Social care funding is “riddled with unfairness”

“The whole system is riddled with unfairness”. That’s the stark conclusion of a social care funding inquiry led by the House of Lords.

In the report, Social care funding: time to end a national scandal, the product of an eight month inquiry, chairman of the Lords’ economic affairs committee Lord Forsyth of Drumlean, said: “Social care is severely underfunded. More than a million adults who need social care aren’t receiving it, family and friends are being put under greater pressure to provide unpaid care, and the care workforce continues to be underpaid and undervalued. The whole system is riddled with unfairness.”

The committee, which has heard evidence from a wide range of stakeholders, makes six recommendations for Government:

  • Increase funding by £8 billion to restore levels of quality and access to those observed in 2009/10. This should be its top priority.
  • Introduce a basic entitlement to publicly funded personal care for individuals with substantial and critical levels of need. Accommodation costs and the costs of other help and support should still be incurred by the individual. The Health Foundation and the King’s Fund estimate this would cost £7 billion if introduced in 2020/21.
  • Explore a cap on accommodation costs.
  • Adopt a staged approach to providing additional funding: an immediate £8 billion funding, followed by free personal care introduced gradually until full coverage in 2025/26.
  • Provide additional funding as a government grant, distributed directly to local authorities using a national funding formula
  • Fund social care largely from general taxation.

The Committee found that publicly funded social care support is shrinking: funding is £700 million lower than 2010/11 in real terms, despite continuing increases in the numbers of people who need care. The funding shortfall has meant local authorities are paying care providers a far lower rate for local authority-funded care recipients than self-funded care recipients, and those care providers with a high proportion of local authority-funded care recipients are struggling to survive.

To address unfairness in the system the Committee proposes bringing the entitlement for social care closer to the NHS by introducing free personal care, which would include help with washing, dressing or cooking.

Those in care homes would still pay for their accommodation and assistance with less critical needs like housework or shopping. Those receiving care in their own homes would not have to pay accommodation costs, which may encourage care users to seek essential help with personal care early.  

Lord Forsyth said: “Fixing underfunding is not difficult. Fixing unfairness is more complicated, but the Government has ducked the question for too long. They need to publish a White Paper, not a Green Paper, with clear proposals for change now.  

“Our recommendations will cost money, but social care should be a public spending priority. By 2023/24, the NHS funding will have increased by £20.5 billion per year. This is more than the entirety of local authority adult social care expenditure.” ffffff

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