Even as Theresa May’s government rides high in the polls, the past week is likely to be one that the government may wish to forget. The week started with an inauspicious row over the cost of the PM’s leather trousers, on Wednesday Jeremy Corbyn turned in another impressive performance at the despatch box and the PM was even excluded from the working dinner after Thursday’s European council meeting. But behind the sound and fury of Westminster, this week saw the PM grappling with one of the most pressing public policy challenges of our time.
Social care budgets, which fund things like grab rails in older people’s homes, individual help with tasks such as washing and dressing and the provision of care home beds, isn’t necessarily what leaps to mind when considering pressing challenges for the government. But the UK’s aging population – coupled with a £5 billion squeeze on local authority spending – means that this is likely to be a serious issue for Westminster for many, many years to come.
Local authorities, which fund social care, have consistently warned that rising demand and budget cuts were a recipe for disaster. This week, as the issue cut through to the front pages in a consistent way, the Government acknowledged that they might have been right. While November’s Autumn Statement didn’t make any more funding available for the NHS or social care, on Monday The Times splash revealed that the “absolute crisis” in social care had prompted the PM to plug the gaps identified by local authorities.
The social care system faces long-standing and serious challenges, many of which predate this government. The Times investigation found that at least 250 residential care homes have closed since March 2016, which means that over 5,000 beds have been lost over the past 18 months. In addition, complaints about home care have risen by a quarter in the past year, while complaints over residential homes have increased by just over 21 per cent. Pressure on social care means pressure on the NHS too. Record levels of delayed hospital discharges due to the absence of community and home facilities are a clear indicator that the pressures of social care are also contributing to a crisis in the NHS.
Her Majesty’s Opposition, always eager to highlight how perceived underfunding is impacting the NHS, acted smartly to insist that Theresa May’s government had ignored this issue for too long and had been finally forced to act. Having secured an Urgent Question on social care on Tuesday, Corbyn, increasingly adept at the despatch box, devoted all six of his questions to the “crisis made in Downing Street” at PMQs on Wednesday.
Repeatedly pressing the Prime Minister on how any extra money raised through council tax rises would be distributed across the country, Corbyn neatly sketched a postcode lottery of care, with those local authorities with higher rates of deprivation coming off worse from the proposed changes. Theresa May and Jeremy Hunt, were both keen to stress that this was an issue that Labour had similarly neglected and that a “long-term, sustainable solution” was needed. For the Health Secretary, this meant finding a “way of devoting a greater share of our national resources into health and social care” with young people saving more for their own care.
Appearing before MPs on Thursday, the Chief Executive of NHS England, Simon Stevens, will (not for the first time) have done little to endear himself to Number 10, by insisting that social care needs not only an “immediate” injection of funding but a new “social contract”. "There is no point in saying to our parents 'yes you've got a free bus pass’ if you're not able to leave the house because you don't have the availability of a home help," he said.
A long-term solution to the issue of funding for social care will not come easy and is not likely to be quick, popular or cheap. But with the system already at crisis point and the attendant risk to the NHS, the Government may need to revisit its decision not to provide any further central funding for the social care system sooner rather than later. Otherwise, we’ll be hearing more about this issue in weeks to come.