The increase in NI will do little to address the social care crisis in England
Standing on the steps of Downing Street after his 2019 election victory, Boris Johnson said he had a fix for social care, ready to go. After the tax increase announcement last week, it is clear what he meant two years ago. His plan is to subsidise people with housing wealth to reduce the burden on them for funding their care. New tax revenue from an increase in National Insurance and more tax on Dividends will be funnelled first to the NHS. What’s left will help protect the wealth of those with more than £86K of assets. After that, little will be left for social care, doing nothing to address two decades of under funding the sector.
Having kicked the social care funding crisis into the long grass for a few more years, Johnson, unlike his predecessors, will be unable to side-step the social, economic and political consequences. The care sector is at such a crisis that another year of under-funding will further compromise essential care services, forcing more families to look after their vulnerable relatives. By focusing on preserving people’s wealth, it means people in England will continue to struggle to access social care.
Local Authority Directors of Social Care estimate there are 1.5 million people over 65 in England who have been denied funding for their legitimate personal care needs. Which means the current social care provision is now only catering for the most needy. Without the extra funding required, estimated at £7 Billion annually by the Government’s own Health and Social Care Commission chaired by Jeremy Hunt, the home care and care home provision will continue to shrink This will inevitably leave more families to look after their old and vulnerable. But most are not well equipped to care for those with complex health needs, including dementia, learning difficulties and significant mobility constraints. And families are likely to become very resentful of the need to trade off paid employment to retrain and act as a volunteer carer for a loved one.
Last week, on the day of the Government’s announcement, I was invited to describe some of these consequences to BBC South West. A care home colleague and I explained to journalists just how the social care crisis has become much more acute recently because of the shortage of key workers in England and how we are losing carers to other sectors that are now able to offer much higher rates of pay. It is estimated that by the end of 2021 social care vacancies could reach as high as 170,000 in England.
Jeremy Hunt’s recommended £7 Billion for social care didn’t factor in these upward pressures on wages. In order to compete with Amazon and other employers offering better pay and benefits, a figure in excess of £7 Billion is now needed annually by the sector.
Estimates on what might be left for social care after the NHS backlogs created by the pandemic have been addressed, range between £0.5 Billion and £1 Billion annually, starting in three years time. This won’t be sufficient to stop the shrinkage of the sector, especially as the Government has said these funds will be targeted to improve training and to raise standards of care. There has been speculation this weekend that Local Authorities will raise council taxes to fund their social care obligations since central Government will not. If they do, will it be too little too late?
Those of us in the sector are wary of the Government’s latest funding priorities for social care. “Improved training and raising standards” smells of a Government preparing to deflect accountability for high COVID death rates in care homes to beleaguered care home providers. And it appears the Care Quality Commission is getting harder to please, issuing more negative ratings of care services. Giving further reason for many weary care providers to finally turn their backs on the sector.
We may now have the highest total tax burden in England since the 1950s, but it is not to fix social care. Very few of us living in England should take comfort from the announcement last week. Those with property wealth may believe they will benefit. But, in reality, if a loved one needs care it is very likely you will have to share the role of delivering personal care with other members of your family. There simply won’t be enough professional carers and care homes to provide for the rapidly increasing demand for social care from an ageing and increasingly unhealthy population.
In light of the announcements last week, you’d be wise to start planning for how you will care for your ageing parents and vulnerable relatives. You may also want to plant a seed with your own offspring to prepare them to look after you when you eventually need it!
Simon Spiller is co-owner and Registered Provider of The Croft Residential Home in Newton Abbot, Devon, as well as owning other small businesses. He is a Fellow of the Royal Society of Arts.