also need to stop seeing social care as a solution to pressures on the NHS. We need to consider social care, free at the point of delivery and equitably applied, as a positive form of social and economic investment that promotes inclusion and enables everyone to participate in and contribute to their communities.

Lisa Robillard Webb – centraldevonlabour@gmail.com

Other columns by Lisa Robillard Webb