Britain’s social care is in meltdown. Underfunded, understaffed, and overburdened. The latest debacle to hit the sector is the alarming revelation that 900 care workers are quitting every day. Short-term fixes won’t do. The sector needs a drastic overhaul.
It leaves us as a nation in a state of inequity. And it leaves us with two options. We will have to fork out for private social care or end up using centrally funded NHS hospitals. Because poor levels of care from staff shortages will drive us there.
It’s already happening though. Councils dropped spending by 9% in real terms between 2010 and 2015. And the number of pensioners receiving care from local authorities declined by 26%. The funding gap has been estimated to be £2.3bn.
The only concession the government has made was to allow local authorities greater flexibility over council tax to allocate more to adult social care. Many say this is inadequate. And so far solutions have acted as little more than a sticking plaster applied to a full on emergency.
Rehaul on social care reform
The NHS is centralised, so why not social care? This would ensure everyone got the same level of care no matter how rich or poor their borough is. And in many ways, you cannot consider one without the other. Without good social care, people will use the NHS more.
And when it comes to elderly people, much that happens on the national level within the health service will impact on social care – such as the NHS’s provision of community services like stroke rehabilitation.
Lessons learned abroad
Some economies have gone through their own crises and come out with ‘radical’ solutions. Prior to 2000, Japan did not have a publicly funded health service. Traditionally, family looked after elderly people but eventually more ended up in hospitals because there was nowhere else to go. Japan introduced long-term care insurance offering social care for over 65s according to need. Taxes, premiums, and co-payments funded this capability.
Germany has a similar system to cover basic needs. People in need of social care are assessed on whether they meet the threshold for care. They may then receive benefits in cash which they can use to pay for carers and accessibility renovations, receive in-kind-services benefits, or a combination of both.
But the immediate crisis is arguably to do with staffing.
60,000 EU nationals currently work in social care, which means the labour force may be even more vulnerable post Brexit. In addition the number of people needing daily physical assistance is expected to double by 2030, and the UK will need to recruit and train 1.6 million health and social care workers by 2022 to accommodate this increase.
Many care workers are very low paid, even earning below the minimum wage, with limited opportunities for career progression. Recruitment won’t be enough. Value, training, and prospects will need to be injected into a new workforce strategy to ensure longevity and good quality care.
Ministers need to desperately get back to the drawing board on social care to prevent the rising catastrophe on the horizon of our health system.