By Gordon Peters
Gordon Peters argues in this article that Labour must not kick the social care challenge into the long grass.
Gordon is a former Director of Social Services in Hackney and a steering group member of the End Social Care Disgrace campaign .
The article first appeared in Chartist 29 July 2024
That social care provision in England* is in crisis is widely accepted. At the same time it is shamefully obvious that neither Tory nor Labour has a plan to deal with it. At best, Wes Streeting’s acceptance of the need to create a national care service of some kind over the next two full Parliaments admits something has to be done, but manages – as all governments since the 1999-2000 Royal Commission have done – to kick it into the long grass.
Since 2010 with austerity in public spending the norm, over half a million isolated people have lost their meals on wheels, only those with very limiting conditions now pass the eligibility criteria for home help, over 90% of residential care is owned by private firms, mainly large corporations whose business model demands higher profits than the building industry, and smaller providers usually with smaller, family-friendly units are themselves going out of business and cannot afford to pay decent wages.
The wages of care workers (at about 1.6 million the largest employment sector) remain the worst of all, where half the total workforce is below the legal minimum wage. And dependence on migrant workers, currently subject to extremely restrictive and intrusive Government oversight, is predominant. A typical urban local authority has at least 40% less money to spend on social care than it had in 2010. This compares with annual rises in NHS expenditure, even if these not sufficient to meet need and reduce waiting lists.
There are political, cultural and economic excuses for the lack of attention to social care. “It doesn’t come up on the doorstep’’ as a Shadow Minister said. Surveys suggest most people are unaware what social care consists of and many assume it is free – until the shock of caring or arranging for a family member occurs. It is widely assumed to be an economic cost, a drain on finances. But in fact adult social care is a net contributor to the national economy, putting in roughly twice the amount – over £50 billion, particularly through employment and value added – to that which it costs to provide, currently around £24 billion. Similar calculations have been variously made by Future Care, the Women’s Budget Group and End Social Care Disgrace. Social care is then fundamentally an economic booster, a largely unrecognized investment in the economic wellbeing of all, not only the vulnerable who receive day-care, home care or residential care. The argument that stems from this is that it has to be regarded as equivalent to the NHS, an affordable and necessary lynchpin of any modern welfare state, a net contributor to economic and social wellbeing. It is the reverse of being a drain on resources.
The 2022 Labour Party Conference committed (even if subsequently ignored by the Party leadership) to a national care service, with aims for universal access and free at the point of use.
It called upon the next Labour government to transform care provision, widen entitlement, reduce barriers to access, raise the quality of care based on enforced national standards and shift the focus to prevention and early intervention with a new principle of Home First, ensuring choice and control. Labour must deliver a National Care Service with nationally mandated standards but designed and delivered locally, which is:
- co-produced with service users
- guided by a taskforce on independent living
- guided by a taskforce on independent living
- democratically accountable
- publicly funded
- free at the point of use, and
- not for profit
Labour must ensure people get the care and support when and where they need it through national assessment criteria to avoid any post code lottery.
Labour must deliver A New Deal for Care Workers ensuring staff are recognised for the vital work they do with the pay, terms and conditions they deserve, tackling high vacancy rates, and transforming training.
Labour must fully recognise and support the contribution of 8 million family carers. It should deliver a new partnership with carers and families so unpaid family carers get a generous allowance, proper information, advice and breaks and more flexibility in the workplace. It should provide investment to improve and expand on facilities for care provision within the public sector.
Gordon Peters
*Scotland and Wales also have significant shortcomings in their social care provision, however in both countries they have advanced national care plans for implementing nationwide reforms to provision, funding, and more universal accessibility.
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