Coalition kicks social care reform into long grass

The wait is finally over for social care; now we know what the coalition’s plans are for the sector.

Looking at what the government has published – see here for the full rundown – it is a mixture of reform and continuing existing policy.

Firstly, as expected, Labour’s National Care Service plans have been abandoned. This is clear from the announcement that a new commission on long-term care will be established to report back within a year.

I’ve said before that the last thing the sector needs is yet another commission on the future of long-term care. We had that last year with the Big Care Debate, and others previously. Precisely what differences a new commission will find I don’t know. It just seems like a way of kicking the issue into the long grass and delaying some difficult decisions. Again.

Also, the lack of reference to disabled people in the plans – one mention under the Access to Work proposal – shows the main thinking of any reform is geared to older people.

But interestingly, it says the commission will consider several options; not just the Conservative plan for a voluntary insurance scheme, but also Derek Wanless’ partnership model, where the state and the individual both contribute to care costs.

This is significant because when the results of the Big Care Debate came out, the partnership model was most popular among respondents, and some third sector organisations had also publicly backed such a scheme. It also shows that the Tories may be backing away from their widely-derided option.

Elsewhere, the existing personal budgets and direct payments schemes are to be extended, giving more service users control over their care. This is no surprise – it fits nicely with the coalition’s plans to devolve more power to communities as part of their ‘Big Society’ reforms.

Despite rumblings that some social workers are losing faith with personalisation, the extension of it is generally good news for service users who want to take control over their care, and means no significant upheaval for adult social work departments.

Also, as expected, there will be greater integration of health and social care funding, to focus on preventative action, access to respite care will be improved and Access to Work will be reformed.

So, while there are positives in the announcement, the overriding sense is of disappointment. Firstly that disabled people seem to have been overlooked, and that the much-needed reform of long-term care has again been put back until at least next year. The whole sector has been crying out for reform for years, and another commission – to tell us what we already know – does not help. Why can’t the information in last year’s Big Care Debate be used to put together a coalition white paper on social care reform? Or is that too obvious?

A blog on the plans for families and children will also appear later.

Social care needs to be a priority for new government

Since the Conservative and Liberal Democrat coalition took power earlier in the week and started outlining its policies, one issue seems to have been conspicuous by its absence: social care.

As I have previously blogged, in the general election campaign social care seemed to disappear off the political radar, despite it being touted as a key issue in the run-up to it being called. Now post-election, it continues to be ignored in children’s and adults services; nowhere in the policy outline was social care mentioned.

Indeed, Michael Gove, the new head of the (swiftly renamed) Department for Education, has said in a letter to civil servants that education is the priority for the department, thus seemingly sidelining children’s services, although he added that this area will be strengthened and reformed, but didn’t elaborate on how.

Also, Andrew Lansley, the new health secretary, has spoken extensively of the plans for the NHS, while adult social care has garnered barely a mention.

This lack of attention is worrying; ask anyone within adult social care and they will say that reform – especially of the way it is funded – is urgently needed. Children’s services also need to be strengthened and supported. They can’t be left to drift as they have done for the past few years.

Leading social care organisations are also worried. Counsel & Care, a charity working with older people, their families and carers, have called for reform of social care to be made a priority by the new government.

Meanwhile, Carers UK’s director of policy and public affairs, Emily Holzhausen said; “We are deeply disappointed that the programme for Government published in the coalition agreement this week does not establish social care as a political priority.

“Clear plans must be brought forward as a matter of urgency, setting out a sustainable funding model for fair, universal, and transparent care services.”

However, despite the worries, I’m trying not to be too negative. It is still very early days for the government and we shouldn’t be too quick to judge – social care is a complicated issue and it may take more time to put together a policy.

Also, Paul Burstow, a Lib Dem MP with a history of championing issues such as social care funding, dementia and adult protection, has been appointed as a minister for state – the rung below cabinet – in the Department of Health. Having someone with in-depth knowledge of and a passion for the issues involved could ensure that they get the attention they need.

But until the government makes any policy announcements, as with everyone else blogging on this in the sector, everything is speculation and educated guesswork.

A final thought; in among all the speculation, there is one decision on social care that will have to be made soon – whether to pass Labour’s Personal Care at Home Bill. The Tories are against it, as are the Lib Dems, who would prefer to use the money for this to give carers extra short breaks, so I think we know what the result will be there.

Do you agree? Please let me know your thoughts below.

What will new government bring for social care?

After all the courting of the past few days, the Conservatives and Liberal Democrats have finally decided on a political marriage. But what will this mean for social care?

