Election 2019: What does it mean for social care?
We take a closer look at what the Conservatives promised the sector in their manifesto – and what they haven’t – to identify what lies ahead following Boris Johnson’s landslide victory.
A resounding Conservative majority has propelled Boris back into Downing Street with a mandate to implement his policy platform. Although the initial focus will inevitably be on Brexit, Boris now commands the first significant majority of any government since the New Labour years, and will use it to fulfill his domestic policy aims.
The Conservatives have long come under fire for kicking social care policy into the long grass and it has now been over two years since the long-awaited government green paper policy on social care reform, proposing reform of social care and support for older people, was promised by Theresa May. The Conservatives’ manifesto stopped short of providing a plan for reform, instead proposing a temporary solution of an extra £1 billion a year for the next five years and the promise of cross party talks.
The promised funding has a number of caveats: the £1 billion is the same money that was announced at the Conservative conference in September and so is not a new commitment; it is to be shared between adult social care and children’s services in a proportion that will be left to councils to decide, depending on local priorities. It doesn’t grow year on year in line with inflation or with demand – and this demand is growing.
The current model is that councils are responsible for delivering care, funded from central government and local taxes. The Conservative manifesto indicates continuing fiscal austerity for councils, with many already buckling under the pressure of delivering care home costs, paying for children in social care and funding services for an ageing population; they will be making a standing start.
The funding proposed is not going to be enough to continue to meet demographic pressures as our population ages over the next five years. To illustrate this point, the Liberal Democrat manifesto promised £4 billion for children’s services and £3 billion for adult social care each year; Labour’s manifesto proposals included a national care service providing free personal care and doubling carers’ allowance costed at £10.8 billion by 2023-24. Unlike the Conservatives, both also made provision to cease council fiscal austerity measures. These proposals provided a more credible – albeit expensive – solution to keep the system running.
With that in mind, all the proposed Conservative funding would do is continue funding the current system, and that current system is widely seen to be very unfair for people who need to use it, and it has been struggling to have enough funding to deliver high quality care. The temporary plan would leave us in the current cycle seen over past years where councils find themselves in financial crisis and the Government has to inject emergency finance each year. This money has to come from somewhere and the sting in the tail for the Conservatives is they have rather boxed themselves in with their manifesto promise on taxes. They have promised not to raise income tax, national insurance or VAT, and these represent the only realistic sources of income capable of covering this level of ongoing funding.
In absence of wider reform, these financial pressures have led to a lack of detail about wider proposals for the sector. In common with all of the main parties’ manifestos, the Conservatives failed to provide any credible workforce proposals to tackle the recruitment crisis in social care. There are 122,000 agencies in the adult services care sector and the vast majority pay at or near minimum wage; five out of six major supermarkets pay shop floor staff more than the average social care worker earns. There is no plan on how the roughly 120,000 workers required to plug the current gap will be recruited. The Conservative manifesto also assumes the same quite traditional social service with the state deciding the type of delivery they consider is best for the individual. There is no mention of independence, quality or personal control.
Therefore much rides on the proposed cross-party talks. This is most likely to take the form of an independent commission aimed at building some form of cross-party consensus on how best to raise money. Matt Hancock, the Health and Social Care Secretary, was re-elected in his safe seat of West Suffolk, and would seem set to lead these talks.
There are a number of challenges to cooperation. The political animosity around Brexit and the tone of the election campaign surely makes a cross-party consensus less likely. The crushing defeat of Labour and the Liberal Democrats raises the prospect of several new leaders in the New Year, adding further uncertainty. Theresa May’s majority-destroying General Election Manifesto in 2017 – with the hurried proposals for reform of social care funding and the disastrous dementia tax announcement – showed parties are all too willing to play party politics with these issues and will make those involved in discussions a little more cautious.
The size of the Conservative majority and comfort of knowing the next election is five years off does make it easier for Boris and the other party leaders to reach compromise. It remains entirely possible the vexed issues of squaring the circle of social care funding and Brexit may well both be resolved in this legislative session! The answers to some of these outstanding questions may come on 19 December when the Queen’s Speech – the second of the year – takes place.
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