This article first appeared in the morning of Wednesday 4th January 2023.
A new year perspective on social care - With a TV guide thrown in!
There are some policy issues that have a high profile for years - decades, even - but then vanish from political view.
There are other issues which go in peaks and troughs - dominating the headlines but then disappearing before, eventually, returning to public prominence.
An example of the latter is all too prevalent today. Not only does industrial action have a higher profile now than at any time since the miners’ strike, in the mid-1980s, but public services are being affected more profoundly than any stage since the late-1970s and its infamous ‘winter of discontent’.
It is perhaps harder to think of issues that have had a high profile before going ‘under the radar’. But I was reminded of a good example while watching, over the past couple of days, ITV’s ‘Stonehouse’. It’s great viewing with Matthew Macfadyen delivering a brilliant performance as the ex-minister, John Stonehouse, who loses office in 1970 and then - spoiler alert - tries to start life afresh by faking his own death.
But why did Labour, and Stonehouse, lose office so unexpectedly at that year’s general election? With a bit of dramatic licence - fair enough; it’s a drama not a documentary - the ‘Stonehouse’ scriptwriter suggests that England’s early exit from 1970’s World Cup was largely responsible. It certainly denied Harold Wilson the ‘feelgood’ factor that he’d been expecting from, ideally, England retaining the trophy they’d won earlier in his premiership.
But most political historians would beg to differ. They generally attach much less significance to Gordon Banks’ illness, Alf Ramsey’s substitutions or Germany’s stunning comeback than to the publication, before the election, of some trade figures which undermined Wilson’s arguments on the economy and confirmed predictions by the Opposition leader - Ted Heath.
For several decades now, the UK’s trade figures have attracted virtually no political or media attention. In the 1960s and 1970s, though, their publication was eagerly awaited. The ‘balance of trade’ was regarded as a key measure of Britain’s economic wellbeing, so it was Wilson’s misfortune that damaging figures were published as the election approached. Without them, Wilson might have stayed in office and Stonehouse’s career could have remained in the ascendant - rather than beginning its precipitous decline.
But there’s also a third type of policy issue: the subjects which seem to take an eternity to receive the political or public attention they deserve. In our view, at GK Strategy, they’re exemplified by social care, which has been the focus of several projects for our clients over recent months.
Social care has long been seen as a ‘Cinderalla’ service – especially when compared with other aspects of healthcare, such as accident and emergency services or people’s access to GPs. Indeed, it’s a perception that has been confirmed by our all our research work and each of our interviewees. Particular problems include low wages, high staff turnover and vacancy levels which are already serious but only likely to get worse, due to the UK’s ageing population.
Despite these challenges, the Department of Health & Social Care has yet to publish either its long-awaited workforce strategy or even its reaction to last year’s Select Committee report on the health and social care workforce. Indeed, DHSC’s response is now, depressingly, more than three months overdue.
So it’s generally a pessimistic picture. Yet, to quote one of our interviewees, there are a few “glimmers of hope”. Positively, for example, more young people have shown an interest in working in social care after seeing its importance during the pandemic, while the Select Committee put forward some interesting recommendations for improving social care’s status which, like its pay levels, has often been low. Helpfully, but more negatively, both the cost-of-living crisis and this year’s expected recession seem likely to ease some of the sector’s recent staff shortages. Many staff will surely feel the need to move from part- to full-time working, while lower disposable incomes should reduce the number of jobs available at employers like retailers - who have been finding it ever easier, in recent years, to entice staff away from social care.
Above all, perhaps, it seems increasingly likely that the Government will finally realise that it can only tackle the NHS’s most serious problems if it can address, first, the evident challenges in social care - especially the funding levels which contribute to its low pay levels and consequent recruitment and retention difficulties. So, at long last, social care’s turn in the public and political spotlight is surely coming ever closer.
Earlier this week, in his New Year message, the Archbishop of Canterbury described the state of social care for the elderly as one of Britain’s biggest challenges. Today, it’s the turn of The Times as it looks at how the health service can be helped this winter. Giving more powers to pharmacists could, it argues, help the NHS a little; ending a longstanding problem with the NHS pension scheme, which incentivises early retirement, could help a lot; but only more competitive pay levels in social care can enable its 150,000- plus vacancies to be filled, 13,000 hospital ‘bed blockages’ to be ended and record patient backlogs to be reversed.
Let us hope that those messages sink in with ministers and, indeed, with their Opposition counterparts - especially as Labour’s policy- making moves up a gear as the next general election draws closer. Let’s hope, too, that the Government’s response to the Select Committee proves to be worth the long wait. Above all, perhaps, let’s hope for some proper and permanent solutions so that social care doesn’t become one of those issues that keeps returning to the headlines due to ‘sticking plaster’ solutions being preferred to fundamental reforms. As our recent research projects have found - across residential homes for children and the elderly alike – social care is simply too important for that.