Now the dust is settling, here is a little of what is known, plus some conjecture and guesswork.

Firstly, it means that Labour’s plans for a National Care Service are dead. The Tories always opposed it, and the Lib Dems also had problems with it, so it’s a definite no-go. This means that social care will go back to square one, waiting again for the reform it so badly needs.

On the upside, it looks likely that plans for a set of national eligibility criteria for social care services, proposed by Labour, will be brought in as the coalition parties also both support it. This should end the ‘postcode lottery’ of unfairness in social care and can only be a good thing.

Now, things become less clear; we know there will be big public sector spending cuts in the Budget, which will probably be in June. Both parties have denied that it will hit frontline services, but councils will have to make some big savings and services could be hit – such as scrapping some services that are not perceived to deliver value for money – and eligibility criteria could be ramped up again.

I suspect that a new White Paper on the future of social care may be commissioned in the near future. The Liberals are in favour of (yet another) commission on reforming care funding, but the Tories aren’t, so action may come relatively quickly – we all know the problems in the sector, they just need to be addressed.

Whether the Conservatives’ stated plan for a voluntary £8,000 insurance scheme to pay for elderly residential care comes to pass remains to be seen.

Both parties were relatively light on detail about reform in their respective manifestos, but there were differing ideas, such as the Lib Dem idea of giving all carers one week of respite, so it is hard so say in which direction the government will go.

Also, remember there were the secret cross-party talks about the future of social care earlier in the year – which Andrew Lansley, the new health secretary, scuppered – could anything come out from that?

Hopefully in the coming weeks we will hear something more concrete about what will happen to social care. The sector needs reform quickly, so the coalition needs to work together to find the best solution – whatever that is…

Uncertainty in social care after election result

So, 3 days on since the election result was announced and we still don’t know who will form the next government. As a result, from a social care perspective, we still don’t know where the future direction of policy will go either.

So, nothing has changed there, then. It’s been like this for months as green papers and white papers have come and gone, with little changing on the ground.

The only certainty, in terms of policy, came with Labour and its plans for a National Care Service, as laid out in April’s White Paper. But many in the sector doubted it would ever make it to fruition, given their standings in the polls.

Indeed, at the time of writing, a Conservative-Liberal coalition is looking possible, which would mean the end of Labour’s ideas; the Conservatives did not sign up to it, and the Liberals rejected several elements of it.  

Their ideas for reforming social care have not been laid out in as much detail as Labour’s, so many are left wondering what will happen.

My hope is that if there is a coalition – be it Conservative-Liberal, Liberal-Labour or some other variation – it will give a chance for a consensus to emerge over future policy direction. If that happens then if there is another election in the near future, there is a chance that the policy might be consistent. But that’s a hope.

More realistically, my guess is that another commission will be formed to review social care and make recommendations from that – although what could be said differently to the results of last year’s Big Care Debate is unclear. The Liberals said they would do this in their manifesto, although the Conservatives are said to be against that as well.

So, as I write, it seems like the only things that are certain are: the social care industry will continue to do its best with the limited resources it has and a funding system that nobody likes – like it has done for years; and that nothing will change that situation in the immediate future.

What happened to social care in election debate?

After 3 weeks out of the country – I was one of those caught up in the volcanic ash crisis – I’m getting back up to speed with what’s been happening in social care and where the main parties stand on it before the election.

There was precious little mention of social care or older people in last night’s TV debate – well, the bit I watched before jet-lag caught up with me – but I haven’t seen much else about it in the news. I’m told there was not much talk about it while I was away either.

Considering that social care was supposed to be one of the main debating points in this election, everyone seems to have gone quiet on it since Labour announced its White Paper on the future of social care and plans for a National Care Service.

But while we know about Labour’s plans, you have to look hard to find the Conservative and Liberal Democrat policies on older people – social care as a category isn’t there, disappointingly.

More disappointing is the lack of concrete policies. For instance, the Conservatives pledge to introduce a ‘home protection scheme’ to ensure people don’t have to sell their homes to pay for care, but don’t say how it would work, or how it would be funded.

They do however advocate the extension of direct payments and individual budgets to give people more choice and control over their care. While this is a continuation of an existing policy, it does hint that if the Tories win, they may not make fundamental changes to the personalisation agenda.

Meanwhile, the Lib Dems say they would undertake a review of social care. It’s difficult not to be sarcastic about that pledge – hasn’t the sector had enough of those in recent years?

