The government’s long-awaited adult social care white paper has appalled campaigners by failing to address the social care funding crisis.
The white paper, People at the Heart of Care, is more than 100 pages long, but it says nothing new about how the government plans to ensure adult social care in England is properly funded over the next decade.
So far, the Department of Health and Social Care (DHSC) has been unable to explain why the much-anticipated white paper, published yesterday (Wednesday), ignores the key issue of funding.
Just two days before it was published, the Association of Directors of Adult Social Services (ADASS) warned that its members were “expressing unprecedented alarm” at a “rapidly deteriorating picture of hundreds of thousands of older and disabled people left waiting for help”.
ADASS said that nearly 400,000 people were now waiting for an assessment of their needs or for services.
Mark Harrison, a member of the steering group of the Reclaiming Our Futures Alliance (ROFA), said the white paper “offers no solutions to the funding crisis facing social care, it will not solve the extreme staffing shortages and for the tens of thousands stuck and dying on waiting lists for assessment or services – their wait will go on and get worse”.
He said the failure to address the funding crisis would mean councils continuing to push disabled people into poverty “by unfairly charging and taking money from benefits, forcing people to make a choice between eating, heating and social care”.
He said ROFA was calling again on the government to implement its National Independent Living Support Service proposals, which would provide a free, universal system of independent living, funded by progressive taxation.
ROFA is also calling on the government to introduce a legal right to independent living by bringing the UN Convention on the Rights of Persons with Disabilities into UK domestic law.
Disability Rights UK (DR UK) said the white paper had “failed to address the fundamental crisis in social care”, while the funding the government has already promised as part of its reforms was “tiny” in comparison with what was needed.
Fazilet Hadi, DR UK’s head of policy, said: “Whilst some of these measures are welcome, they are definitely icing on the cake, whilst attention to the actual cake itself is missing.
“The white paper does almost nothing to support disabled people in 2021-22 to receive acceptable and appropriate levels of care.
“The disparity between how social care and the NHS are treated remains markedly unfair.
“Where money to stem backlogs in elective surgery is found immediately, significant additional funding for social care isn’t even on the radar.”
Bristol Reclaiming Independent Living (BRIL) said it was clear that social care in England was “in crisis”.
A BRIL spokesperson said: “This much-delayed white paper shows how little the government understand or value social care or the lives of disabled people, older people and family carers.
“£5.4 billion, spread across three years and 150 councils is nowhere near enough to ‘fix social care’.
“Most of this will be used for the government’s ‘care cap’, which punishes the poorest families.
“By co-opting disabled people’s principles of choice and control and independent living, to justify these ineffective plans, shows how indifferent the government are.”
Liz Kendall, Labour’s shadow social care minister, told the government in the House of Commons yesterday (Wednesday) that ministers had “utterly failed to deal with the immediate pressures facing social care”.
Former health and social care secretary Jeremy Hunt, the Conservative MP who now chairs the Commons health and social care committee, said the funding previously announced by the government “falls far short of the annual £7 billion sum that our evidence found would be necessary to fix social care”.
He said: “The white paper states that it provides an ‘ambitious ten-year vision’, but it doesn’t acknowledge the scale of extra resource needed to realise that vision, based on the crisis the sector faces right now.”
The failure to address the funding crisis comes less than two months after government-funded research suggested that cuts to social care, health and public health caused 57,550 more deaths in England in the four years after 2010 than would have been expected if spending had continued on pre-2010 trends.
Although the failure to address the core funding issue in the new white paper has so far drawn almost universal criticism from disabled people’s organisations and the care sector, some of the government’s wider “vision” for adult social care has been welcomed.
The white paper says the government wants people to have “choice, control, and support to live independent lives”, to access “outstanding quality and tailored care and support”, and to find adult social care “fair and accessible”.
It says the “starting point” for its vision is “embedding personalised care”, while it also focuses on a move away from residential care, with more people living in their own home, with choice and control over their housing and support options.
The document does not appear to offer any new funding, but it does offer new detail on how the government plans to spend some of the £5.4 billion it announced in September for social care reform over the next three years, which will be raised through the new – much-criticised – health and social care levy.
This includes a new service that will carry out minor repairs and changes to help people remain independent and safe in their own homes, and an increase in the upper limit of the disabled facilities grant (DFG), which provides funding for adaptations such as stairlifts, ramps and wet-rooms.
Last year’s spending review had already announced that DFG spending would rise to £573 million in 2021-22, an increase of more than 13 per cent on 2020-21 and a huge increase from the £220 million provided in 2015-16.
There will also be at least £300 million over three years to integrate housing into local health and care strategies, and at least £150 million of extra funding to increase adoption of new technology across social care.
And at least £5 million over three years will fund local organisations to pilot new ways to provide personalised advice to help people “navigate local adult social care systems”.
But the white paper also makes it clear that the government has ruled out any possibility of a universal free social care system, stating: “We want to ensure the public understands the need to contribute to the costs of their care so that they can plan for it, but no one should be required to pay unpredictable and unlimited care costs.”
There appears to be no further pledge on charging for care, other than repeating previous proposals that will introduce a lifetime cap of £86,000 on how much anyone pays for personal care, allow slightly more generous means-tested support, and introduce a significant increase in the amount of relevant assets (from £23,250 to £100,000) below which people are eligible to receive some financial support from their local authority.
Sajid Javid, the health and social care secretary, said: “This ten-year vision clearly lays out how we will make the system fairer and better to serve everyone, from the millions of people receiving care to those who are providing it.”
Care minister Gillian Keegan added: “The lives of millions of people will be improved by our plans for social care supported by significant investment for system reform to deliver the person-centred care we need.
“We promised to come forward with proposals to improve social care and that is exactly what we are doing.”
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