The health and social care secretary appears to have ruled out sweeping changes to the funding system for adult social care.
Matt Hancock, giving evidence about the adult social care funding crisis to a House of Lords committee on Tuesday (pictured), told peers that he saw a “series of injustices” in the system but was “more attracted to options that build and directly improve on the system than ripping the whole thing up and starting from scratch”.
He had earlier confirmed to the Lords economic affairs committee, which is conducting an inquiry into the funding of social care in England, that the government’s green paper had been delayed yet again due to the parliamentary Brexit crisis.
The Department of Health and Social Care (DHSC) originally promised that the green paper would be published by the end of 2017, and then July last year, before delaying it to the autumn and then the end of 2018.
After missing the December 2018 deadline, it was delayed until “the earliest opportunity” in 2019, before Hancock told MPs it would be published by April.
Now that deadline has been missed as well, and Hancock said he could only promise that it was “coming in due course”.
He added: “I wish that the green paper had been published by now and we are continuing to work on it in the department because this is such an important issue and a longstanding policy problem that needs to be tackled.”
He also ruled out proposals that would change the system to one that was solely funded nationally, with no financing by local authorities, saying: “I don’t agree with that.”
And he suggested that the green paper – when it was finally published – was unlikely to include a definitive plan for how he believed adult social care funding should be reformed.
He said: “What I would like to do is bring forward a green paper that can bring together the debate, because it does have to be cross-party, and bring that debate behind a direction of travel where we can make progress.”
But he did stress to the committee that the funding crisis affected both working-age adults and children, as well as older people, pointing out – as many politicians fail to do – that about 50 per cent of local authority funding in this area is spent on working-age adult social care.
And he also said he wanted to see more funding for home-based support, rather than residential care.
He said: “I think there’s a big difference and a big opportunity to make social care better, better for the individual being cared for and better value for money, by a shift from residential to domiciliary care.
“Domiciliary care is cheaper than residential care. People want to stay at home for as long as possible.”
He added: “That sort of thing is much easier to fix than the long-term ‘who’s going to pay for it?’ and that will get a mention in the green paper no doubt.”
He accepted that there was often a financial incentive for councils to place older and disabled people into residential care because it can allow the local authority to take account of a family home as a financial asset when deciding how much the person should pay towards their care, which it cannot do if they remain in their own home.
He told peers: “What we do know is that more people go into residential care than is clinically justified and that domiciliary care is on average… better as well as being better value for money.”
Hancock said that “taxpayer” funding would “inevitably be part of the solution” but that he believed it was “impossible” to put an “exact figure” on how much would be needed, and that he could not confirm that there would be an increase in taxpayer funding for the system because of the government’s forthcoming spending review.
He said the government had put an extra £10 billion into social care over the last three years, while its spending was £3.9 billion higher this year in real terms than in 2015-16, a nine per cent real terms increase.
Two years ago, the UN’s committee on the rights of persons with disabilities warned the UK was “going backwards” on independent living, and called on the government to draw up a “comprehensive plan” to address the problem, and to take “urgent action” to ensure disabled people were provided with “adequate support to live independent lives”.
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