Last month, the Commons Health and Social Care Select Committee published a report on the Adult Social Care Workforce and Funding. Michelle Ferris, Head of Charities and Care at Albert Goodman, highlights the main points.
The report highlights the challenges which the sector has faced over the course of the last seven months. It is not intended to be an in-depth inquiry (given the number of these that have already been carried out without action), but rather a short, focused one looking at funding and workforce issues, in the light of both Brexit and the Comprehensive Spending Review due in the Spring of 2021.
The report is clear that the Committee believes that the Government understands the urgent need for reform, and indeed put a number of case studies to Matt Hancock, Secretary of State for Health and Social Care. There are twenty-one conclusions and recommendations to improve funding and the strength and stability of the workforce, centred around two key elements – the historical injustices in the system, and the current funding pressures.
The report calls for a minimum increase in annual funding of £3.9bn by 2023-24 to meet demographic changes and planned increases in the National Living Wage, but notes that this will not address shortfalls in quality of care, reverse the decline in access or address further issues. The overall recommendation is ultimately an extra £7bn per year for social care, with the acknowledgement that this could easily rise to over £10bn to address most problems.
Previous reports have recommended free personal care and a cap on care costs (at an estimated cost of £5bn per year) or a lifetime cap on care costs (at an estimated cost of around £3.1bn by 2023-24), but this goes a step further to look to address wage issues within the sector, as well as an increase in the scope of personal care funded.
In considering recommendations, the Committee heard evidence regarding the system in Japan, where service users pay a co-payment of between 10% and 30% of the total care cost. Those in residential care pay ‘hotel costs’ (accommodation and food) but these contributions are means-tested and capped for those on low incomes. The system is funded through general taxation and through ‘premiums’ paid by all people over 40 at a rate of 1% of income.
With UK National Insurance contributions expected to hit £143.4bn in 2019/20, a 2% rise in national insurance would cover almost all of what the report is recommending.
The report also calls for the Government to publish a 10-year plan for the social care sector, as they have for the NHS, with the argument being what most have been saying for years, that the systems are intrinsically linked. The report also comments on the testing system available for care home staff, including a recommendation that the Government should consider including a named key relative in routine testing. This is an idea starting to gain real traction on the ground to enable a safe level of interaction with family, which is so vital for all individuals, but particularly those with dementia and Alzheimer’s.
The big question is, will this make a difference? Certainly, the Select Committee have more freedom to call for such measures, without consideration of the public purse or political pressures, but there are some compelling arguments pulled out in what is really a brief report. The case study of Japan is particularly interesting, and certainly there is more public awareness of the state of the care sector than there ever has been previously, making perhaps an increase in National Insurance slightly more politically palatable for Rishi Sunak and the Government. If nothing else, the report adds a further layer of pressure to the position, one which I would encourage you all to build on, to get the situation built into the Comprehensive Spending Review.
A full copy of the Commons Health and Social Care Select Committee Report is available here.