More than words

Alf Dubs on holding the Prime Minister to his commitment to fix the social care sector

In Boris Johnson’s first speech as Prime Minister he pledged: “We will fix the crisis in social care once and for all with a clear plan we have prepared to give every older person the dignity and security they deserve. I will take personal responsibility for the change I want to see”.

Since Mr Johnson made that pledge, less than a year ago, an estimated 20,000 people  have died of Covid-19 in England’s care homes, prompting Sir Simon Stevens, Chief Executive of NHS England to tell the BBC’s Andrew Marr that “we must use this moment to properly resource and reform the way social care works in this country”.

Before the pandemic hit the UK, our social care sector was already in crisis. Highly fragmented and underfunded, the system relied on informal carers and piecemeal local arrangements, with no uniform statistics able to provide a national picture. A quarter of staff were on zero hours contracts, compounded by a one third churn in employment each year. As the NHS CEO also observed, “not the preconditions for providing high-quality social care”.

According to estimates released by the Health Foundation pre-Covid, the social care funding gap was already likely to be between £2.1bn and £12.2bn by 2023/24. Research from Which? suggested that one in 10 older people faced care costs of over £100,000. And Age UK estimated around 1.5 million people aged 65 or over with unmet care need and that by 2030 this could grow to 2.1 million if nothing is done.

The cost of this chronic long-term underfunding has not only been borne by the NHS but also by an army of unpaid volunteers, usually women and largely invisible, who have filled the care gap. Meanwhile, for too many older people and those needing lifelong support at home, care in the community has become a cover for unseen neglect.

The Covid crisis has laid bare these deep and systemic inadequacies in the current social care system and has revealed the true extent of the impact that underfunding, structural issues and market instability have had on the system’s ability to respond and protect older people at a time of crisis. On top of this the Association of Directors of Adult Social Services estimates that providers may now face up a further £6.6bn of pandemic-related costs by the end of September.

The founders our health service were not discouraged by post-war austerity – indeed they insisted that one of the legacies of that war should be its creation. In the same way, the legacy of our current pandemic must be a national social care system that takes its rightful place alongside the NHS as a core public service. One that is properly resourced on the principle of social care being free at the point of need and accessible to all, and which guarantees support for older people to live a dignified and fulfilled later life.

The UK population will continue to grow older and fears of a second wave of this terrible disease means the government must act with urgency to meet both the short-term and long-term needs of the social care sector. The Prime Minister’s comments this week, that “too many care homes didn’t follow the procedures” have rightly angered a sector that has done its best in extremely difficult circumstances, with slow and unclear government guidance and extremely limited resources. It underlines precisely why Boris Johnson’s commitment to fix the crisis once and for all is so important. He must now make good on that pledge, unless, of course, he didn’t mean it.

Lord Alf Dubs is a Labour Peer

Published 7th July 2020




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