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Adult social care needs a 10 year plan and £7bn annual funding, say MPs

The Health and Social Care Committee has published a report calling for urgent social care reform, with recommendations including a 10 year plan, similar to that seen in the NHS, and £7bn annual increase in funding by 2023-24.

The £7bn would only be a starting point in solving the long-standing funding and workforce issues faced in social care, with the full cost of adequate funding potentially reaching tens of billions of pounds.

The inadequacy of local authority funding and the disparity in the funding between social care and the NHS has lead to difficulties with transitions, such as hospital discharging.

The lack of funding is also evident in the social care workforce, with over 20 per cent of care workers paid only the National Living Wage, and one in five care workers aged under 25 paid even less.

The current funding system, which only funds social care for people with assets worth less than £14,250, has forced some older people to move to a cheaper home and has discouraged younger adults with lifelong care needs from saving to buy their own home.

The Alzheimer’s Society has calculated the typical total cost of care for people living with dementia as £100,000, with two-thirds of that cost being paid by people with dementia and their families.

These issues have been exacerbated by COVID-19 and MPs have set out a number of recommendations for social care reform:

  • The Japanese System: Providing universal comprehensive social care packages which are co-ordinated by care managers, the Japanese system is funded through general taxations and through ‘premiums’ paid by everyone over 40 at a rate of 1% of income. Prices are set nationally meaning care providers compete over quality and reputation rather than price.
  • Free personal care and a cap on care costs: Estimated to cost £7bn, individuals with substantial and critical levels of need would have a basic entitlement to publicly funded personal care.
  • Lifetime cap on care costs: An individual’s contribution would be set at a maximum with the state funding the rest.

Immediate funding is needed to avoid market collapse as a result of providers focusing on the self-pay market.

Jeremy Hunt calling for 10 year plan
Jeremy Hunt

Health and Social Care Committee Chair Rt Hon Jeremy Hunt MP said: “We conclude that the government must use the spending review to raise the annual adult social care budget by £7bn as the starting point for a wider series of reforms. Whilst that is a significant sum, it would not increase access or quality of care. However it would meet demographic and wage pressures as well as meet the catastrophic care costs faced by people with dementia or other neurological conditions.

“To address wider issues the sector needs a 10 year plan and a people plan just like the NHS. Without such a plan, words about parity of esteem will be hollow. We owe it to both the staff and families devastated by loss to make this a moment of real change.”

The report includes some further recommendations including: protecting social care’s supply of PPE; improving the level of recognition for social care workers (such as building on initial steps such as the CARE badge and recruitment campaigns); and working with Skills for Care to create a plan to streamline the training of social care workers and improve career progression.

Professor Martin Green, chief executive of Care England, comments on the report: “We concur with the Health and Social Care Committee’s assertion that action needs to be taken now, we simply cannot afford to wait. The sector needs support and one tangible way to provide this is via a 10 year plan for adult social care. This plan must be carefully aligned with the NHS and I hope that the Committee will monitor progress as it must not sit on a shelf and gather dust or we will be face with a vastly depleted social care sector with huge repercussions for the nation.

He adds: “The report addresses the short, medium and long term requirements.  It is heartening that after so long in the wilderness the sector is being listened to and we hope that this report will be the turning point that we so desperately need.”

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