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Tough choices, obvious solutions

Jill_Pitkeathley.jpgJill Pitkeathley on the dilemma facing politicians over the long-term sustainability of our social care system

Earlier today, I led a Labour opposition day debate in the House of Lords on reviewing the current social care system. A debate that took place against an all too familiar backdrop of negative newspaper headlines. Pick up any newspaper or tune into a news bulletin and there’s a good chance you’ll be met with stories about a social care system at tipping point. A service which is slow, patchy, cruel and in need of additional funds.

It’s never nice to read these headlines. Not least because behind every story there’s a real person who, through no fault of their own, isn’t getting the care they deserve. That isn’t the Britain that I want, and it certainly isn’t the Britain my party wants.

The only crumb of comfort is that following years of negative stories, there now appears to be an emerging consensus that identifies both the problems and how to resolve them. There was of course, some past agreement but it never reached across so many political parties and health organisations. Now, when even the Chief Executive of the NHS says extra money should be devoted to social care, we are perhaps ready to address the issues.

Last week, following the Autumn Statement, many of us were appalled that the Chancellor, Philip Hammond felt he could ignore pleas from all sides and fail to put extra resources into social care. His decision has rightly been met with incredulity and dismay.

There is a shortfall in social care funding of over £2bn pounds each year, according to the Kings Fund think tank. 80% of councils do not have enough provision – especially for care at home – and it is estimated that one million people are going without the care they desperately need. Despite warm words from ministers on family carers’ rights, many are finding it increasingly difficult to cope. And the results of the shortfall in funding are only too apparent.

Too many people end up in acute care in hospitals already bursting at the seams. A lack of capacity in the system is leading to so-called ‘bed blocking’, and that’s before winter pressures set in. So, the government must recognise that the current situation is bad for everyone. For councils, the NHS, care homes and carers. Most of all however, it’s bad for anyone who desperately needs access to quality, compassionate care but is unable to pay for it themselves. That is not how I define ‘a society which works for everyone’.

One of my main concerns when discussing the issues facing social care is the danger of criticism sapping the morale of staff who do their best despite low pay. We owe it to them as much as the recipients of care to think boldly.

It’s fair to say that the world has moved on since the modern health and social care systems were established after the Second World War. At that time, there was no need for the type and range of care needed in the modern era and ministers therefore need to get serious about reform. Various attempts have been made at this but no government has given a sufficient response, and it is clear that solutions will take years to implement. So we need a cross-party approach which takes an honest look at the system and is then equally honest with care recipients about what they can expect.

A single health and social care budget would enable the NHS and care providers to agree the best use of public money, and to focus on services which reduce the demand for long-term care. Proper coordinated care can only happen if there is a single budget controlled by service providers, rather than politicians. If the government refuses to adopt this approach, its only option is to come clean with the public about how the system works, its shortcomings, and exactly what services they can and cannot expect to receive. A much, much tougher call.

Baroness Jill Pitkeathley is a backbench Labour Peer in the House of Lords and the former Chief Executive of Carers UK

Published 1st December 2016

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