More promisingly, they talk about re-establishing the link between the basic state pension and earnings.

There has also been little mention of the future of social work, although there are fears among some social workers that cuts to frontline services may be made; there have been assurances that teachers, doctors and nurses will not be axed, but no such declarations made for social work.

So, the future of social care, one of the bigger issues facing the UK, has once again been swept under the carpet. In a way it is not surprising, because there are no easy answers or snappy soundbites and some of the solutions may not be vote-winners. But it should have been a key part of the debate because this will affect everyone in the UK at some point.

General election: let battle commence on social care

Finally, one of the worst-kept secrets in the country is officially announced; the general election will be on May 6.

It has been said by many that adult social care will be one of the crucial points on which the election is fought. If so, this can only be a good thing, but only if the public know exactly what they will be voting for and currently, they don’t.

We know Labour’s plans for the future of adult social care; they were in last week’s White Paper. They have outlined plans for a National Care Service, along the lines of the NHS. How it would be paid for is still unclear – but don’t let practical details get in the way of a good policy.

But as for the other main 2 parties – and, in the interests of balance, all the minority parties as well – we know that they don’t think much of Labour’s ideas, but other than that, we know very little about their plans.

The Conservatives have been plugging away with its £8,000 voluntary insurance scheme for paying for elderly care. However, those in the know in the sector don’t believe that this will come up with enough to cover the costs. The Tories disagree. Other than that, we know they favour telecare and a national system of assessment and eligibility for care, and that’s about it.

Meanwhile, the Liberal Democrats want to find cross-party consensus on the way forward in social care, as was being discussed in secret by health ministers earlier this year before Andrew Landsley blew the lid on the meetings. They also want yet another commission to investigate possible ways forward, and have said they would spend £420 million to give carer’s an extra week’s respite – as long as they care for more than 50 hours per week.

I haven’t heard much from any of the minority parties on social care – if anybody knows more, please leave a comment below.

But all this shows that we do not have a full debate on social care – that can only be achieved when others announce their policies and can be analysed objectively against the others.

That is the challenge now for the Conservatives and Liberals – show us your plans and let us decide which way forward is the best for social care.

Scandal of selling homes to pay for care

Over the past few days, one of social care’s great recurring stories reappeared, as it seems to do every few months; the ‘scandal’ of old people having to sell their homes to pay for residential care and/or not being funded by the state for their care.

This time, it was the Daily Mail, which ran with a typically hyperbolic headline of ‘3,000 victims of home snatchers: Record numbers of elderly are forced to sell their homes to pay for care’ .

As usual with these stories, the gist was how scandalous it is that people who have worked hard all their lives to save money and/or buy a house now have to lose/sell it to pay for residential care in their old age, while people who never saved get it for free.

Leaving aside the rights and wrongs of this – there are good arguments on both sides – it again shows that politicians cannot afford to ignore this issue.

Social care has been getting a higher profile in recent months – the green paper on the future of adult social care funding was published in June, for instance – but little action has so far be forthcoming.

While Labour has announced its free personal care at home bill, this doesn’t address the problem of people having to pay for residential care and could even create other issues.

For example, it is likely to encourage older people to stay in their own homes for longer, knowing that if they move into residential care they will have to pay for it and possibly give up their home. As a result, some people may not go into care when they need to, and could suffer as a result, whether in the form of injuring themselves in an accident or fall, or in terms of isolation if they are housebound.

And for those who say ‘well, in Scotland they get it free’; they don’t. There, while the care element might be free, the ‘hotel’ costs of residential care – food, board and lodgings etc – isn’t, so many older people still have to stump up money to pay for their care, including selling their home.

This issue is hugely emotive and could become an issue in the upcoming election. Any party that offers a solution to this ‘problem’ would be onto a sure-fire vote-winner.

The options mooted thus far by Labour and the Conservatives involve insurance schemes, which involve paying a lump sum up front. Labour’s idea is a £20,000 scheme, which would cover the costs of personal care at home and residential care, and while the Tories’ response only costs £8,000, it just covers residential care.

The Liberals meanwhile have sat resolutely on the fence, calling for an all-party commission to come up with a solution, rather than posit any ideas of their own.

None of these options seem to have garnered much public approval so the way forward is unclear.

All it does mean is that the current system creaks on and the reform of it – desperately needed, as organisations within the sector have said time and again – is delayed again.

Perhaps if it does become an election issue, then something might get done. If not, then the Daily Mail, as well as the other national newspapers, will have a guaranteed headline article to publish every few months.