By John Hannen
Last year Carers UK estimated that there were 13.6m unpaid carers in the UK – this is up from 9.1m carers before the pandemic. These figures are calculated using a polling that takes a broad and inclusive definition of care compared to NHS estimates of 5.4m carers. I would recommend the broader view. If you have to think about how others will cope when you plan a holiday, avoid jobs outside your locality, avoid shift work or require flexible work then care responsibilities have an impact on you, whether or not you might be considered a ‘primary carer’.
People from low income or marginalised communities are likely to face higher levels of care responsibilities due to a greater prevalence of ill health. This doesn't just illustrate the impact of Covid on our lives, but how care responsibilities are a fact of life for many in the UK and how burdens are distributed unequally.
It's in the light of this context that the government's announcement on 7th September needs to be understood. The challenge for care isn't the precise level of cost that needs to be paid by the population but how 13.6m carers and most importantly the people they care for can live fulfilling lives.
The Dilnot Commission made recommendations on the future of care in 2011. The commission recommended capping the costs care recipients faced and required increases in public spending to do this. Many consider the care system to have already been in crisis at that point. At this point we were promised a Green Paper on social care – which would act to inform discussions around what proposals might be developed.
A decade later there have been large cuts in care spending and significant increases in care demand, with only small rises in council tax to help prop the system up. We're not faced with the situation the Dilnot Commission faced – there's more unmet demand out there now and the care sector does not have the same capacity and capability to meet many basic needs. There are about 100k unfilled job roles in the care sector, with pay rates too low to attract and retain skilled staff. Also, with restrictions on unvaccinated workers this is expected to increase to 170k vacancies by the year end. And no Green Paper was published during this decade. The word ‘failure’ cannot begin to describe the response of successive UK governments to this issue.
On Tuesday the government fulfilled its commitment to bring forward plans to reform social care made in the General Election in 2019. The government's focus has been on how to end the situation where people have to sell their home in order to access residential care in line with the Dilnot Commission. This was addressed with an increase in National Insurance which will cap the costs people face, but there were no proposals for how care is to be improved.
The only mention of carers was in the promise that the government will "take steps to ensure that the 5.4 million unpaid carers have the support, advice and respite they need". My experience tells me that "take steps to ensure" are a red flag in any announcement and show that those making the proposal do not feel they can make a binding commitment.
I'd hoped to be able to go through the government's proposals on social care in some detail and share that with you in this piece. I think it's important to help VCSE organisations understand the operating environment and prepare for what is to come, good or bad. However, my summary can only be as follows:
The government have made some changes to taxation and payment thresholds for social care. Beyond this there will be an extra £1bn/year to be spent on social care provision. This will help but won't address workforce gaps, low pay, the uncertain financial position of many care providers and the quality of care. For this to change there needs to be proper reform. In terms of the actual reform of social care, there is no plan. None was announced.
We now have to wait for a White Paper (no publication date is set) which will set out the governments actual proposal for social care. The one challenge here is that this will need to be co-produced with care providers and carer support organisations. The implication being the government doesn't yet have a starting point for discussions, so this could take some time.
In the meantime, those of us with leadership roles in our communities, towns and cities need to think about how we can do the job the government hasn't started.
A financial sticking plaster is being applied that will prop the system up and remove some inequalities but not address the main issues.
At GMCVO we have a growing role in brokering social investment and driving innovation in new economic models. We are exploring how we might work alongside others in the VCSE sector and build a platform to develop community owned approaches. We will want to shape government proposals but do not want to just wait for them in order to be disappointed. We will update you on our work but if you are keen to explore this with us then do get in touch.