A full year has passed since the Government announced its intention to set out plans to reform care and support in a social care green paper. Since then the paper has bounced across two departments, three secretaries of state and various remits (at first it covered only older people, before expanding to working age adults).
The line from government is that the paper is still due out in 2018. Rumours are that the Department of Health and Social Care is currently circulating it amongst other departments ahead of its imminent release. However, if the last few weeks of political turmoil are anything to go by, the ability and appetite of government to release any substantial reform and funding ideas which could prove controversial is potentially limited.
However, what an ‘imminent release’ does, is to enable the department to avoid having to respond to questions social care providers and local authorities are asking about the future funding and organisation of the sector.
Our recommendation to social care providers and those helping those who need care to live better, more independent lives, is to be as pro-active as possible in engaging, regardless of the timing of the green paper.
We would also caution that any green paper, if one appears at all, is unlikely to resolve the social care crisis. At a recent event held by the Institute for Public Policy Research (IPPR) on the case for funding and reform of the sector, panellists stated that there have been 12 social care papers in the last 10 years and none of them have led to substantial changes to how the system works and is funded.
The main reason for this is that social care is one of the most politically sensitive policy issues around. In the face of an ageing population that is living longer and with more complex health conditions, fixing social care looks like a crowd-pleasing initiative. However, scratch below the surface and you will find all sorts of contentions around tax rises, inter-generational fairness, inheritance and local authority funding.
For proof of how politically damaging taking a stand on social care can be, look no further that the 2017 General Election and the Conservative Party policy to ask recipients of domiciliary care to pay for their care in the same way as those in residential care do. Within hours of its announcement the policy was labelled ‘the dementia tax’ and is considered to have been a key determinant in the Conservatives losing their Parliamentary majority.
In this context, it isn’t surprising that politicians shy away from proposing solutions, instead falling back on ambitions around cross-party discussion or commissions, which only rarely come to fruition.
The upside of this for providers and innovators is that policy makers are always seeking solutions to propose to the electorate and interested in hearing from business.
However, social care providers have a number of challenges to consider when making their pitch to government:
- Every problem should have a solution: The fact that the social care sector is struggling and that local authorities are under pressure to fund it isn’t really in dispute anymore; what policy makers are starved of is viable solutions. No matter how severe your problem is, your chance of successful engagement will be much higher if you have developed some ideas about how to solve them. This is something GK can assist on, as experts in creating research-led strategy that aims to resolve issues;
- The Treasury: The department without which nothing happens. Any messaging should show a clear return on investment for government, or it is unlikely to get off the ground. It is also worth remembering that the Treasury has already set out £20bn for health this year, as well as some funding for social care, so any request for more investment will need to really stand out ahead of the next spending review;
- The NHS: There is general acceptance that social care is one of the biggest pressures on the NHS. However, this has not led to policy decisions that would see the budgets for health and social care brought together. The £20bn NHS deal announced in July for example, will only cover the NHS England budget, and there is little sign NHS bosses will be willing to share it. In a recent select committee appearance, NHS Improvement CEO, Ian Dalton restated that the settlement should not be used to for services outside of NHS England’s remit, such as social care, advocating instead for separate budgets to be allocated. The NHS’s fight to hold on to its funding should not deter social care providers form engaging with NHS bodies. NHS leader’s lobbying voice is powerful, and providers should seek to work with them to present integrated health and care solutions which would help relieve both capacity and financial pressure on the system. The need to engage more effectively with the NHS will only become more important as integrated care systems develop over the coming years.
by Jennifer Berger, Account Director