One of the most defining moments of the recent UK General Election was when the Conservatives decided to include controversial social care plans in their manifesto. Whilst I didn’t agree with what is now known as the ‘Dementia Tax’, what I was pleased about was that politicians of all persuasions finally started talking in earnest about what I believe has become the elephant in the room of British politics.
I blogged for Huffington Post during the 2015 General Election campaign pleading for social care to be debated. It wasn’t. By contrast, in 2017 it was everywhere, from articles and columns to interviews and debates. But with the election’s minority government outcome, the Queen’s speech outlining the Conservative’s programme for office gave social care just a 15-word mention:
“My ministers will work to improve social care and will bring forward proposals for consultation.”
Social care is controversial. It’s difficult. It is potentially impossible, with a minority government, to reach the cross-party consensus that radical reform would need. And more than all of those, social care has been kicked into the long grass so many times before so why not again? Maybe the public will just forget about it. Or maybe not.
There has long been talk of a crisis in social care. The problem is, the word crisis is bandied around so readily that many people just glaze over. During the election campaign, I think some of the reasons why social care is in genuine crisis did finally hit home to people who had previously either been sceptical or oblivious, but with no concrete plans from the government beyond a consultation exercise that will doubtless become a very long and drawn out affair, and no Queen’s speech for another two years, where does this leave social care?
In dire straits would be the obvious answer, but don’t assume that the problems are just confined to social care. The knock-on effect is to the NHS, which is also experiencing its own crisis. Thus we are in a situation where the two mechanisms by which people are cared for in a huge variety of situations, from critical care to community care, are on the brink (and in the case of some insolvent care providers, already over the brink).
I have always argued one salient point whenever I’ve talked or written about the importance of health and care:
No matter who you are, what you have, where you are going in life and what you want (or need) to do, if you do not have your health and care needs met, everything else is irrelevant. Potentially you aren’t even getting up in the morning.
For that reason, there is nothing that should be more important to a country, or its people, than health and social care.
However difficult in these times of Brexit, terrorism and disaster we must not let our politicians forget that. As ministers look to ‘improve social care’ they need, as a matter of urgency, to talk to the people who use social care, from every age group and circumstance. I suspect that people using services might be pretty low down on the list of individuals to contribute to what is expected to be a Green Paper published at the end of this year, but no academic, health or social care professional, care provider, charity leader, lawyer or insurance expert can tell you more about what social care needs that the people needing social care.
So how might those conversations go? Undoubtedly capacity in the system, or lack of it, would be a big issue, alongside the quality and diversity of services. Staffing in the context of recruitment, professional standing and the remuneration offered to frontline social care staff would feature prominently. And the financial inequalities between people paying privately for care and people whose care is publically funded would get us into the realms of the much-talked-about care cap.
But bigger than all of this, for me, is the overarching theme of how we understand and value social care and the intrinsic link to healthcare. Good care in people’s own homes or community settings is vital for the proactive management of long-term conditions, which by default then reduces additional physical or mental health problems, promotes wellbeing, enables people to continue using or to regain as many life-skills as possible, keeps families united and provides dignified support to all who need it.
In short, if Ministers are looking for a saviour for the NHS, social care is it.