Few issues are raised more times in Parliament than the ongoing social care crisis. According to the Hansard number-crunchers, between 1997 and 2007 it was mentioned 5,500 times, and between 2008 and 2017 it appeared almost 30,000 times. That demonstrates the scale of the problem as pressure mounts due to an ageing population combined with austerity cuts.
Yet Philip Hammond unveiled his second Budget this year without a single mention of social care. Not one. A big fat zilch. That wasn’t a total surprise – beforehand, the government announced that a long-awaited consultation paper on its future, expected this autumn, would be published next summer instead. The government says an independent panel of experts will consult on establishing a “a long-term, sustainable solution to providing the care older people need”. But the precedents don’t bode well.
In 1999, it was proposed that older people should be able to access free personal care, including help with washing, dressing and preparing meals. It was taken up in Scotland but not in England. Labour published a White Paper setting out plans for a National Care Service to run parallel to the NHS, to “meet the needs of people when they need help, free when they need it”. But the scheme got no further thanks to the incoming coalition government of David Cameron and Nick Clegg. Their 2014 Care Act enshrined in law a cap on care costs meaning no one would pay more than £72,000 over their lifetime. But that was shelved, at least until 2020, because of the cost.
Simon Bottery of the independent health think tank the King’s Fund said there has been lots of innovation and development at a local level, but centrally we have “essentially got the same method of funding social care as we’ve had for the last 20 years”.
There were almost 12 million people over the age of 65, with 1.5 million of those over 85, living in the UK in 2016. Last year, there were 1.8 million requests for social care support – almost a third of which resulted in none being provided. Between 2001-02 and 2013-14, there were almost 33 million referrals to social care services in England – although some of these will have been for the same person. In 2016, Age UK estimated that 1.2 million older people in England were living with unfulfilled social care needs, a rise from 800,000 in 2010. Almost £170bn in cash was spent by English councils on adult social care over the past 10 years. Between 2010-11 and 2015-16, overall funding from central government to councils fell by 37% in real terms, according to a Parliamentary report ahead of the March Budget.
With funding squeezed across the board, councils are having to spend a higher proportion of their finances on social care because of legal obligations – if someone meets the threshold of need and can’t afford their own care, councils must step in. As a result, adult social care is swallowing a growing proportion of councils’ total budgets. In 2010-11, it was 29% of their outgoings, but for some councils it’s now approaching half of all their spending. And these growing pressures have led the government to step in with emergency injections of cash three times since 2010, worth £4.6bn in total. But these emergency payments are seen by many as a sticking plaster – the Local Government Association describes them as “one-off funding and not a long-term solution”.
BBC specialist reporter Rachel Schraer wrote: “For the past two decades, successive governments have known something needs to be done. They’ve published at least 300,000 words in formal consultations, policy papers and commissions on the subject. That’s nearly two Homer’s Odysseys or, if you prefer, three Harry Potter and the Philosopher’s Stones. It’s a lot of words. The figure would be even higher if we included every non-governmental commission, engagement exercise or piece of new guidance. But little radical change has been made to a system many agree needs to be completely rethought.”