Care after Covid

09 Feb 2021

Crises stress test our capacity to respond, the strength of our organisations and the flexibility of our people.  They are also an opportunity to see clearly what works, what doesn’t and what needs to change.

Social care is often talked about as the ‘third rail’ of British politics – no politician concerned about their career wants to touch it.  The 2017 ‘dementia tax’ election is proof that there is no benefit to being open about the cost of care and who should pay.  This government has promised – and subsequently delayed –its long-anticipated social white paper to ‘fix social care for good’.

But several years since announcing that social care needed to be reformed, the can continues to be kicked down the road.

But we are reaching a breaking point, with over 1.4 million people across England being denied the care they need, due to a combination of cuts in the care sector, this can no longer be allowed.  If the vaccine roll-out works effectively the Government will have substantial political capital – where better than to spend it than on social care?

So what should Government do?  A long-term strategy will take time – and it should be built by cross-party consensus so that it lasts.

But work on a long-term strategy does not mean doing nothing in the here and now.  In the immediate aftermath of the crisis it should focus on three things.

First, government should look to retain capacity in the sector.  The care sector has suffered over the last year with higher costs and reduced occupancy income for activities which are already low margin. As some forms of temporary support are removed it is important that we do not see a significant loss of capacity.

After the financial crisis in 2008, housebuilding saw a significant number of regional and family firms, and hundreds of local subcontractors, go to the wall.  This left a small number of major national players and a sector that was difficult to reform and modernise.  There are lessons here for care.

Second, there should be an emphasis on quality – but not on CQC ratings but on the underlying factors that help us deliver the highest quality of care.  For me that means ensuring that we have great staff who are well-training and committed for the long-term.  Allowing providers to pay the Living Wage, and local equivalents, by adequately funding local authorities, would be a key signal that we mean what we say about valuing carers – and care.

Third, a key part of the longer-term strategy will be about reducing complexity.  Providers have adapted quickly during the crisis but the huge variety of funding and contractual requirements have not helped us. The system needs to be made more legible to those working in it and to the public outside.

This will not be solved quickly.  In the short term, though, we must not allow complexity to obscure the impact of spending decisions.  After the financial crisis, the funding of local authorities was hardest hit by central government austerity – with severe consequences for social care.  If Ministers talk in glowing terms about carers, and at the same time reduce the budgets that pay for care services, we need to be clear about the impacts and the consequences. The government is currently funding the additional care costs by allowing local authorities to increase local taxes, but this doesn’t cover the huge gap in funding and is merely putting a plaster over it.

Covid-19 has had profound consequences for many in the care sector.  But, during such a difficult period, our frontline staff have been amazing. Its important that, as we slowly emerge from the crisis, this is not forgotten but is the basis for a strong new settlement.